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Archived: Natural Ability Requires improvement

This service was previously registered at a different address - see old profile

This service is now registered at a different address - see new profile

We are carrying out a review of quality at Natural Ability. We will publish a report when our review is complete. Find out more about our inspection reports.

Inspection Summary


Overall summary & rating

Requires improvement

Updated 1 September 2018

This inspection was carried out between 11 and 23 July 2018. The inspection was announced as the provider was given short notice of the visit to make sure someone would be available.

This service provides care and support to nine people living in six small ‘supported living’ settings, so they can live in their own home 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.

This inspection had been brought forward due to concerns. This was because staff had raised concerns about safeguarding incidents that had occurred. These had not been reported to the local authority or to the Care Quality Commission, and had not been investigated by the provider. This meant vulnerable people had not been protected and safeguarding adults’ protocols had not been followed. Also, the provider’s quality monitoring processes were not effective in identifying gaps and shortfalls in the quality and safety of the service.

People were supported with their medicines in a safe way but there was no guidance for staff about when to support people with over the counter or ‘when required’ medicines. We have made a recommendation about this.

Staff told us they had not always felt well supported and had not received some of the training they needed. We have made a recommendation about this. Individual supervisions with staff had not been held in a confidential way. On-call management arrangements had not always been supportive to staff who worked with people who used the service. The provider showed us how these issues were being addressed.

There had been a registered manager at the service but they retired in November 2017. A new manager had applied for registration but left the organisation during this inspection. Another manager (from the organisation’s education department) was acting as manager in the interim until a new manager could be appointed. 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.

The care service has been developed and designed in line with the values that underpin the Registering the Right Support and other best practice guidance. These values include choice, promotion of independence and inclusion. People with learning disabilities and autism using the service can live as ordinary a life as any citizen.

People were fully included in their local community and lived ordinary, fulfilled lives as local citizens. They took part in meaningful occupations, such as farming and gardening. They also enjoyed a number of individual leisure activities that they were interested in.

People were treated with dignity and respect. They were encouraged to make their own decisions and to lead as independent lives as possible.

People who could express a view felt the staff were caring and kind. People said they “liked” the support workers and described them as “nice”.

Staff were extremely knowledgeable about individual people and were aware of their individual preferences. People were supported to do their own shopping and make their own meals, with support only where needed.

The service was working within the legal requirements of the Mental Capacity Act 2005 (MCA 2005). People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; they understood the need to obtain consent when providing care. Staff had completed training in relation to the MCA 2005.

Senior manager had recently identified a number of areas for improvement and development. The organisation was committed to implementing those improvements and

Inspection areas

Safe

Requires improvement

Updated 1 September 2018

The service was not always safe.

People had not been fully protected as the organisation had not followed appropriate procedures to safeguard people.

Medicines were administered safely but the guidance for staff was incomplete.

Staffing levels were safe, although they did not always meet their agreed one-to-one support arrangements.

Effective

Requires improvement

Updated 1 September 2018

The service was not always effective.

Staff did not always feel sufficiently trained or supported in their role. The provider had plans to address this.

People were fully involved in managing their own meals, including menu planning, shopping and cooking, with support where necessary.

People had access to health and social care professionals

Caring

Good

Updated 1 September 2018

The service was caring.

People and staff enjoyed friendly, appropriate, supportive relationships.

People’s independence was promoted, such as travelling in the local area alone.

People were encouraged to make all their own decisions and choices about their daily lives.

Responsive

Good

Updated 1 September 2018

The service was responsive.

People received a personalised and individual service that met their specific needs. People had monthly meetings with keyworkers to discuss their goals and were the decision-makers about future plans.

People were supported by small teams of staff who were very knowledgeable about their preferences, abilities and needs

Not everyone had information about how to complain but said they would tell their family. There had been no complaints.

Well-led

Requires improvement

Updated 1 September 2018

The service was not always well led.

The provider’s quality assurance system had not been effective in making sure that people were safe. There was not always a check of incidents to reduce the risk of these being repeated.

There was no registered manager in post. An interim manager was to oversee the service until a new appointment was made.

The organisation was committed to improving the service and had a detailed action plan about changes that would be made.