SJOG Hospitaller Services Northern Supported Living

St John of God Hospitaller Services Northern Supported Living provides personal care to people. At the time of the inspection the service was supporting 19 people with personal care. People lived in a variety of houses and bungalows across the north east area in partnership with a housing provider.

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

We expect health and social care providers to guarantee people with a learning disability and autistic people respect, equality, dignity, choices and independence and good access to local communities that most people take for granted. ‘Right support, right care, right culture’ is the guidance CQC follows to make assessments and judgements about services supporting people with a learning disability and autistic people and providers must have regard to it.

Right Support:

People were supported to have maximum choice and control of their lives and staff assisted them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice. People were supported safely with medicines. Staff followed Infection prevention and control good practice guidance.

Right Care:

Staff understood how to protect people from poor care and abuse. The service had enough appropriately skilled and trained staff to meet people’s needs and keep them safe. Where people had support, this was flexible, available when they needed it and to the level they needed. Care and support was provided in a person-centred way. People said staff treated them with care and kindness and supported them to take part in their individually preferred activities and to follow their own lifestyles. Staff understood people's individual communication needs.

Right Culture:

Staff placed people's wishes, needs and rights at the heart of everything they did. They sought advice and feedback from everyone involved in people's care. The service was open to new ways of working and ongoing developments were introduced to promote independence and continuous improvement. Staff told us they were supported by a strong management team who supported them personally and professionally.

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 11 January 2018).

Why we inspected

This inspection was prompted by a review of the information we held about this service.

For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating. The overall rating for the service has remained good. This is based on the findings at this inspection.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for St John of God Hospitaller Services Northern Supported Living on our website at www.cqc.org.uk.

Follow up

We will continue to monitor information we receive about the service, which will help inform when we next inspect.

St Bede’s House provides 24 hour care and support for one person who has a learning disability and lives in their own home.

The service has 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.

At the last inspection, the service was rated Good.

At this inspection we found the service remained Good. We have rated the effective domain was outstanding due to the innovative and multidisciplinary approach used by the provider to support the person to lead a more fulfilled life.

Relatives felt the service was safe. Policies and procedures were in place to keep people safe such as safeguarding, whistleblowing and health and safety. Staff were trained in safeguarding and understood the importance of acknowledging poor practice and reporting their concerns to management. Medicines were managed safely by trained, competent staff. Accident, incident and safeguarding concerns were recorded and investigated to prevent any reoccurrence. Infection control procedures were followed. Staff had access to personal protective equipment. The provider had a file containing information for staff in case of an emergency to ensure service continuity.

Relatives described the effectiveness of the service as amazing and excellent. The provider used a holistic approach to assessing and planning support to meet the person's outcomes. Staff supported the person to achieve their outcomes by using an innovative method by using a range of activities. Staff worked diligently to plan activities which enabled the person to sample various outings and events using behaviour monitoring to recognise which benefited the person in reducing behaviours that may challenge. The provider used current legislation and national guidance when supporting the person. For example, Social Care Institute of Excellence guidance on co-production. Co-production is a method of ensuring people are involved in planning their support. Staff were trained in a range of subjects to meet the needs of the service. Supervision and appraisals were in place for staff following yearly planners. Referrals to health and social care professionals were made when appropriate to ensure healthcare was monitored. Staff provided support and guidance with nutritional needs. 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. Staff gained consent before any intervention with the person.

Staff were caring in their approach with the person they supported. Staffing rotas were developed to ensure staff had the opportunity to spend quality time with the person. Staff put the person at the heart of everything they did. They also offered kindness and maintained relationships with relatives as part of their caring role. The culture within the service was one which promoted personalised care tailored to the person’s needs. Staff respected the person’s privacy and dignity ensuring their independence was promoted. Staff were aware of the person’s life history and knew how important contact with their family was.

Care plans were individualised and contained information on how to support the person in a person centred way. Plans were in place to meet the person’s physical, mental, social and emotional well-being. The staff used a variety of methods to gain information when developing support plans. For example, life history and assessments from other health and social care professionals. Where possible the person was involved in how they preferred their support to be delivered. The provider had a system and process in place to manage complaints which included pictorial information. No complaints had been made to the service. End of life care was not relevant at this inspection.

The provider had an effective quality assurance process in place to ensure the quality of care provided was monitored. The registered manager and service improvement manager’s audits fed into the service’s action plan. People and relatives views and opinions were sought and used in the monitoring of the service. The provider maintained links and worked in partnership with organisations to ensure best practice and national guidance was incorporated into the quality of care provided. The registered manager held regular meetings to discuss best practice and share learning. Staff felt the registered manager was open and approachable. Staff felt supported by the provider. The provider was meeting the conditions of their registration and submitted statutory notifications in a timely manner. A notification is information about important events which the service is required to send to the Commission by law.

With advance agreement we contacted the representative of the person who used the service. They told us that the service was 'very good'. They were 'happy enough' with the care received and felt their relative was 'settled' because of the continuity of care from the same staff who knew their needs really well. The service kept them updated with the care received and communicated well with them telephoning regularly and discussing issues when they visited.

We found that the service had suitable arrangements in place to act in accordance with the person's wishes. Care and support met the person's needs and protected their rights.

The staff which were employed by the service were suitable and adequately skilled. There was an effective system in place to assess and monitor the quality of the service provided and records were accurate which protected the person from risks of unsafe or inappropriate care and treatment.

With advance agreement we contacted the representative of the person who used the service. They told us the service was 'wonderful in all respects'. They said they 'couldn't praise the organisation enough but specifically the individuals (who provide care)'. They told us that staff kept their relative safe and promoted their independence as far as they possibly could and they were almost like family. The representative said that the family were very involved with the choices regarding the care of their relative and they attended regular review meetings with the manager and staff in their relative's home.