We carried out a review of the data available to us about Next Steps Ltd on 6 July 2023. We have not found evidence that we need to carry out an inspection or reassess our rating at this stage.
This could change at any time if we receive new information. We will continue to monitor data about this service.
If you have concerns about Next Steps Ltd, you can give feedback on this service.
About the service
Next Steps Ltd is registered as a domiciliary care and supported living agency who provide care and support to people living in supported living properties. Not everyone who used the service received personal care. CQC only inspects where people receive personal care. This is help with tasks related to personal hygiene and eating. Where they do, we also consider any wider social care provided. At the time of inspection six people received personal care across five individual supported living properties.
People’s experience of using this service and what we found
Right support
People received support to develop, flourish and pursue their own interests.
People received support with their medicines safely and in the way they preferred.
People were supported to have maximum choice and control over their lives.
The staff team provided person-centred care which was stimulating and followed people’s preferences.
Staff enabled people to access and follow up specialist health and social care support in a timely manner.
Right care
People were protected from abuse and avoidable harm.
People were supported to communicate in the way they preferred. Staff were provided with the training to support people in this area.
People’s care and support plans were detailed and regularly reviewed and updated. This ensured people received the right care that was responsive to their changing needs.
People received care that supported their needs and aspirations, was focused on their quality of life, and followed best practice.
Risks associated to people’s care and choices were set out in their care records and regularly reviewed.
The staff team provided kind, compassionate and effective care and support.
Right culture
The companies’ ethos, values, attitudes and behaviours were followed by staff in supporting people to be empowered and lead fulfilled lives.
People receive good quality care, support and treatment from staff that sufficiently trained and supported in their roles.
People and those important to them were involved in planning and reviewing their care.
The registered manager promoted an open and welcoming culture. People using the service, relatives and staff felt valued and supported.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection
The last rating for this service was good (published 6 April 2021).
Why we inspected
We undertook this inspection to assess that the service is applying the principles of ‘Right support right care right culture’.
The inspection was prompted in part due to anonymous concerns received of alleged neglect and poor care to some people. A decision was made for us to inspect and examine those risks. We found no evidence during this inspection that people were at risk of harm or neglect.
Follow up
We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.
Next Steps is a domiciliary and supported living service providing personal care to nine people across seven properties at the time of the inspection. The service supports people with learning disabilities, autism, mental health and physical disabilities.
Not everyone who used the service received personal care. CQC only inspects where people receive personal care. This is help with tasks related to personal hygiene and eating. Where they do, we also consider any wider social care provided.
People’s experience of using this service and what we found
The provider and manager had not followed government guidance for the management of COVID-19 in relation to regular staff testing.
Staff had received training in infection control and demonstrated an understanding of what personal protective equipment (PPE) should be used when supporting people.
Quality monitoring systems needed strengthening to ensure that care plans and risk assessments contained all the required information for staff to follow to maintain people’s safety.
Monitoring of people’s daily records required improvement to ensure that staff are recording care provided as per people’s care plans and risk assessments.
People were protected from abuse and relatives told us their loved ones received safe care.
People received support from a regular staff team and staff were recruited safely.
Staff were trained in administering medicines safely. Competency checks had been completed to ensure staff were following safe practices.
People’s relatives spoke positively about the staff and felt people were encouraged to gain new skills and independence.
People were supported to remain in contact with their loved ones during the COVID-19 pandemic by phone calls, videos calls and social distanced meets.
Quality monitoring of accidents and incidents ensured that information and learning was shared with staff to reduce the risk of future occurrences.
We expect health and social care providers to guarantee autistic people and people with a learning disability the choices, dignity, independence and good access to local communities that most people take for granted. Right support, right care, right culture is the guidance CQC follows to make assessments and judgements about services providing support to people with a learning disability and/or autistic people.
The service was able to demonstrate how they were the underpinning principles of Right support, right care, right culture. People’s care was person centred and focussed on developing independence with recorded goals on how to achieve this.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection
The last rating for this service was good (published 09 March 2020).
Why we inspected
We received concerns in relation to the management of medicines and people’s finances. We also received some concerns about staff training and management oversight. As a result, we undertook a focused inspection to review the key questions of safe and well-led only.
We reviewed the information we held about the service. No areas of concern were identified in the other key questions. We therefore did not inspect them. Ratings from previous comprehensive inspections for those key questions were used in calculating the overall rating at this inspection.
We found no evidence during this inspection that people were at risk of harm from this concern. Please see the safe and well-led sections of this full report.
You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Next Steps Ltd on our website at www.cqc.org.uk.
Follow up
We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.
Next Steps Ltd is a supported living service. At the time of inspection, the service was supporting nine people in six different properties.
The service has been developed and designed in line with the principles and values that underpin Registering the Right Support and other best practice guidance. This ensures that people who use the service can live as full a life as possible and achieve the best possible outcomes. The principles reflect the need for people with learning disabilities and/or autism to live meaningful lives that include control, choice, and independence. People using the service receive planned and co-ordinated person-centred support that is appropriate and inclusive for them.
