18 October 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 inspection took place on 24, 28 August and 6 September 2018 and was announced. We gave the service 48 hours’ notice of the inspection visit because the location provides care for people living in their own homes or in a ‘supported living setting. We needed to be sure they would be in. One adult social care inspector carried out this inspection.
Before the inspection we reviewed information we held about the service. This included inspection history, complaints and notifications we had received from the provider. Notifications are changes, events or incidents the provider is legally required to let us know about.
We contacted the local authority: Commissioning Team; Clinical Commissioning Group (CCG; and the Safeguarding Adult’s Team. We reviewed the website of the local Healthwatch. Healthwatch is an independent consumer champion that gathers and represents the views of the public about health and social care services in England.
One the day of inspection, we spoke with the registered manager, two deputy managers, one carer and one relative. We visited five people in their homes and we were able to speak with three of these people. Following the inspection, we spoke with two carers and two relatives by phone.
During our inspection we reviewed a range of documents and records which included, care plans for three people who used the service and three staff records. We also looked at various quality audits completed by the registered manager and area manager.
Following the inspection we emailed one NHS physiotherapist; one local authority day services manager; one advocate and one local authority social worker to obtain their feedback.
18 October 2018
This inspection took place on 24, 28 August and 6 September 2018 and was announced.
St Anne's Community Services - South Tyneside, provides personal care and support to people living in their own homes or in a 'supported living' setting, 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 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.
The care service had 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.
The service had a registered manager. 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 and their relatives we spoke with told us they felt safe and well cared for. Staff understood their roles and responsibilities regarding keeping the people they cared for safe. Safeguarding alerts that had been raised had been dealt appropriately and in line with the provider’s own policy.
Robust recruitment checks were carried out prior to any new staff commencing employment. Staff had the appropriate skills and had received training for their role. Training records however, showed that for some staff certain areas of training had lapsed. The registered manager told us that all outstanding training would completed by the end of September 2018. Staff confirmed they had regular supervision sessions and yearly appraisals.
The process of handling of people’s medication was safe. Records showed that staff carried out regular health and safety checks at people’s homes to make sure they were safe. Risk assessments were in place for people who used the service and described potential risks and the safeguards in place to mitigate these risks.
People contributed to the development of their care plans which were written in a person-centred way and were clear to understand. Person-centred is an approach that ensures the person is included in their support and their preferences are respected. Care plans also demonstrated involvement from other healthcare professionals to ensure that people’s ongoing and any emerging health needs were met. Care plans were assessed on a regular basis to ensure people received care and support that was appropriate to their needs. Staff understood the needs of people and that was evidenced when we visited people in their homes.
Where possible, people were supported and encouraged to lead as independent a life as possible. Social activities and involvement with the local community are a great focus for the service and this was confirmed when we spoke with people, staff and relatives. People were also supported to maintain and develop relationships that were important to them.
People are supported to have maximum choice and control of their lives and staff support them in the least restrictive way possible; the policies and systems in the service support this practice.
Staff were able to describe to us the importance of ensuring that people’s nutritional needs were met.
People and relatives told us that staff treated people with care, kindness and compassion and we were able to observe this when we visited people in their homes. Staff were able to describe how they would maintain people’s dignity and respect at all times and relatives we spoke with confirmed this.
Feedback regarding the service is sought via a yearly questionnaire, which is sent to people using the service, their relatives and other stakeholders. The provider also has a complaints policy in place which also allows for feedback to be given.
Staff told us they felt that supported and valued by the registered manager and deputy managers and that all managers were very approachable.
The provider had notified CQC of all significant events in line with their legal responsibility. The provider had a range of internal audit systems in place and had taken steps to address any actions resulting from these audits. However, audits carried out at regional level had not taken place since February 2018. This was discussed with the registered manager.
Records reviewed showed that the provider carried out regular risk assessments for both people and their home environment.
Further information is in the detailed findings below.