13 February 2020
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.
This inspection was carried out by one inspector.
Service and service type
This service provides care and support to people living in two ‘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
This inspection was announced. We gave the service 48 hours' notice of the inspection. This was because it is a small service and we needed to be sure that the provider or registered manager would be available to support the inspection.
What we did before the inspection
We reviewed information we had received about the service since the last inspection. We contacted the local authority for their feedback. We used the information the provider sent us in the provider information return (PIR). This is information providers are required to send us with key information about their service, what they do well, and improvements they plan to make. This information helps support our inspections. We used all of this information to plan our inspection.
During the inspection
We spoke to one person who used the service about their experiences. We spoke with five members of staff including the registered manager, the provider, deputy manager and two support workers.
We reviewed a range of records. This included a person’s care records and medication records. We looked at three staff files in relation to recruitment and staff supervision. A variety of records relating to the management of the service, including policies and procedures were reviewed.
After the inspection
We continued to seek clarification from the provider to validate the evidence found. We looked at training data, minutes of meetings and policies and procedures. We emailed two health professionals who visit the service and received responses. We spoke with a relative and two people who provide community activities for the people who used this service.
13 February 2020
About the service
Reflective Care Limited provides personal care for young people living with a learning disability in a supported living setting; with people as tenants in shared houses for three to six people. The service supports people to live in their own homes as independently as possible, while continuing to develop daily living skills, such as making drinks and preparing meals. At the time of this inspection two people were receiving personal care and lived in New Romney and Folkestone.
People have their own rooms and can access shared communal facilities a lounge, dining room, kitchen and laundry, when they wish. Staff are available for 24 hours, seven days a week and there are facilities at each house to keep records secure.
Not everyone living in the houses received the regulated activity although they received a level of
support. CQC only inspects the service being received by people provided with 'personal care’. Personal care includes help with tasks related to personal hygiene and eating. Where they do, we also take into account any wider social care provided.
People’s experience of using this service and what we found
The people who received support and personal care had lived in the shared houses for several years. People knew staff very well; staff had a good understanding of each person’s individual support needs and they had the skills to provide the care people wanted and needed.
People were empowered to be involved in how the service developed. Staff assisted people to make their preferences known and supported them to make decisions about how and where they spent their time. This meant 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.
People’s needs, and preferences had been assessed and recorded. Support plans included information about people’s lives, including life histories, their likes and dislikes and health care needs. They were discussed, agreed and reviewed with people, their relatives or representatives and appropriate health and social care professionals.
An effective quality assurance system monitored the services provided and action had been taken when areas for improvement had been identified. The management continually sought feedback from people, relatives and health professionals and those we spoke to were consistently positive about the services provided. A complaints procedure was in place and staff encouraged people to raise any concerns they might have.
Staff were complimentary about the provider and registered manager. They said they all worked together as a team, to ensure people were comfortable and received the support and care they needed. Staff said the registered manager was approachable and had an open-door policy.
Regular team meetings enabled staff to discuss any changes in people’s needs and put forward suggestions to improve practice and outcomes for people. Meetings were also held in the houses for people to discuss the day to day management in each, such as who is responsible for cleaning and cooking, and other aspects of the support provided.
Staff had completed relevant training and were supported to develop their roles and responsibilities through supervision and ongoing training to develop their practice. Robust recruitment procedures ensured only suitable staff were employed.
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 10 May 2017)
Why we inspected
This was a planned inspection based on the previous rating.
We will continue to monitor information we receive about the service until we return to visit as per our inspection programme. If we receive any concerning information we may inspect sooner.