We carried out a review of the data available to us about Brandon Trust Supported Living - Oxfordshire 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 Brandon Trust Supported Living - Oxfordshire, you can give feedback on this service.
About the service
Brandon Trust Supported Living Oxfordshire is a supported living service providing personal and nursing care to people with a learning disability in their own houses and flats. At the time of inspection there were 134 people using the service in 47 separate supported living settings. Some people lived on their own, whilst other people lived in shared accommodation. People received a variable number of care hours per week, depending on their assessed needs.
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 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 able to demonstrate how they were meeting the underpinning principles of Right support, right care, right culture. Right support- People had choice and control around their care arrangements. Care focussed on people’s abilities and promoted their independence. Right care- staff were respectful of people’s dignity, privacy and treated them as individuals with their own beliefs, thoughts and aspirations. Right Culture- the provider’s management displayed caring and person-centred values. They modelled this behaviour to staff and set expectations that these values should be integral to staff’s working practice.
Care enhanced people's lives by helping them to develop their skills and seek opportunities to have useful, fulfilling lives. People were supported to maintain relationships that were important to them and care was arranged so people could access the services and activities which they wished. People’s care plans identified how they would like to be supported and what they would like to achieve with the help of care and support. People’s communication needs were identified and met to help ensure they could give meaningful feedback or raise concerns around their care.
People received safe care focussed on minimising restrictions related to their care to promote their safety. People were supported to take positive risk to promote their independence whilst still receiving support to help keep them safe. There were enough staff in place, who had received the right training and support in their role.
People were supported to lead healthy lives and access healthcare services when required. Staff had worked with many people to overcome their anxieties around accessing healthcare services. Where appropriate, healthcare professionals were involved in planning and reviewing people’s care. Staff were proactive in maintaining these relationships and effective in implementing healthcare professional’s advice.
There were effective systems to oversee the quality of the service. There were registered managers in place who were responsible for organising and overseeing people’s care. The registered managers were knowledgeable, approachable and professional in their role. They had a good understanding of people’s needs and how they wished to be supported.
Staff were caring and kind. People and relatives told us that staff were patient and understanding. Staff were motivated in their role and understood the principles of promoting people’s privacy, dignity by treating them with respect.
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 1 April 2020)
Why we inspected
We undertook this inspection to assess that the service is applying the principles of Right support right care right culture.
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.
We found the following examples of good practice.
Entry to the building was well managed, visitors temperatures were taken and identities recorded.
The management of waste personal protective equipment (PPE) was safe and well organised.
Cleaning schedules were clearly displayed for staff.
The provider worked closely with the registered manager to ensure safety of people living at the service. They would only allow a new admission after a confirmed negative result of the Covid-19 test of a person. Due to the layout and size of the building, social distancing was difficult. However, staff had taken steps that supported people with social distancing where ever possible. The management were aware of zoning guidelines but did not need to implement it as no people were Covid-19 confirmed or suspected in this location.
The provider ensured there was a sufficient stock of PPE and the vetted supplier ensured it complied with the quality standards. Staff had infection control training and understood the correct donning and doffing procedure.
People were supported by a stable and committed team of staff whom they knew well. This helped people to recognize the individual staff with the need to wear face masks. Staff were well supported and praised the management team, comments included, "We are looked after and supported, I’ve no complaints about how things have been managed.”
The provider considered risks and impact of the inspection on the individual staff members, this included around their health conditions as well as their caring responsibilities. Regular testing for Covid-19 had recently been introduced for both people living at the service and the staff. There was a comprehensive contingency plan what to do in case of an outbreak. The provider ensured people's relatives were able to get in touch with people, for example by using technology.
Further information is in the detailed findings below.
Brandon Trust Supportive Living Oxfordshire is a supported living service providing personal care to 129 people at the time of the inspection living across 43 shared or single occupancy households.
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.
People’s experience of using this service and what we found
People received high-quality and person-centred care from staff who were compassionate and dedicated in improving people’s lives and reach their potential. We received many positive comments about the exceptional caring nature of staff and the quality of the management who led the service. Staff were aware of the importance of providing a high standard of care. They supported people to understand changes in their physical well-being and were sensitive and caring towards people who needed emotional support.
