We carried out a review of the data available to us about Future Living on 6 July 2023. We have not found evidence that we need to carry out an inspection or reassess our rating at this stage.
This could change at any time if we receive new information. We will continue to monitor data about this service.
If you have concerns about Future Living, you can give feedback on this service.
When the service was last inspected in January 2017 one breach of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 was identified At that inspection we found that safe recruitment procedures had not always been followed and there was a lack of recording of
monitoring checks by the provider.
During this inspection, we checked that the provider was meeting the legal requirements of the regulations they had breached. You can read the report from our last comprehensive inspection, by selecting the 'All reports' link for Mrs Tracey Jayne Mitchell, on our website at www.cqc.org.uk.
The service is also known as Future Living and provides a supported living service to people living in their own home. People who live in the supported living property have individual tenancy agreements. At the time of the inspection, the provider was providing personal care and support to three people who shared a bungalow. Mrs Tracey Jayne Mitchell as a sole provider runs the service. As a sole provider, she is not required to employ a registered manager. Instead, they had opted to manage the service themselves.
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.
At the last inspection, we rated the service as Requires Improvement. At this inspection, we found that the provider had made the required improvements within the service.
People received a safe service. The registered manager understood their responsibilities to raise concerns and record safety incidents, concerns and near misses and report these internally and externally as necessary. The provider embedded a proactive approach to managing risks to people who used the service. The provider made sure there was enough staff on duty.
At the last inspection in January 2017, safe recruitment processes were not completed. At this inspection, this had improved. Records showed the provider had safe recruitment procedures in place.
The provider was clear about its responsibilities and role in relation to medicines. The provider managed the control and prevention of infection well. Staff understood their responsibilities to raise concerns and report incidents and accidents. Where incidents had occurred, the provider had used these to make improvements and shared and lessons learned with staff.
People received effective care and support from competent and well-trained staff. Staff received a thorough induction at the start of their employment. New staff completed a qualification known as the Care Certificate at the start of their employment if they do not already hold a relevant qualification. The Care Certificate covers an identified set of standards which health and social care workers are expected to adhere to. All staff received regular supervision and annual appraisals.
Care plans were clear, detailed, and easy to read. Staff regularly reviewed care plans. The provider offered a healthy and balanced range of meals to suit each person's dietary needs and preferences. Feedback from relatives was very positive.
Staff understood and demonstrated a good working knowledge of the Deprivation of Liberty Safeguards and the key requirements of the Mental Capacity Act 2005. The provider and staff had received training on the MCA. There was also a policy on the MCA which was accessible to staff.
People gave their consent before accepting care or support. Staff treated people with dignity, respect, and kindness and understood how to communicate with people. Staff supported people to maintain and develop their relationships with those close to them, their social networks, and community.
People knew how to give feedback about their experiences of care and support, and could do so in a range of accessible ways, including how to raise any concerns or issues. Staff told us the provider was a good manager. The provider was passionate and dedicated to providing an excellent service to people. There was a positive culture in the service, the provider led by example.”.
At the last inspection in January 2017, the provider did not carry out regular monitoring checks. At this inspection, we found this had improved. The provider had engaged an external contractor to support them. There were effective quality assurance arrangements at the service in order to raise standards and drive improvements.
People are 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 support this practice.
Further information is in the detailed findings below
The service is also known as Future Living and provides a supported living service to people living in their own homes. People who live in the supported living properties have individual tenancy agreements. At the time of the inspection they were providing personal care and support to three people who shared a bungalow in the Broadclyst area a few miles outside of Exeter. The service is run by Mrs Tracey Jayne Mitchell as a sole provider. As a sole provider she is not required to employ a registered manager. Instead they had opted to manage the service themself. 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 service was previously inspected on 18 December 2015. At that inspection we were unable to check that staff had been recruited safely because some staff recruitment records had not been stored securely and were missing. We also found some risks to people’s health had not been regularly monitored, and that quality monitoring systems were not fully effective. During the inspection on 3 January 2017 we checked to see if these matters had been addressed. We found staff records had been stored securely and were available for the inspection. However, the records showed safe recruitment procedures had not always been followed. Checks had been carried out on applicant’s criminal record history and their suitability to work with vulnerable people. However, there was a delay in obtaining references and these were sometime obtained several weeks after new staff began working in the service. This meant there was a risk that people were not always supported by staff with the appropriate experience, character or trustworthiness. The provider assured us references and DBS checks will always be taken up in future before new staff begin working for the service.
We found some improvements had been made to the quality monitoring systems but lack of recording of monitoring checks by the provider meant quality monitoring remained only partially effective. Concerns found at the previous inspection relating to risks to people’s health had been addressed through regular six monthly health checks at the local health centre.