People’s experience of using this service and what we found
People received good quality care. Auditing systems were in place however improvements were required to strengthen them and ensure they identified all areas that required improvements.
People made great progress with the service. People’ speech, behaviour and independence were all areas that people had made significant developments with since using the service. Relatives commented positively about the progress people had made and commended the staff’s caring approach.
People received safe care, and staff understood safeguarding procedures and how to raise concerns. Risk assessments were in place to manage risks associated with people’s lives, and staff we spoke with felt safe supporting people with a wide range of needs.
Staff recruitment procedures ensured that appropriate pre-employment checks were carried out. Medicines were stored safely and were administered in accordance with people’s preferences. Staff were well trained to support people effectively.
People were supported to have their nutritional needs met. Healthcare needs were met, and people had access to health professionals as required. Care plans outlined any support people required to manage their healthcare needs.
People's consent was gained before any care was provided. Staff treated people with kindness, dignity and respect and spent time getting to know them.
People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.
Care plans reflected peoples’ likes, dislikes and preferences. People were empowered to make their own choices about what interests they pursued. This included holidays and activities with staff they enjoyed spending time with.
A complaints system was in place and used effectively. The management team were keen to ensure people received good care and support and listened to feedback when provided.
Investigations took place into accidents, incidents and any events that could be learnt from. Learning was shared with the team and improvements were made when required.
At the start of inspection, the service had a registered manager in post however they subsequently left. A new manager had been recruited.
The outcomes for people using the service reflected the principles and values of Registering the Right Support by promoting choice and control, independence and inclusion. People's support focused on them having as many opportunities as possible for them to gain new skills and become more independent.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection
The last rating for this service was Good (published 1 August 2017).
Why we inspected
This was a planned inspection based on the previous rating.
Follow up
We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.
At the last inspection in September 2015, the service was rated Good. At this inspection we found the service remained Good.
People continued to receive safe care and support. Staff were knowledgeable about the risks to people and effective plans of care had been developed to guide staff in mitigating people’s known risks. People could be assured that sufficient numbers of staff were available to provide their care and that they would receive their prescribed medicines safely.
People were supported by staff that knew them well and had received the support, supervision and training that they needed to provide effective care. People were supported to maintain adequate nutrition and staff promptly referred people to medical professionals when required.
People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice.
People were treated with dignity and respect and could be assured that they would be supported to pursue their interests and hobbies. Staff were committed to providing care according to people’s individual preferences.
There was a strong system of quality assurance overseen by a visible and supportive management team. People felt able to approach the management team and they actively promoted a person centred culture that was focussed upon people’s strengths.
This unannounced inspection took place on 23 & 24 July 2015. This domiciliary care service is registered to provide personal care support to people living in their own homes. At the time of the inspection the service supported 9 people.
There was a registered manager in post at the time of our inspection. 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 told us that they felt safe in their own home. Staff understood the need to protect people from harm and abuse and knew what action they should take if they had any concerns. Staffing levels ensured that people received the support they required at the times they needed. We observed that on the day of our inspection there were sufficient staff to meet the needs of the people they were supporting. The recruitment practice protected people from being cared for by staff that were unsuitable to work at the home.
Care records contained risk assessments to protect people from identified risks and help to keep them safe. They gave information for staff on the identified risk and informed staff on the measures to take to minimise any risks.
People were supported to take their medicines as prescribed. Records showed that medicines were obtained, stored, administered and disposed of safely. People were supported to maintain good health and had access to healthcare services when needed.
People were actively involved in decision about their care and support needs There were formal systems in place to assess people’s capacity for decision making under the Mental Capacity Act 2005 and Deprivation of Liberty Safeguards (DoLS). People felt safe and there were clear lines of reporting safeguarding concerns to appropriate agencies and staff were knowledgeable about safeguarding adults.
Care plans were in place detailing how people wished to be supported and people were involved in making decisions about their care. People participated in a range of activities both in the home and in the community and received the support they needed to help them do this. People were able to choose where they spent their time and what they did.
Staff had good relationships with the people who they cared for. Complaints were appropriately investigated and action was taken to make improvements to the service when this was found to be necessary. The manager was accessible and made monthly visits to people using the service to monitor the quality of the service provided. Staff and people were confident that issues would be addressed and that any concerns they had would be listened to.
One relative's comments to us were representative of what all relatives we spoke with told us, "I've been involved in the support plan. The service has been very good.They listen. The staff are friendly, they actually care. My relative has never been happier."
We found from listening to what relatives told us, talking with staff and reviewing records that people had been supported to achieve personal goals. One relative told us. "They have come on a lot because they have been taught new things to do." Another relative told us, "They get to do things they have never experienced before"; and another told us, "Family members can't believe how well they have come on."
All relatives we spoke with told us that they knew how they could raise any concerns and that they were confident they would be listened to.
We found that what relatives had told us about the service was corroborated by documentation that we reviewed and through our discussion with the owner and the registered manager. The service was meeting the essential standards of quality and safety.