Sheffield Supported Living

Sheffield Supported Living Service provides personal care to people living in a ‘supported living’ setting, so they can live as independently as possible. At the time of the inspection there were 56 people using the service who received personal care from six supported living schemes across Sheffield and Rotherham.

People’s experience of using this service and what we found

Systems to assess, monitor and improve the service were not effectively implemented.

Risk assessments were not always effective as they were not frequently updated to reflect people's current needs. Medicines were mostly managed in a safe way but systems in place to check staff competency and training required improvement. Systems to safeguard people from abuse were not always effectively implemented or monitored.

We expect health and social care providers to guarantee autistic people and people with a learning disability the choices, dignity, independence and good access to local communities that most people take for granted. Right Support, right care, right culture is the statutory guidance which supports CQC to make assessments and judgements about services providing support to people with a learning disability and/or autistic people.

This service was able to demonstrate how they were meeting some of the underpinning principles of Right support, right care, right culture.

Right support:

People using the service lived in small domestic style properties to enable them to have the opportunity of living a full life. People had their own bedroom and shared lounge and kitchens. Where required staff slept in the house to be available in the event of an emergency.

Right care:

Care and support plans were person-centred but not always reviewed or updated to reflect peoples changing needs.

Right culture:

The service promoted people’s independence and choice to support people to be part of their community and participate in the activities they wanted to do.

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 29 July 2019).

Why we inspected

The inspection was prompted in part due to concerns received about the care people were receiving. A decision was made for us to inspect and examine those risks. As a result, we undertook a focused inspection to review the key questions of safe and well-led only.

We reviewed the information we held about the service. No areas of concern were identified in the other key questions. We therefore did not inspect them. Ratings from previous comprehensive inspections for those key questions were used in calculating the overall rating at this inspection.

The overall rating for the service has changed from good to requires improvement. This is based on the findings at this inspection. We have found evidence the provider needs to make improvement. Please see the safe and well led sections of this full report.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Sheffield Supported Living on our website at www.cqc.org.uk.

Enforcement

We are mindful of the impact of the COVID-19 pandemic on our regulatory function. This meant we took account of the exceptional circumstances arising as a result of the COVID-19 pandemic when considering what enforcement action was necessary and proportionate to keep people safe as a result of this inspection. We will continue to monitor the service to keep people safe and to hold providers to account where it is necessary for us to do so.

We have identified breaches in relation to safeguarding service users from abuse and improper treatment and governance at this inspection.

Please see the action we have told the provider to take at the end of this full report.

Follow up

We will request an action plan for the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.

Wensley Street provides personal care to people living in a ‘supported living’ setting, so that they can live as independently as possible. People using the service lived in six neighbouring houses, with office accommodation on the same site. The service can support up to 30 people with learning disabilities. At the time of this inspection 20 people were living at the service.

People’s experience of using this service and what we found

People told us they felt save living at Wensley Street. Staff understood what it meant to protect people from abuse. They told us they were confident any concerns they raised would be taken seriously by the registered manager. Safe procedures were in place to make sure people received their medicines as prescribed. There were enough staff available to ensure people’s care and support needs were met. The provider had effective recruitment procedures in place to make sure staff had the required skills and were of suitable character and background.

Staff were provided with an effective induction and relevant training to make sure they had the right skills and knowledge for their role. Staff were supported in their jobs. Staff understood the requirements of the Mental Capacity Act 2005. 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 relevant health and social care professionals to ensure they were getting the care and support they needed to best meet their needs.

Positive and supportive relationships had been developed between people and staff. People were treated with dignity and respect. Staff were committed to promoting people’s independence.

People’s care and support was planned and delivered in a way that ensured it met their needs and reflected their preferences. The care records we looked at included risk assessments. They had been devised to help minimise and monitor the risks, while promoting the person’s independence as far as possible. We saw people’s care records were regularly reviewed with the person.

There were effective systems in place to monitor and improve the quality of the service provided. People and staff told us the registered manager and team leaders were supportive and approachable. People and staff were asked for their opinion of the quality of the service via regular meetings and satisfaction surveys. The service had up to date policies and procedures which reflected current legislation and good practice guidance.

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 engage with the local community and become more independent.

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 7 July 2018) and there were three breaches of regulations. 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.

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. People using the service lived in six neighbouring houses, with office accommodation on the same site.

Care services for people with learning disabilities should developed and designed in line with the values that underpin the Registering the Right Support and other best practice guidance. These values include choice, promotion of independence and inclusion. People with learning disabilities and autism using the service can live as ordinary a life as any citizen.

At the time of the inspection 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 and associated Regulations about how the service is run.

Staff did not always ensure that people were engaged with when at home, meaning that people were at risk of social isolation. However, we found that people were supported to engage in activities in the community.

Care plans were not always personalised to people’s individual needs, and risk assessments were not always adhered with.

We found that the way that medicines were managed at the service required improvement so that people received their medicines as prescribed.

The provider did not always comply with the Mental Capacity Act in relation to consent and making decisions in people’s best interests.

The provider ensured that when people’s needs changed appropriate referrals were made to external healthcare professionals, and people’s needs were met in relation to nutrition and hydration.

There was a comprehensive programme of audits within the service, however, they had not identified shortfalls or concerns within service provision.

Wensley street had been a care home accommodating up to 30 people. In August 2016 they changed their registration status to provide supported living. Supported living means that people are supported to live in a way that they want and that people are given more choice and control.

The service did not meet all the regulations we inspected and were given requirement actions for not following their own recruitment practices. You can see what action we told the provider to take at the back of the full version of the report.

There was a manager at the service who was registered with CQC. 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.

Arrangements were in place to ensure medicines were safely administered but there had been a number of medicine administration errors. The registered manager told us they were working with the pharmacist to improve the medicines administration and to ensure all staff were competent in the process.

We have made a recommendation about the safe management of medicines.

Recruitment practices ensured that the staff employed were suitable to work with people but there were some gaps in staff personnel files. The registered manager was reviewing staff files to make sure all the required documentation was there. Staff received training and support to deliver a good quality of care to people.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the registered provider’s policies and systems supported this practice.

People were involved in menu planning, shopping and meal preparation. We saw people were able to choose what they wanted to eat and there was no set times. There was plenty choice of food and snacks were available.

Staff respected people’s privacy and dignity and spoke to people with understanding, warmth and respect. There was a friendly, homely atmosphere and staff supported people in a kind and caring way that took account of their individual needs and preferences. People’s needs had been identified, and from our observations, we found people’s needs were met by staff who knew them well.

Care records detailed people’s needs and were regularly reviewed.

There were systems in place for monitoring quality, which were effective. Where improvements were needed, these were addressed and followed up to ensure continuous improvement. The registered manager was aware of how to respond to complaints. Information on how to report complaints was clearly displayed in the service.