United Response - Limborne Supported Living Services provides care and support to people living in two ‘supported living’ settings, so that they can live as independently as possible. People’s care and housing are provided under separate contractual agreements. CQC does not regulate premises used for supported living; this inspection looked at people’s personal care and support. At the time of our inspection 12 people were supported by this service.This unannounced comprehensive inspection took place on 31 October 2017. At our previous inspection in November 2015 we found that the service was good over all but required improvement in relation to our question ‘Is the service safe’. This was because we identified that necessary safeguarding alerts about three incidents had not been made. This was a breach of the regulations.
At this inspection we found that staff understood local safeguarding procedures and their role in protecting people from abuse and avoidable harm. Records showed where concerns about people’s safety had been identified the local authority had been appropriately informed. This meant the service was no longer in breach of the regulations.
There were clear management structures at the service and the provider had ensured that the staff team had been appropriately support since the registered managers resignation. An interim manager was currently providing effective leadership to the staff team and interviews for the permanent manager’s position were planned for the day following our inspection. We were subsequently informed that a new manger had been appointed, who would apply to the commission to become the service’s registered manager. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.
People and their relatives told us they felt safe and well cared for by the staff team who they got on with well. Their comments included, “We get on very well with the staff that are here,” “The staff are very kind, caring and welcoming” and “They are looking after me.” A health and social care professional told us, “I consider the service to be very safe and caring for the tenants they support.”
Staff had the skills and experience necessary to meet people care needs. The service operated an extensive induction process and staff training was updated regularly. Relative told us, “They don’t just let new staff get on with things. They have a new staff member and I think she has done three months of supervision” and “The training that they get seems quite good” While staff commented, “We are always going on training.”
Recruitment practices were robust and there were sufficient staff available to meet people’s care needs. Staff rotas showed planned staffing levels were routinely achieved. The service had one full time staff vacancy at the time of this inspection and agency staff had been used to cover some shifts. People had expressed concerns about the use of agency staff to cover weekend shifts and the acting manager was working to resolve these issues and a new member of permanent staff had been appointed. People told us, “There are enough staff” and staff commented, “We are never understaffed.”
Staff and the interim manager understood the requirements of The Mental Capacity Act 2005 and the importance of respecting people’s decisions and choices. During the inspection, at both addresses, we observed staff supporting people to make choices and respected their decisions. Care plans provided staff with guidance on how to support people with decision making and staff told us, “[People] all chose what they want to do.”
Staff knew people well and understood their individual care and support needs. People’s care plans provided staff with detailed information on their individual likes and preferences. As well as guidance on how to provide support to help people manage anxiety. Staff told us people’s care plans were, “Very comprehensive.” Where specific risks to individuals had been identified staff had been provided with guidance on how to manage these risks. Records showed people met regularly with their key workers to discuss and review care plans and one person commented, “We have a proper support meeting every so often to go through the care plan and discuss whatever we want to do.”
People were supported to live active, varied lives and encouraged to be as independent as possible. Care plans included people’s goals and long-term aims and staff supported people to develop the skills necessary to achieve these objectives. Everyone who used the service had been supported to find employment and one person was in the process of planning to move into their own flat.
There was a positive and supportive culture within the service and staff took pleasure in describing people individual achievements. The interim manager told us, “I am proud of the way people are treated like equals.”
The service’s quality assurance systems worked well and were used to drive continuous improvements in performance. Audits were completed regularly and action taken where any issue were identified. Feedback was actively encouraged from people and their relatives. A questionnaire was underway at the time of our inspection had produced consistently positive feedback. People’s comments had included, “I get a lot of help and I can do what I want.”
The service records were well organised and policy documentation accurately reflected current practices.