Derby and Derbyshire Supported Living

Updated 16 October 2019

The inspection

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Care Act 2014.

Inspection team

The inspection was carried out by one inspector.

Service and service type

This service provides care and support to people living in a number of ‘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.

The service had a manager registered with the Care Quality Commission. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.

Notice of inspection

This inspection was announced. We gave the service 48 hours’ notice of the inspection. This was because it is a small service and we needed to be sure the registered manager would be in the office to support the inspection and as people are often out, we wanted to be sure there would be some people at home to speak with us.

What we did before the inspection

We reviewed information we had received about the service since the last inspection. We sought feedback from the local authority and professionals who work with the service. We used the information the provider sent us in the provider information return. This is information providers are required to send us with key information about their service, what they do well, and improvements they plan to make. This information helps support our inspections. We used all of this information to plan our inspection.

During the inspection-

We spoke with six people who used the service, and two relatives about their experience of the care provided. We spoke with seven members of staff, including the registered manager, team leaders and care workers. We spoke with one visiting healthcare professional during the inspection to gain their opinion of the service.

We reviewed a range of records. This included five people’s care records and four medication records. We looked at three staff files, in relation to training and supervision. A variety of records relating to the management of the service, including policies and procedures were also reviewed.

After the inspection

We spoke with two further relatives and one professional following the inspection.

Updated 16 October 2019

About the service

Derby and Derbyshire Supported Living provides personal care to people with a learning disability or autistic spectrum disorder, who may also be living with physical disability. People received care in their own private single, or multi occupancy living accommodation via individual private tenancy agreements. At the time of our inspection there were 14 people using the service.

Not everyone who uses 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 consider any wider social care provided.

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 was appropriate and inclusive for them. People's support focused on them having as many opportunities as possible for them to gain new skills and become more independent.

People’s experience of using this service and what we found

People were supported by staff who had the knowledge and skills to ensure they were safe from harm. Risk assessments had been completed to consider what support was needed in these areas to reduce any risk identified. Staff were recruited in line with best practice and the number of staff were reflective of the package each individual needed. Medicines were managed safely, and staff ensured clear infection control measures were in place. The registered manager had reflected on incidents and lessons had been learned.

People’s care was provided by staff, which people and relatives told us were kind and compassionate. People’s needs were respected, and individual care was provided in a dignified way. Care plans were reflective of individual needs, and any support required with communication, or with access to any social, cultural or religious practices was clearly identified.

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. Staff had received training relevant to their role. Where people required support with their nutritional needs this was documented, and staff accessed additional advice and support when required. Good health care was promoted, and staff worked in partnership with a number of local health and social care professionals.

The registered manager ensured that any complaints, including verbal complaints, had been responded to and people who used the service, their relatives and staff were encouraged to give feedback about the service. There was a range of improvements ongoing which were being continually updated by people’s feedback, from the provider outcomes and in line with the changes in market share.

The Secretary of State has asked the Care Quality Commission (CQC) to conduct a thematic review and to make recommendations about the use of restrictive interventions in settings that provide care for people with or who might have mental health problems, learning disabilities and/or autism. Thematic reviews look in-depth at specific issues concerning quality of care across the health and social care sectors. They expand our understanding of both good and poor practice and of the potential drivers of improvement. As part of the thematic review, we carried out a survey with the registered manager at this inspection. This considered whether the service used any restrictive intervention practices (restraint, seclusion and segregation) when supporting people. The service used positive behaviour support principles to support people in the least restrictive way. No restrictive intervention practices were used.

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 18/02/2017).

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.