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Supported Tenancy Network Good

Reports


Inspection carried out on 5 December 2018

During a routine inspection

The Supported Tenancy Network provides services to people with learning disabilities and complex physical health needs so that they can live as independently as possible in their own homes. People who use the service are tenants in their own right and live with support in various types of accommodation provided by a variety of different landlords.

At the time of the inspection the service was made up of 18 homes, providing support for 60 people who live in the Salford area and who require 24-hour support. The head office is based at the Humphrey Booth Resource Centre, which is located in Swinton.

The provider, which is called Aspire for Intelligent Care and Support C.I.C Ltd, is an employee owned social enterprise and is a ‘community interest company,’ which registered with CQC in June 2015. At the time of the inspection the service continued to receive support from Salford local authority, who had previously operated the service, for human resources and IT support. The service also worked in partnership with the local authority for any new referrals to ensure a person-centred approach to the delivery of care and support.

The 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.

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.

At this inspection we found the service remained Good.

There was a registered manager at the service. 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 told us they felt safe when receiving a service at home and were supported to have 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. People’s relatives also confirmed they felt [their relative] was safe.

The ethos of the service was to promote people’s skills and independence. People were supported and encouraged to do tasks for themselves, for example making and buying their own food. People were supported to take positive risks, such as travelling independently.

Each person had a communication care plan which comprehensively detailed how they communicated what they wanted and how they were feeling. This included verbal and non-verbal communication, with communication aids being used where required, for example in pictorial format.

Care plans were written with easy read symbols and simple words to inform people about their care, support and activities. Information was available in an easy read format, for example the guide to services and complaints procedure.

Risks people may face were assessed and clear guidance was provided for staff to reduce and manage these risks. Staff assessed people’s moods moment by moment and any activities undertaken were tailored to the person’s current mood and level of anxiety.

Detailed positive behaviour support plans were used to identify people’s complex behaviours and the strategies and techniques required to reduce their anxieties.

Comprehensive annual reviews were held, with family involvement, which identified what was working well, areas for development and strategies and plans for the future.

Inspection carried out on 18 and 24 November 2015.

During a routine inspection

This was an announced inspection carried out on the 18 and 25 October 2015.

The Supported Tenancy Network provides services to people with learning disabilities and complex physical health needs so that they can live as independently as possible in their own homes. People who use the service are tenants in their own right and live with support in various types of accommodation provided by a variety of different landlords. The service is currently made up of 18 homes, providing support for 63 tenants who live in the Salford area and who require 24 hour support. The head office is based at the Humphrey Booth Resource Centre, which is located in Swinton.

The provider, which is called Aspire for Intelligent Care and Support C.I.C Ltd, is a new employee owned social enterprise and is a ‘community interest company,’ which registered with CQC in June 2015.The service had up until that point been operated by Salford City Council. The ‘community interest company’ structure is intended to ensure that assets are kept within the company and activities are carried out to benefit the local community. Though Aspire is a new provider, the service is run by the same management team and staff, who were previously employees of the local authority.

There was a registered manager in place. 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 told us that Aspire was owned by the staff who ran it. All staff had the opportunity to purchase a one pound share that had no monetary value, but allowed them to vote at the annual general meeting and have input into how their company was run.

Without exception, everyone we spoke with told us they believed their relative was safe.

We found people were protected against the risks of abuse, because the service had robust recruitment procedures in place.

We found the service had suitable safeguarding procedures in place, which were designed to protect vulnerable people from abuse and the risk of abuse. We looked at the service safeguarding process used to manage any concerns and looked at the service whistleblowing policy.

As part of the inspection we looked at a sample of 15 care files and found that a range of risk assessments had been undertaken by the service. These provided guidance to staff on people’s individual needs and included risk assessments for people using swimming pools, travelling in vehicles, use of public transport, bathing or showering and use of wheel chairs.

The service medication policy included guidance to staff on how to deal with medication errors. Relatives we spoke with told us that they had no concerns about how the service managed and administered medication to their loved ones.

We spoke to staff to see whether they had any concerns about staffing levels following the change of provider. Without exception, staff we spoke with did not raise any staffing concerns and on the whole felt the move to a new provider had been a positive experience.

We looked at the service Learning and Development Plan, which set out the training and development pathway for staff. This involved an induction period followed by mandatory/ continuous training and development for staff.

We looked at supervision and annual appraisal forms and spoke to staff about the supervision they received. We found that staff received regular supervision, which enabled managers to assess the development needs of their staff and to address training and personal needs in a timely manner.

At the time of our inspection, there were a number of people who were subject of a Deprivation of Liberty Safeguards (DoLS). Staff we spoke to were able to explain the principals of the legislation and confirmed they had received training in Mental Capacity Act (MCA), which we verified from looking at training records.

We asked staff how they sought consent from people who had difficulty communicating. A house manager explained how the service had recently purchased IPads to support people with communication and making choices.

Without exception, people told us that staff were kind, caring and dedicated to their role.

We observed a very caring environment where staff clearly knew the people they supported. Interaction was affectionate and sincere.

People we spoke with confirmed that they felt fully involved in determining their relative’s care needs. People confirmed they were involved in regular reviews of care and felt listened to by the service.

People told us that they believed the service was responsive to their needs, listened and acted upon any concerns they raised.

We found people who used the service were encouraged to live independent lives and were supported to undertake activities within the local community. Homes we visited were able to demonstrate how people were involved in daily activities and stimulation. We looked at weekly activity programmes showing community based activities.

Care plans provided clear guidance to staff on the level of support required and were regularly reviewed.

We found the service had systems in place to routinely listen to people’s experience, concerns and complaints. Most people we spoke with knew how to make a complaint, although had not needed to make one. Those who had made a complaint felt their complaint was listened to and that action was taken to resolve the issue.

People told us that they believed the service was well managed and they had noticed no change in services provision since transferring from the local authority to the current provider.

Staff told us that management encouraged an open and transparent culture amongst staff and felt the transition to Aspire had gone smoothly and felt it was a positive move. Staff told us that they believed they now had more freedom to be innovative in supporting people without the constraints of the local authority. Staff felt valued and supported in their role.

We found that regular reviews of care plans and risk assessments were undertaken. Regular supervision of staff was also undertaken by the service. We found the service undertook a range of comprehensive checks and audits to monitor the quality of service delivery.

We looked at how the service learnt from any incidents, complaints or safeguarding matters. The service demonstrated to us where lessons had been learnt, what immediate action had been taken and where action plans had been put in place to address deficiencies such as medication errors.