Background to this inspection
Updated
11 December 2018
We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.
This was a comprehensive inspection. The inspection took place on 7 and 9 November 2018 and was announced. We gave the service 5 days’ notice of the inspection visit because the location provides a supported living service for adults who are often out during the day. We needed to be sure that they would be in and people would be willing to speak with us. We also wanted to make sure the registered manager and/or members of their management team would be available at the time of the inspection.
The inspection was carried out by one adult social care inspector. Before the inspection we asked the provider to complete a Provider Information Return (PIR). The PIR is a form that asks the registered provider to give some key information about the service, what the service does well and improvements they plan to make. We also looked at information we had received about the service since the last inspection, such as notifications about significant incidents, and information from people who use the service, staff, relatives and other professionals. Before the inspection we sent out questionnaires to people who used the service, relatives, staff and health and social care professionals. We received responses from five staff and three community professionals.
On the first day of the inspection we visited the agency office where we spoke with the new manager, the previous registered manager (who remained working for the provider in a different role), the provider’s quality manager and the Nominated Individual. We looked at records held in the agency office including two staff recruitment files, staff supervision records, training records, four support plans and quality monitoring and improvement records.
On the second day of the inspection we visited two shared houses in Honiton and Axminster where we met five people who received a service. We also met seven members of staff. We looked at records of care held in each person’s home including three support plans, risk assessments, daily reports, medicine administration records, and records of support given to help people manage their weekly household budgets.
Updated
11 December 2018
This was a comprehensive inspection. The inspection took place on 7 and 9 November 2018 and was announced.
Assisted Living South West Limited is a supported living service for people living in supported living settings in Devon. Most people who use the service live in shared houses with other service users. This service provides care and support to people living in ‘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 this inspection there were 23 people with disabilities who received a range of support from the service, including personal care. Our inspection focussed on the support given to these 23 people. The service also provided support to people who did not require personal care. This part of the service is not covered by CQC legislation and therefore was not included in the inspection.
The provider, Assisted Living South West Limited is part of the Rehability UK group. Rehability UK provides community care and supported living services throughout the country, specialising in the provision of mental health, autism and learning disability care recovery pathways. Rehability UK took over the service approximately one year ago from Eden Futures. The provider, Assisted Living South West Limited, remains the same and therefore no change of registration was necessary.
We checked the service was working in line with ‘Registering the right support’, which makes sure services for people with a learning disability and/or autism receive services are developed in line with national policy - including the national plan, Building the right support - and best practice. For example, how the service ensured care was personalised, people’s independence and links with their community.
There was a new manager in post who had begun working in the service approximately two weeks before this inspection took place. They were in the process of submitting an application to CQC
Rating at last inspection
At our last inspection we rated the service Good. At this inspection we found the evidence continued to support the rating of good and there was no evidence or information from our inspection and ongoing monitoring that demonstrated serious risks or concerns. This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection.
Why the service is rated Good
People told us they felt safe being care for by the service. They knew how to speak out and who to tell if they had any concerns. Some people we met were unable to communicate verbally. They appeared happy and relaxed with the staff who were supporting them. The provider and registered manager had effective safeguarding systems in place. All staff we spoke with had a good understanding of what to do to make sure people were protected from harm or abuse. Care was taken before new staff were employed to make sure the applicants were entirely suitable for the job.
There were enough staff employed so that people received support when they needed it. There was a stable staff group, with many staff having worked in the service for a number of years. People received a consistent service from staff they knew and trusted.
There were good systems in place to assess risk and to ensure people received safe care and support. Support plans contained detailed risk assessments covering all anticipated risks. People were supported to manage their medicines safely.
People told us staff supported them effectively. People’s needs were assessed before they began receiving support and a plan of their support needs was drawn up. The plans contained detailed information about all aspects of each person’s support needs and had been discussed and agreed with each person, and with their families or representatives where appropriate. Staff worked closely with health and social care professionals from other organisations to deliver effective care, support and treatment. Comments included “Yes they do (support me well). They’re good” and “I like all the staff”.
The manager told us they strove to make the places people lived in feel like their homes, and not a workplace for the staff. Staff were passionate about supporting people to gain independence and learn new skills.
Staff had the skills, knowledge and experience to deliver effective care and support. Staff received a comprehensive induction at the start of their employment and regular ongoing training and updates on topics relevant to people’s needs. Staff told us the training was good. Comments included, “We’ve got a really good trainer now” and, “Brilliant. (The trainer is) very approachable. Interesting”. Staff received regular supervision and told us the level of support they received was very good. Staff meetings were held monthly.
People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible. A person told us, “I say what I want” and described how the staff supported them to achieve their goals and wishes.
People were supported to eat a healthy diet and keep hydrated. Staff understood each person’s dietary needs and preferences. Records showed people were supported to attend health checks regularly. Staff had liaised with health and social care professionals to ensure people were supported, either with their consent or in their best interests, to receive the care and treatment they needed.
People told us they continued to receive a service that was caring. During our visit we saw people and staff smiling and laughing together. People told us the staff were always kind and they had lots of fun together. Comments from staff included, “I will always go out of my way for them. That’s what I am here for” and “As a team we all try to make their lives as positive as possible”.
People knew how to make a complaint and were confident any concerns or complaints would be listened to, investigated and addressed. The complaints procedure was in an easy to read format and staff told us they regularly reminded people about the complaints procedure and how to make a complaint.
People and staff told us the service was well-led. Since the last inspection there has been a change of provider and a new manager. There was a clear management structure in place and there were plans to improve and increase the management structure in the near future. Comments from staff included, “I respect this company a lot as they do strive to uphold their values” and “It is a very, very good company”. Many of the staff and people we met told us they had already met the new manager and they spoke positively about him. Staff morale was good.
There were systems in place to monitor the service and ensure all areas were running smoothly and safely. The provider employed a Quality Manager who regularly visited the service and carried out a range of checks to ensure people were receiving a good service. People were consulted and involved and their views were welcomed.
Further information is in the detailed findings below