Archived: Select Lifestyles Limited

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.

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. 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

People were supported by staff who knew how to keep them safe and report concerns of abuse. Risk assessments had been completed to highlight risks to people’s safety and how these risks can be addressed. Staff knew people and the risks to their safety.

People were provided with their medicines in a safe way. There were effective systems in place to reduce the risks associated with COVID-19. There were systems in place to ensure people received their support at the times they needed this.

There were improved systems in place to monitor the quality of the care provided. People and their relatives were provided with opportunity to feedback on their experience of care. People, relatives and staff all spoke positively about the management of the service and felt the service was well led.

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.

This service was able to demonstrate how they were meeting the underpinning principles of Right support, right care, right culture. People were involved in the planning of their care and accessed support that met their individual interests and hobbies. People’s independence was encouraged and we saw people preparing their own meals and going out independently where able. The managers at the service and staff all described their priority as being to deliver person centred care, that met people’s individual needs. This was reflected within care records and conversations with staff who demonstrated extensive knowledge of people’s lives, interests and what mattered to them.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection and update

The last rating for this service was requires improvement (Report published 16 January 2020)

The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection we found improvements had been made and the provider was no longer in breach of regulations.

Why we inspected

The inspection was prompted in part due to concerns received about how people’s finances were managed and potential financial abuse. A decision was made for us to inspect and examine those risks. We found no evidence during this inspection that people were at risk of harm from this concern. Please see the Safe 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.

Select Lifestyles Limited is registered to provide personal care to people within a supported living setting. On the day of the inspection 59 people were being supported with a learning disability.

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

Not all risks to people had been assessed and while some care staff could explain how they managed risks, this was not consistent. Risks related to self-harm had not been mitigated against. This exposed people to the potential of harm. Improvements were needed around the safe management and recording of medicines administration.

The provider’s systems for assessing and monitoring the quality of the service provided were not being used effectively. These systems were not effective in ensuring the risks to people’s health and safety were appropriately monitored and mitigated against.

Care staff described how they would keep people protected from potential abuse and knew how to report allegations of poor practise. Appropriate recruitment systems were in place to ensure care staff were recruited safely. The provider had sufficient care staff to support people and care staff knew how to protect people from the risk of infection.

Services for people with learning disabilities and or autism are supported

The service has been developed and designed in line with the principles and values that underpin Registering the Right Support and other best practice guidance. This ensures that people who use the service can live as full a life as possible and achieve the best possible outcomes. The principles reflect the need for people with learning disabilities and/or autism to live meaningful lives that include control, choice, and independence. People using the service receive planned and co-ordinated person-centred support that is appropriate and inclusive for them.

The service consistently applied the principles and values of Registering the Right Support and other best practice guidance. These ensure that people who use the service can live as full a life as possible and achieve the best possible outcomes that include control, choice and independence.

The outcomes for people using the service reflected the principles and values of Registering the Right Support by promoting choice and control, independence and inclusion. People's support focused on them having as many opportunities as possible for them to gain new skills and become more independent.

Rating at last inspection

The last rating for this service was Good (Report published 27 April 2018).

Why we inspected

We received concerns in relation to the management of medicines, sufficient staffing and training, financial abuse and the general management of the service. 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.

We have found evidence that the provider needs to make improvement. Please see the list relevant key question sections of this full report.

Follow up

We will continue to monitor the service through the information we receive until we return to visit as per our re-inspection programme. If any concerning information is received, we may inspect sooner.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

We last inspected Select Lifestyles on 21 December 2016, when we rated it as ‘good.’ Since the inspection we had received concerns about care provided for one person and how one safeguarding incident had been managed. The inspection followed up on these concerns and we also discussed the information with partner agencies.

Select Lifestyles is registered to provide personal care to people living in their own homes. At the time of the inspection the service was providing care and support to 32 people who were living in shared accommodation across seven locations. The levels of support people received from the service varied, according to their assessed needs.

A registered manager was in place. A 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 were able to tell us of the needs of the people they provided care for and their roles and responsibilities in keeping people safe. Staff understood how to protect people from abuse and were clear about the steps they would need to take if they suspected someone was unsafe.

People had their individual risks assessed and had plans in place to manage them. Medicines were administered by trained staff to support people’s health needs and records were completed to record this.

The provider had arrangements in place to make sure that there were sufficient and regular staff to provide support to people. Staff told us training helped them meet the specific needs of the people they supported and they attended regular training to ensure they kept their knowledge updated.

People’s consent was appropriately obtained by staff when caring for them. People were involved in developing how they wanted to be supported and were encouraged to be as independent as possible. They were supported to access healthcare appointments and to maintain a healthy diet which reflected their choices and preferences.

People told us that the liked the staff who supported them and staff spoke warmly of the people they cared for. Staff enjoyed their role and felt supported by management team to provide a good service.

Complaints information was available in alternative formats. Relatives and staff were confident of the actions they would take if they had concerns and that that any concerns would be dealt with appropriately.

People told us they enjoyed living in the schemes. Staff and relatives spoke positively about the management of the service and the said it was well run for the people it supported. Staff felt the management team involved them and they were able to raise any areas of concern or new ideas with them. The management team ensured regular checks were completed to monitor the quality of the care that people received and had identified areas they felt would improvement the service for people.

Further information is in the detailed findings below.

Select lifestyles are registered to deliver personal care. They provide support to younger adults with learning disabilities or autism or physical disability within four supported living settings. At the time of our inspection 52 people were accessing this care through the provider.

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.

Staff supported people in a way that made them feel safe. Staff understood the procedures they should follow if they witnessed or suspected that a person was being abused or harmed. Criminal records checks were undertaken before staff were able to begin their role. People were supported to take their medication at the appropriate times. Staff had knowledge of the risks posed to people supported them safely.

Staff had the skills and knowledge required to support people effectively. Staff received an induction prior to them working for the service and they felt prepared to do their job. Staff could access on-going comprehensive training and regular supervision to assist them in their role. Staff knew how to support people in line with the Mental Capacity Act and gained their consent before assisting or supporting them. Staff assisted people to access food and drink and encouraged people to eat healthily.

People were involved in making their own decisions about their care and their own specific needs. People felt listened to, had the information they needed and were consulted about their care. Staff provided dignity and respect to people. People were encouraged to retain a high level of independence with staff there ready to support them if they needed help.

People’s preferences for how they wished to receive support were known and always considered by the care staff. Staff understood people’s needs and provided specific care that met their preferences. Staff considered how people’s diverse needs should be met. People knew how to raise complaints or concerns and felt that they would be listened to and the appropriate action would be taken.

People were happy with the service they received and felt the service was led in an appropriate way. Staff felt well supported in their roles and that their views or opinions were listened to. Quality assurance audits were carried out and were used to develop the service.