Archived: Swan House

This service provides care and support to people living 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.

“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.”

Swan House is a supported living service managed by The London Borough of Hillingdon. Swan House is split across two levels with people with mental health needs living independently upstairs and up to nine people with complex behaviour and learning disability living downstairs.

Each person had their own tenancy and lived in a large self-contained flat. The service only provided personal care to people living downstairs. At the time of our inspection, eight people were receiving care and support and a new person was due to move in shortly.

There was a registered manager in post at the service at the time of our inspection. 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 registered manager and site manager were passionate about accessing community resources in order to improve the quality of life of people who used the service.

People's care plans were very comprehensive and detailed people’s identified individual needs. They were personalised to reflect people’s wishes and what was important to them.

Where appropriate, people’s end of life wishes were discussed and recorded.

Care plans and risk assessments were reviewed and updated whenever people's needs changed. People and relatives told us they were involved in the planning and reviewing of their care and support and felt valued.

A wide range of activities were arranged that met people’s individual interests and people were consulted about what they wanted to do.

There were systems and processes in place to protect people from the risk of harm. There were enough staff on duty to meet people's needs and there were contingency plans in the event of staff absence. Employment checks were in place to obtain information about new staff before they were allowed to support people.

The risks to people's safety and wellbeing were assessed and regularly reviewed. People were supported to manage their own safety and remain as independent as they could be. The provider had processes in place for the recording and investigation of incidents and accidents.

People were given the support they needed with medicines and there were regular audits by the management team.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice.

Staff had undertaken training in the Mental Capacity Act 2005 (MCA) and were aware of their responsibilities in relation to the Deprivation of Liberty Safeguards (DoLS). They ensured people were given choices and the opportunity to make decisions.

The provider ensured people's nutritional needs were met. People were involved in the planning of their meals and where possible, shopped for ingredients and cooked their own food with the support of staff.

People were supported by staff who were sufficiently trained, supervised and appraised. The service liaised with other services to share ideas and good practice.

People’s healthcare needs were met and staff supported them to attend medical appointments.

People lived in a comfortable environment which was clean and free of hazards. They were assisted to personalise their flats and the communal areas as they wished.

Staff were caring and treated people with dignity, compassion and respect. Support plans were clear and comprehensive. They recorded people's individual needs, detailed what was important to them, how they made decisions and how they wanted their care to be provided.

Throughout the inspection, we observed staff supporting people in a way that took into account their diversity, values and human rights. People were supported to make decisions about their activities, both at their home and in the community.

Information about how to make a complaint was available to people and their families, and they felt confident that any complaint would be addressed by the management.

There was a clear management structure at the service, and people and staff told us that the management team were supportive and approachable. There was a transparent and open culture within the service and people and staff were supported to raise concerns and make suggestions about where improvements could be made.

The provider had effective systems in place to monitor the quality of the service and where issues were identified, these were addressed promptly.

Swan House provides personal care for up to nine people with a learning disability. There were nine people living at the service at the time of our inspection. Each person had their own tenancy with a housing association which also owned the building.

The service is required to have a registered manager and there was a registered manager in post at the time of our inspection. 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.

Staff had undertaken training in the Mental Capacity Act 2005 (MCA) and were aware of their responsibilities in relation to the Deprivation of Liberty Safeguards (DoLS). We were told and saw that people were given choices and the opportunities to make decisions, however, some of the care records did not contain evidence that consent had been sought.

There were arrangements in place for the management of people’s medicines and senior staff had received training in the administration of medicines. Senior staff carried out regular audits of the prescribed medicines but did not have a robust system to audit medicines that were prescribed for people to take as required.

Staff were caring and treated people with dignity and respect and in a way that took account of their diversity, values and human rights. Care plans were in place and people had their needs assessed. Care records contained detailed information and reflected the needs and wishes of the individual so staff had the information they required to meet people’s needs. However the records were not concise and this made it difficult to find the information quickly.

People and relatives told us they felt safe and we saw there were systems and processes in place to protect people from the risk of harm whilst giving them the opportunity to take positive risks. There were sufficient staff on duty to meet people’s needs and where required staff numbers were increased to ensure people’s safety.

People’s nutritional needs were being met and staff met with people to create their individual weekly menus. Staff supported people to shop for their food and cook meals where they were able to. Staff were knowledgeable about people’s nutritional needs and these were displayed in their flat.

Staff received effective training, supervision and appraisal. The registered manager sought guidance and support from other healthcare professionals and attended conferences and forums in order to keep abreast of developments within the social care sector. Important information was cascaded to staff, to ensure the team were kept informed and received training to deliver effective support to people.

A range of in house and outdoor activities were provided, and staff provided activities on a one to one basis taking into consideration people’s preferences. The registered manager told us they were starting to develop the environment to meet the needs of people with a learning disability.

People, relatives, staff and stakeholders told us the registered manager and staff were supportive and professional. The registered manager told us they encouraged an open and transparent culture within the service. The service supported people to raise concerns and used feedback to make improvements where needed.

The provider had effective systems in place to monitor the quality of the service and ensured that areas for improvements were identified and addressed.