Bells Piece Supported Living Service

Bell’s Piece Supported Living Service provides support to people living in their own homes. At the time of the inspection they were providing personal care and support to nine people. People who live in supported living properties have individual tenancy agreements. Some people lived in flats on a site that held the main office and had a residential home and day care facilities. Other people lived in the community.

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.

The Secretary of State has asked the Care Quality Commission (CQC) to conduct a thematic review and to make recommendations about the use of restrictive interventions in settings that provide care for people with or who might have mental health problems, learning disabilities and/or autism.

Thematic reviews look in-depth at specific issues concerning quality of care across the health and social care sectors. They expand our understanding of both good and poor practice and of the potential drivers of improvement.

As part of thematic review, we carried out a survey with the manager at this inspection. This considered whether the service used any restrictive intervention practices (restraint, seclusion and segregation) when supporting people.

The service used positive behaviour support principles to support people in the least restrictive way. No restrictive intervention practices were used.

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 were happy with the service provided. They had positive relationships with staff and said; “I’m happy with the staff.”

People told us they felt safe and systems were in place to safeguard people. Risks to them were identified and managed. The support required with medicines was assessed, agreed and provided to people. Infection control measures were in place to prevent cross infection. Staff were suitably recruited. People were supported by a consistent staff team and the staffing levels were flexible to enable the service to provide a bespoke service to people.

People were supported by staff who were inducted, trained and supervised. The support required by people with health and nutritional needs was identified and provided. 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 confirmed staff were kind and caring. Their privacy and independence were promoted.

Systems were in place to deal with concerns and complaints. This enabled people to raise concerns about their care if they needed to.

People had person centred care plans in place. They were actively involved in their care and contributed to the development of care plans and reviews. Some people had staff support to access activities and holidays. This was flexible and provided in response to people’s choices. People’s communication needs were identified, and their end of life wishes were explored and recorded.

People were supported by a service that was well managed. The manager has been in post for a short time and is yet to register with the CQC. Records were organised, accessible and up to date. The service was audited, and action taken to address any areas they had identified that needed improving. People and staff were complimentary of the manager and said; “Very approachable” and “Most approachable we’ve had” and “Is really good[staff] will help with any problems we have.” Staff were committed to providing good outcomes for people.

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 3 January 2017).

Why we inspected

This was a planned inspection based on the previous rating.

The overall rating for the service remains unchanged and the service is rated good. This is based on the findings at this inspection.

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.

Bells Piece Supported Living Service provides support to people living in their own homes. They provide care and support in the area of Farnham, Surrey. People who live in the supported living properties have individual tenancy agreements. At the time of the inspection they were providing personal care and support to nine people. We based our inspection at the Bells Piece Care Home which is also the site of the supported living office. People visited the site regularly to take part in various activities associated with their support and interests.

There is a registered manager in post. 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.

The registered manager had a clear vision for the service. They explained they wanted to develop a service which had the possibility to empower people and the ability to manage what came with that. This meant listening to people, learning and reflecting on what they said.

People were placed at the centre of decisions made about the care and support they received. All care plans were person centred and written with the person’s involvement. One person said, “They sit down with me and discuss it, it is all mine.” Staff spoke passionately about the way they supported people to be independent and maintain control over their own lives. People worked towards achieving goals and planning for their future. For example people were supported to plan holidays and then to achieve the plan by budgeting and managing their finances effectively.

People’s voices were heard throughout their support. They were supported to comment at regular reviews of their care plans. They also attended monthly tenants meetings when they could discuss issues openly without staff from Bells Piece Supported Living being present.

Staff supported people to maintain a place in the community, for example they had supported one person to move to a ground floor flat. This person said, “They have given me my life back.” This meant they were able to continue to access the community safely and with minimal support.

People were protected from abuse because the provider had systems in place to ensure checks of new staffs’ characters and suitability to work with vulnerable adults were carried out. Staff had also received training in protecting vulnerable people from abuse.

People and their relatives told us the management and staff were very accessible and approachable. They said they could raise issues or concerns informally with any member of staff or with the registered manager and they always received helpful responses. Staff said everyone in the organisation, from the top down, focused on the well-being of the people they supported.

The service had a complaints policy and procedure that was included in people’s support plans. People said they were aware of the procedure and knew who they could talk with. People and staff said they felt confident they could raise concerns with the registered manager and they would be dealt with appropriately. One staff member explained they would always support the person in writing a complaint if they wanted them to.

There were systems in place to monitor the care provided and people’s views and opinions were sought on a daily basis. People were involved in staff recruitment. This meant the staff team could then be matched to the person on the basis of their personality and interests, as well as their knowledge and skills. Suggestions for change were listened to and actions taken to improve the service provided. All incidents and accidents were monitored, trends identified and learning shared with staff to put into practice.

One family member told us "I am absolutely delighted with them. They continue to impress me - they are very good". Another family member told us "I do not have any problems - I have always found them to be extremely helpful. My relative is very happy which to me is the most important thing of all. I am very happy with the service".

Care plans that we looked at evidenced staff supporting people to make their own choices about what they had for lunch, what activities they took part in and what they needed support with. Records that we looked at evidenced that people were involved in choosing how and when they wanted their care and support. This indicated that people were involved in planning their care on a daily basis.

One person using the service told us "I really like the staff, they are nice and we do lots of fun things together. We go shopping together and go to the pub. If I do not know what I want to do they give me ideas of things I might like". Another person told us "if I want to stay in all day they don't make me go out but they do encourage me to be more active and go out more. I like the staff - I would not change anything".

We spoke with two people using the service during the inspection. They both told us, in their own way, that they were happy and content.

They showed us their self contained flats and we saw that they had rota's which explained to them in words and pictures when staff would be visiting in order to support them during certain times of the day.

One person showed us their cat and told us that staff accompanied them to the vet with the cat. We talked to the person about their apartment and garden and they appeared happy and content.

We also gathered evidence of the service provider's performance through observing staff practice and sampling records and documents during and following the inspection.