At the time of this inspection the service supported three women who shared a bungalow. The provider told us they had no plans to increase the size of the service in the near future. Each person had a tenancy agreement for their bedroom and the use of shared communal areas in the bungalow they rented. Staff were allocated 24 hours a day to support each person on a shared basis. In addition staff were available to provide support on a one-to-one basis according to each person's needs. We met the three people during our inspection. They had little or no ability to communicate verbally, although we saw from their responses they were able to understand what people were saying. They were relaxed and happy and led active and fulfilling lives. A relative told us they telephoned the service every week and said “As far as I am aware (person’s name) is receiving first class care both day and night. We certainly have no complaints. They are ‘spot on’. We cannot visit the service regularly, but as far as we are aware we cannot fault the management of the service.”
People were supported by sufficient staff with the right skills and knowledge to meet their individual needs. There were always at least two staff available to support people during the day and at night there was one staff available. Staff told us they had received good training on a range of topics relevant to the health and safety of people who used the service. They received regular supervision and told us they were well supported. They understood the importance of enabling people to make choices and decisions about their lives where possible. Staff were caring and respectful.
Each person had been involved, as far as they were able, in drawing up a plan of their care needs. Care plans were clearly written and contained detailed information about all aspects of their health and personal care needs. Staff were aware of risks to each person’s health. Risks such as moving and handling, diabetes, epilepsy and choking were explained in the care plans and understood by the staff team. Staff sought advice and guidance from health and social care professionals promptly when needed. However, they had not received recent advice from specialists on the prevention of choking. This was sought promptly following the inspection.
Medicine were stored and administered safely. Each person had secure storage facilities in their room and received individualise individualised support from staff to ensure they received their medicines in accordance with the prescriber’s instructions.
We found one breach of the Health and Social Care Act 2008 (Regulated Activities) Regulations. You can see what action we told the registered provider to take at the back of the full version of this report. We also made one recommendation regarding the providers’ quality improvement systems.
The service has not been inspected previously. The service was registered on 12 May 2015. The service is also known as Future Living. The service is run by Mrs Tracey Mitchell as a sole provider. As a sole provider she is not required to employ a registered manager. Instead she has opted to manage the service herself. 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.
On the day of this inspection there were three people receiving supported accommodation. Each person had a tenancy agreement for their bedroom and use of shared communal areas in the bungalow they rented. Staff were allocated 24 hours a day to support each person on a shared basis. In addition staff were available to provide support on an individual basis according to each person’s needs. We met each of the people living there. They had little or no ability to communicate verbally, although we saw from their responses they were able to understand what people were saying. They were relaxed and happy. Two people we spoke with responded positively when we asked them about the support they received, either by smiling or by giving a ‘thumbs up’ sign.
People led a good quality of life. They had their own transport, (either individual or shared) and they were able to go out regularly and enjoyed an active social life. Staff were attentive, caring, and knew each person well and understood their needs. Staff we spoke with were positive and enthusiastic about their jobs.
The provider had some monitoring processes in place, although these were not fully effective. We were assured in our discussions with staff, and from daily reports, that staff recognised the risks to each person’s health and well-being, but this was not fully supported by the care records. Risks such as pressure sores or weight loss were not assessed using nationally recognised screening tools, or reviewed regularly.
Staff assured us their recruitment procedures had been thorough. However, the recruitment records were either missing or incomplete. This meant we were unable to see proof that satisfactory checks and references had been taken up before new staff were appointed. We saw some records of staff training, and received verbal assurances that staff had received a range of training since they began their employment. However, this could not be fully evidenced in the staff employment files and we were unable to see how the provider planned future training needs for each member of staff. There were inadequate records in place to show how the individual staff training, learning and development needs were planned and met.
Each person had been involved as far as they were able in drawing up and agreeing a plan of their care and support needs. Their care plans were well laid out and easy to read. The care plans explained each person’s daily routines and how they wanted staff to support them. The plans were not dated and therefore it was not possible to see how often they were updated, although we were satisfied the information was up-to-date.
People were protected from the risk of abuse and avoidable harm because staff had received training and information on how to recognise abuse. Staff knew who to contact if they had any concerns.
Where people required equipment to enable them to move safely this had been provided following assessment by relevant professionals. This included hoisting equipment with overhead tracking, a bath hoist, wheelchairs and hoist tracking.
Medicines were securely stored and administered safely by staff who had been trained and assessed as competent. People were supported to maintain good health. Staff told us they received good support from GP’s and health professionals such as physiotherapists.
We found one breach of the Health and Social Care Act 2008 (Regulated Activities) Regulations (2014).You can see what action we told the provider to take at the back of the full version of the report. We have also made one recommendations. This relates to the processes followed when assessing the risks to people’s health and welfare.