Background to this inspection
Updated
20 October 2021
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.
Inspection team
The inspection was completed by one inspector.
Service and service type
This service provides care and support to people living in 22 ‘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.
The service had a manager registered with the Care Quality Commission. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.
Notice of inspection
We gave the service 24 hours’ notice of the inspection. This was because we needed to be sure that the provider or registered manager would be in the office to support the inspection.
What we did before the inspection
We reviewed information we had received about the service since the last inspection. We sought feedback from the local authority and professionals who work with the service. The provider was not asked to complete a provider information return prior to this inspection. This is information we require providers to send us to give some key information about the service, what the service does well and improvements they plan to make. We took this into account when we inspected the service and made the judgements in this report. We used all of this information to plan our inspection.
During the inspection
We spoke with the registered manager and the nominated individual. The nominated individual is responsible for supervising the management of the service on behalf of the provider. We looked at care records for four people, as well as records held on accidents and incidents, staff recruitment and supervision and records relating to the monitoring of the care provided.
After the inspection
We held video calls with five people who use the service. We had telephone conversations with two relatives. We also had telephone conversations with seven members of staff.
Updated
20 October 2021
About the service
Select Lifestyles provides personal care to people who may have a Learning Disability and Autism living within supported living schemes. At the time of the inspection, there were 61 people receiving personal care from the service across 22 locations. Not everyone who used the service received personal care. CQC only inspects where people receive personal care. This is help with tasks related to personal hygiene and eating. Where they do we also consider any wider social care provided.
People’s experience of using this service and what we found
Although systems were in place to ensure concerns of abuse were reported, these systems had not always been used by staff and on one occasion had led to people being harmed. The provider was investigating this at the time of the inspection and gave us assurances that lessons would be learnt.
Incidents had occurred within the service that indicated that staff did not always provide care that achieved good outcomes for people. Incidents had occurred in the service that exposed people to harm. Although the provider had taken action in response to each incident, further work was required to address the culture within the service and monitor staff practice so they could be sure people were safe.
Risks to people's safety had been assessed and staff knew the actions they should take to reduce risks. There were systems in place to ensure there were enough staff to meet people’s needs and medicines had been given in a safe way.
There were systems in place to monitor the quality of the care provided and people had opportunity to feedback on their experience of the care.
We expect health and social care providers to guarantee autistic people and people with a learning disability the choices, dignity, independence and good access to local communities that most people take for granted. Right Support, right care, right culture is the statutory guidance which supports CQC to make assessments and judgements about services providing support to people with a learning disability and/or autistic people. Based on our review of Safe and Well Led, the service was not able to demonstrate how they were meeting some of the underpinning principles of Right support, right care, right culture. Although people were supported to exercise choice and control over their daily lives, our review of incidents that had occurred in the service indicated that the culture was not always empowering and had led to poor experiences for some people. This related to staff practice exposing people to risk of harm.
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 18 June 2021).
Why we inspected
We received concerns in relation to how people were safeguarded from abuse and staffing levels. As a result, we undertook a focused inspection to review the key questions of safe and well-led only.
We reviewed the information we held about the service. No areas of concern were identified in the other key questions. We therefore did not inspect them. Ratings from previous comprehensive inspections for those key questions were used in calculating the overall rating at this inspection.
The overall rating for the service has changed from good to requires improvement. This is based on the findings at this inspection. We have found evidence that the provider needs to make improvement. Please see the safe and well-led sections of this full report.
Follow up
We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.