We carried out a review of the data available to us about Cartref Homes Supported Living Scheme on 6 July 2023. We have not found evidence that we need to carry out an inspection or reassess our rating at this stage.
This could change at any time if we receive new information. We will continue to monitor data about this service.
If you have concerns about Cartref Homes Supported Living Scheme, you can give feedback on this service.
Cartref Homes supported living scheme was providing care and support to16 people living in six supported living settings at the time of inspection. The service provides specialist support to people with learning disabilities, autism, mental health needs and physical disabilities to help them to live as independently as possible and achieve their goals. Staff provided flexible support across 24 hours, including sleeping in overnight.
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 services people lived in were small, no more than five people shared together, and property was sought to meet people’s needs. People had access to shared areas and private areas, and could lock their bedroom doors to maintain their privacy and security. Gardens were accessible, some people chose to maintain their own garden areas and others chose to pay for the services of a gardener.
People’s experience of using this service and what we found
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. Staff supported people to make the choices and decisions they were able to on a day to day basis. People were part of the local community, accessing local shops and leisure opportunities or working in either a part time paid capacity or as a volunteer. People told us about the holidays they had been able to take.
There were enough staff to make sure people received the support they were assessed as needing, including going out to their chosen activities. Some people needed to have more supervision than others. Risks were carefully and positively managed while promoting independence. Staff understood their responsibilities in safeguarding people from abuse and helping people to understand how to stay safe.
Staff received the training, support and supervision they needed to carry out their role and achieve their personal development goals. Staff supported people to maintain and improve their health by encouraging a healthy diet and to access healthcare when needed.
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 care and support was individual, planned and provided in a way that put them at the centre of planning. Staff knew people well, their likes, dislikes and what and who was important to them. The individual way people communicated was key to the support provided, including verbally, or by their behaviour or body language.
There was an open culture, led by the two registered managers who were described by staff as being approachable and supportive. People knew the registered managers and were relaxed in their company. The provider had a good oversight of the service, using their monitoring processes to make sure people received a good quality and safe service.
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 (published 24 August 2018) and there were two breaches of regulation. 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
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.
There had not been a registered manager at since October 2017. The manager of the service had started the process to become the registered manager in April 2018 and their application was being processed at the time of this inspection. 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.
At the last inspection on 27 April 2016 we rated the service as Good. At this inspection on 21 June 2018 we found two breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.
Quality assurance processes were not effective. The provider’s training programme did not ensure that staff had the essential training they required for their roles. New staff had not received all the training they required to safely carry out their roles before supporting people alone in the community. Existing staff had not had their training refreshed at frequency outlined by the provider, to make sure they continued to have the skills and knowledge they required to support people. There were shortfalls in health and safety, fire, infection control, food hygiene, moving and handling and first aid.
People were protected against the risk of abuse. Staff and the management team knew how to recognise and report any safeguarding concerns and were confident in doing so. People knew how to raise a concern or complaint and there were processes in place to respond to these.
Risk assessments were detailed and gave staff guidance about any action staff needed to take to make sure people were protected from harm. When people presented behaviours that may challenge themselves or others, effective strategies were in place which had been developed in consultation with a clinical psychologist.
Effective recruitment processes were in place. There were suitable numbers of staff available so that people’s individual needs were met at the times that they required support.
People understood the importance of keeping their home clean and were supported by staff to do so.
People were supported to have maximum 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 were supported to maintain their health, access health services and were given information about how to eat healthily.
People told us staff were kind and caring and helped them to be independent. Staff supported people to take practical steps towards achieving their goals.
The provider was effective in responding to people’s changing needs. People's view and experiences were sought and acted on so that people felt that they were really listened to.
Feedback from people, relatives and professionals was that the service was well managed and that staff and managers were approachable.
The provider worked alongside other agencies to continuously improve the quality of service provided.
You can see what action we told the provider to take at the back of the full version of this report.
Cartref Supported Living Scheme provides services for younger adults, including people with learning, autism and physical disabilities. They provide personal care to people in their own home and also support people to access the community. The service provides care for people in and around the Sittingbourne area. There were four people receiving support to meet their personal care although most only needed minimal support. The service also supported people to access the community and there were a further five people who they provided services to who did not require personal care.
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.
People were protected against the risk of abuse. All staff were trained and recognised the signs of abuse what to look out for. Both the registered manager and staff understood their role and responsibilities to report any safeguarding concerns and were confident in doing so.
Risk assessments were detailed and gave staff guidance about any action staff needed to take to make sure people were protected from harm.
Effective recruitment processes were in place and followed by the registered manager. Staff had received training relevant to their roles. Staff had the opportunity to discuss their performance during one to one supervision meetings and had an annual appraisal that discussed their future development and possible further vocational training.
There were suitable numbers of staff available to meet people’s needs. People’s planned care was allocated to members of staff at appropriate times.
Staff were trained to assist people with their medication, with some people being able with minimal support to self-medicate. We found some issues with the way medication was being recorded and have made a recommendation about that.
People were supported to access the community regularly. People were also supported and helped to maintain their health and to access health services if they needed them.
People told us staff were kind, caring and communicated well with them. People’s information was treated confidentially. Paper records were stored securely in locked office.
Procedures, training and guidance in relation to the Mental Capacity Act 2005 (MCA) was in place which included steps that staff should take to comply with legal requirements.
People’s view and experiences were sought through review meetings and through surveys. People’s views about the service they received were positive.
People were supported to be as independent as possible. People told us that the service was well run. Staff were positive about the support they received from the registered manager. They felt they could raise concerns and they would be listened to.
Audit systems were in place to ensure that care and support met people’s needs.
Communication between staff within the service was good. They were made aware of significant events and any changes in people’s support needs.