Mediline Supported Living Swallow

Updated 11 January 2023

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.

As part of this inspection we looked at the infection control and prevention measures in place. This was conducted so we can understand the preparedness of the service in preventing or managing an infection outbreak, and to identify good practice we can share with other services.

Inspection team

The inspection was carried out by two inspectors.

Service and service type

Mediline Supported Living Swallow is a 'care home'. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

This provider is required to have a registered manager to oversee the delivery of regulated activities at this location. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Registered managers and providers are legally responsible for how the service is run, for the quality and safety of the care provided and compliance with regulations.

At the time of our inspection there was not a registered manager in post.

Notice of inspection

This inspection was unannounced. Inspection activity started on 5 October and ended on 11 October 2022. Inspectors were on site on 5, 6 and 11 October 2022.

What we did before inspection

Before the inspection we reviewed the information we held about the service and the service provider. We sought feedback from the local authority and professionals who work with the service. We looked at the notifications we had received for this service. Notifications are information about important events the service is required to send us by law. The provider completed a Provider Information Return (PIR). A PIR is information providers send us to give some key information about the service, what the service does well and improvements they plan to make. We used all of this information to plan our inspection.

During the inspection

We observed staff interactions with all 4 people who used the service over the 3 days of inspection. Some people were unable to communicate verbally; we spent time observing their body language during their interactions with care staff. We observed the care and support provided to people in the communal areas across different parts of the day. We used the Quality of Life Tool which is designed to support the corroboration of all sources of evidence gathered during inspection.

We spoke with 4 staff members. This included the manager and 3 support workers. We reviewed a range of records. This included 3 people's care plans, 4 medicines records and 3 staff files in relation to recruitment and staff supervision. We also reviewed records related to the management of the service, which included policies and procedures, training records, quality assurance checks and a range of health and safety records.

After the inspection

We continued to seek clarification from the provider to validate evidence found. We spoke with 2 professionals who were currently involved with the service, 2 relatives of people living at the care home and 1 other member of staff over the telephone.

Updated 11 January 2023

About the service

Mediline Supported Living Swallow is a residential care home that provides care and accommodation for up to five people with a learning disability, or with autism. It is part of the wider Mediline Supported Living Limited group, who have other care homes and supported living premises in and around the Greater Manchester area. At the time of the inspection four people were living at the service.

We expect health and social care providers to guarantee people with a learning disability and autistic people respect, equality, dignity, choices and 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 supporting people with a learning disability and autistic people and providers must have regard to it.

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

The quality and assurance systems in place to monitor the safety and quality of care provided had not identified the concerns we found. More robust levels of monitoring and oversight were required by the provider, so that the service improved for people living in the home.

Based on our review of the key questions; safe, effective, responsive and well led, we found the service was not able to demonstrate how they were meeting the underpinning principles of right support, right care, right culture.

Right support: The service did not support people to have maximum choice, control and independence. Staff supported people in the least restrictive way possible and in their best interests. The policies and systems in the service supported this practice. Staffing levels were not always aligned with people’s support needs, particularly during the night. There was no evidence of staff engaging people in meaningful activities when in the home, as staff were busy with other tasks during the inspection. One person had access to a mobility car, but no support staff were able to drive. People had exclusive use of their own bedrooms and living spaces and were able to personalise these accordingly.

Right care: People received kind and compassionate care. Staff protected and respected people's privacy and dignity. They understood people's needs and provided appropriate care. Where appropriate, staff encouraged and enabled people to take positive risks. Staff understood how to protect people from potential abuse. The service worked well with other agencies. Staff had training on how to recognise and report abuse and they knew how to apply it.

Right culture: Staff knew most people well and were responsive to their care needs. Care was not always fully person-centred due to constraints within the service. People and those important to them were involved in planning their care. Staff communicated with families and other professionals. People had access to independent advocates to help represent their wishes. Best interest decisions were documented, and people's dignity was respected. Staff felt supported in their roles and felt able to report concerns to management if they should arise.

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 3 August 2018).

Why we inspected

This inspection was prompted by a review of the information we held about this service. As a result, we undertook a focused inspection to review the key questions of safe, effective, responsive and well-led only.

We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.

For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating.

The overall rating for the service has changed from good to requires improvement based on the findings of this inspection.

We have found evidence that the provider needs to make improvements. Please see the safe, effective, responsive and well-led sections of this full report.

You can see what action we have asked the provider to take at the end of this full report.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Mediline Supported Living Swallow on our website at www.cqc.org.uk.

Follow up

We will request an action plan from the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.