24 January 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.
The inspection was carried out by one inspector.
Service and service type
This service provides care and support to people living in a ‘supported living’ setting, 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
We gave the service 24 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 in the office to support the inspection.
Inspection activity started on 26 November 2019 and ended on 28 November 2019. We visited the office location and people at home on 26 November 2019 and spoke to relatives on the telephone on the 28 November.
What we did before the inspection
We reviewed information we had received about the service since the last inspection. We sought feedback from the local authority and Healthwatch. Healthwatch is an independent consumer champion that gathers and represents the views of the public about health and social care services in England. We used all of this information to plan our inspection.
The provider was not asked to complete a provider information return prior to this inspection. This is information we require providers to send us to give some key information about the service, what the service does well and improvements they plan to make. We took this into account when we inspected the service and made the judgements in this report.
During the inspection
People found it difficult to communicate with us about their experiences of support due to their complex support needs, however one person was able to indicate they were happy with the support they received. We spoke with two people’s relatives and one health care professional. We spoke with five members of staff including the provider and four support workers.
We reviewed a range of records. This included two people’s care files and three people’s medicine administration records (MAR). We also examined a variety of records relating to the management of the service, including quality assurance processes and staff supervision and training records.
24 January 2020
About the service
4 Futures provides care and support for people with a learning disability or autistic spectrum disorder, younger adults and older people. The service provides care and support to people living in a 'supported living' setting; the people receiving support at the time of inspection lived in one four-bedroom house.
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. At the time of our inspection, the service was supporting four people, however only three people received support with personal care.
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 cared for safely. Risk assessments were in place and reviewed regularly and as people’s needs changed. Staff understood safeguarding procedures. There were safe procedures in place for the administration of medicines and people received their medicines as prescribed.
Pre-employment checks were carried out to ensure that only suitable staff were employed. There were enough staff to meet people’s care needs.
People made decisions about their daily routines and these were respected by staff. 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 were supported to access health care services when needed. People received the support they needed to meet their nutritional needs.
People’s care records contained clear information covering all aspects of their support needs. Staff had a good understanding of people’s wishes and individual preferences. People’s personal histories, preferences and dislikes and diversity needs such as cultural or religious needs were considered within the care plans.
Staff received the training required to meet people’s needs. Staff enjoyed working at the service and there was good communication and team work. Staff were caring in their approach and people were treated with respect. Staff maintained people’s dignity and promoted their independence.
The service applied the principles and values of Registering the Right Support and other best practice guidance. These ensure that people who use the service can live as full a life as possible and achieve the best possible outcomes that include control, choice and independence.
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.
The registered manager was also the provider. They were involved in all aspects of the running of the service and had suitable processes in place to monitor and develop the safety and quality of the service.
The provider worked in an open and transparent way and was keen to develop and improve the service. People knew how to make a complaint if they were not satisfied with the service received.
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 June 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 re-inspection programme. If we receive any concerning information we may inspect sooner.