Archived: North West Supported Living Service

North Cumbria Domiciliary Support Service runs two different types of service to people with learning disabilities/and or autism. One is a supported living service that supports people to live in their own home as independently as possible. People’s care and housing were provided under separate contractual agreements. CQC does not regulate premises used for supported living; this inspection looked at people’s personal care and support. There were 24 people at the time of our inspection across eight houses.

The other service is a Shared Lives Scheme (SLS) which provides people with long-term placements, short breaks and respite care, within shared lives carers (SLC) own homes. At the time of our inspection there were 20 households with 21 people living with and supported by shared lives carers.

The service had 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’s experience of using this service

People were very happy with the support from North Cumbria Domiciliary Support Service. They felt safe and were protected from the risk of harm. Staff supported people to be independent whilst also managing risks. People were supported by trained staff to manage their medicines safely. There were sufficient numbers of staff who were safely recruited.

Staff were knowledgeable of people’s care needs and carried out regular assessment of their needs. Staff received training, supervision and appraisal to equip them for their role. People were supported by staff to access healthcare services and took action when they noticed a deterioration in their health.

Everyone told us staff were kind, caring and considerate and staff went to great lengths to help them live their lives to the full. People lived full lives and had control, choice and their independence was promoted. People were given opportunities to gain new skills and become more independent. Staff treated people with dignity and respect by promoting equality, diversity and protecting their human rights.

The service applied the principles and values of Registering the Right Support and other best practice guidance. People were supported to be active citizens and to fully engage in the local community. They told us staff helped them to lead interesting lives of their choosing. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.

The service was well led. There was an established senior management team of registered manager, shared lives coordinator and a supervisor for each supported living setting. The provider had processes for monitoring the quality of the service and this included opportunities for people to give their opinions about the standard and quality of the service they received.

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 4 May 2017).

Why we inspected

This was a planned inspection based on the previous rating.

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.

This was the first inspection of the service since their registration with CQC.

North Cumbria Domiciliary Support Service is a domiciliary care agency which is registered to provide personal care. The service provides support to people with varying disabilities (aged 18 and above), who live in a supported living setting in the community. The service operates 24 hours per day, seven days per week. The care packages are set up following an assessment of people's needs and support can be provided throughout the day and night. At the time of our inspection there were 8 supported living houses and 23 people used this part of the service.

North Cumbria Domiciliary Support Service also operates a Shared Lives Scheme. This part of the service recruits, assesses and supports paid carers. The carers provide support and accommodation to adults with disabilities who are unable to live independently. Placements are made on a short or longer term basis and the person lives with their carer in their home as part of the family. At the time of our inspection there were 14 households with 21 people living within these families.

There is 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.

There were robust staff recruitment and assessment processes in place for both the Shared Lives Scheme and the supported living aspect of the service.

People who used the Supported Living Service told us that there were usually enough staff available to support them. People were provided with continuity of care because the same staff were usually allocated to work with the same people at the same house. People knew their support workers well and spoke positively about them.

People using the Shared Lives Scheme mostly stayed with their ‘matched’ carer. However, there were arrangements in place to help manage consistent support during holidays, for example.

The shared lives co-ordinator and supervisors were skilled and experienced. They were well supported in carrying out their roles. In turn, they monitored the placements and provided support and advice to the carers.

Shared lives carers and supported living workers were familiar with the safeguarding protocols in place to help keep people safe. They told us that they had received training in this matter and discussed the process with us, giving examples to back up their knowledge.

We checked whether the service was working within the principles of the Mental Capacity Act. People 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.

The people using the services of this provider were encouraged and supported to make choices about their care, support and lifestyle. Where people were not able to make decisions about aspects of their life, the service worked with other professionals. This helped to ensure decisions were made appropriately and in the best interests of the person concerned.

People had individualised care plans and risk assessments in place. These helped to make sure people received the support they expected and needed, in a safe way. However, there were discrepancies with regards to the accuracy of information kept in people’s own home and that maintained at the offices of the service.

We have made a recommendation about keeping records up to date.

Medicines were managed safely with administration records well maintained. However, people using the Supported Living Service were not always encouraged to be more independent and responsible for aspects of their medication needs.

We have made a recommendation about supporting people in the least restrictive way with their medicines.

People who used the services had access to health and social care professionals. Support workers and carers provided support to people when they needed to access services or attend appointments at the doctors or dentist, for example.

People who used the services told us that staff were kind and helpful and that they respected their privacy and dignity.

There were policies and procedures in place to help ensure the service operated effectively. Staff were supported and supervised in their work. Supervision of staff helps to make sure that they work safely and follow the policies and principles of the service.

There was a complaints process in place at the service. Records were kept about complaints although the details of actions taken, outcomes and learning points were not clearly documented.

We have made a recommendation about managing and monitoring complaints.

The provider had processes in place for monitoring the quality of the service. There were systems in place to support people using the services to give their opinions about the standard and quality of the service they received.