Staff at every level were aware of their responsibility of raising and reporting any safeguarding concerns and knew how to whistle-blow. Safeguarding systems used ensured that the service was transparent, and they took opportunities to learn from incidents and take appropriate adjustments to reduce the risk to people.
An initial assessment of people’s needs was carried out to ensure staff could meet their needs. They were given opportunities to visit the household and meet the staff and other people before they transitioned into the service.
People’s personal health and emotional risks were assessed and managed well by staff who were familiar with people’s needs. A balanced approach encouraged people to understand and take action to manage their own risks such as managing their own money. Health care professionals were contacted in a timely manner when people’s needs changed to seek advice and further support.
Suitable numbers of trained staff were deployed across the service to meet people’s needs. Safe recruitment practices were used to ensure people were supported by staff who were of good character. Staff told us they felt supported in their role and trained to meet people’s needs.
Staff were trained in medicines to ensure people’s medicines were managed and administered in line with their prescription and guidance. Staff were knowledgeable in controlling the spread of infection.
People were supported to maintain a healthy diet and access health care services to maintain their personal well-being. Staff monitored people’s risks and contacted health care professionals in a timely manner to seek advice and support.
Each person had a personalised support plan. The service regularly reviewed people's needs and worked in close partnership with people, their relatives and health care professionals to make changes to people’s support requirements and care records. 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.
Feedback from health professionals about the quality of care people received and the management team was extremely positive. The management team had ensured effective and supportive systems were in place to enable a smooth transition of people and staff from another service to transition and integrate into organisation.
Robust quality assurance processes at all levels demonstrated continual monitoring and improvement of the service. The views and feedback from staff were valued and acted on and people were empowered to express their views and be involved in decisions involving them and the service. Records showed that lessons were learnt, and actions were taken when incidents, errors or near misses or complaints had occurred.
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 outstanding (published 10 August 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.
There were four registered managers in post supporting the 59 people. 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.
During the inspection, we found the service provided outstanding care and support to people and was very responsive to their needs, wishes and preferences. All people, relatives and staff spoken with were extremely positive about the service. Staff were fully committed to the values of the service and carried these out in practice. These included ‘Let’s start with the individual’; ‘Let’s try something new’ and ‘What options do we have?’ Throughout the inspection, we saw numerous ways of how this value was implemented and embedded into the ethos of the service.
People spoke highly about staff that had often supported them for a long time and knew them well. Staff used the knowledge to enhance people’s lives supporting them to experience a full life with lots going on and individual to their preferences. People told us staff always treated them with dignity and respect. People benefitted from compassionate and caring staff that were enthusiastic about their roles and aimed to provide support in a kind and empathetic way. Where people reached their end of life stage the staff worked with various professionals, such as hospice teams to ensure people received a holistic approach that ensured a pain free and dignified death.
People were supported to live their life enjoying many experiences and activities to enrich their lives. We saw that every effort was made to engage people in meaningful activities and events and to continuously look at all opportunities.
People told us they were safe. Risks to people’s well-being were assessed and recorded. Staff knew how to report any safeguarding concerns and they were confident the registered manager would take appropriate action when needed. Where people needed assistance with taking their medicine this was monitored and carried out safely.
The registered managers’ ensured staff were continually developed so this approach could be sustained. Staff were well supported and had access to development opportunities to maintain and increase their skills. The provider ensured appropriate checks were carried out before staff started working with people to ensure they were suitable to work with vulnerable people.
People were supported by staff that had the right skills and knowledge to fulfil their roles effectively. Staff told us they were well supported by the management. The team worked closely with various local social and health care professionals. People were supported to meet their nutritional needs and maintain an enjoyable and varied diet.
The Care Quality Commission (CQC) is required by law to monitor the operation of the Mental Capacity Act 2005 (MCA) and report on what we find. 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’s needs were assessed prior to commencement of the service to ensure staff were able to meet people’s needs. People’s care plans gave details of support required and were updated when people’s needs changed. People knew how to complain. People’s input was valued and encouraged to feedback on the quality of the service and to make suggestions for improvements.
People, their relatives and external professionals told us they felt the service was well run. The acting area manager and registered managers promoted a positive, transparent and open culture. Staff told us they worked well as a team and felt valued. The registered manager had systems in place to ensure the service delivery was monitored and actions taken if needed.