Background to this inspection
Updated
10 February 2024
The inspection
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 Health and Social Care Act 2008.
Inspection team
The inspection was undertaken by 1 inspector and a second inspector carried out telephone interviews with staff members.
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.
Registered Manager
This provider had a registered manager to oversee the delivery of regulated activities at this location. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Registered managers and providers are legally responsible for how the service is run, for the quality and safety of the care provided and compliance with regulations.
At the time of our inspection there was a registered manager in post.
Notice of inspection
We gave the service 3 days’ notice of the inspection. This was because the service is small and people are often out and we wanted to be sure there would be people at home to speak with us.
What we did before the inspection
We used the information the provider sent us in the provider information return (PIR). This is information providers are required to send us annually with key information about their service, what they do well, and improvements they plan to make. We reviewed information we had received about the service since the last inspection. We used all this information to plan our inspection.
During the inspection
We spoke with the registered manager, the nominated individual who also a director of the company and 1 person who was receiving support. We looked at a range of records which included the care records for 4 people, 3 care workers’ files and a range of records including medicines records and policies. We spoke with 3 staff members following the inspection.
Updated
10 February 2024
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.
About the service
Heston Care Services Ltd is a supported living service for people with learning disabilities and/or autism. At the time of the inspection, 4 people were living at the service and they had their own bedrooms and tenancies with access to communal areas. One of the people being supported lived in a annexe in the garden of the location. A fifth person who received support was living at another location.
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. There were 4 people who received support or encouragement with personal care and 1 person who received support with their medicines.
People’s experience of using this service and what we found
Right Support
People’s medicines were not always administered in line with the provider’s procedure and best practice. People were able to go shopping, access their religious community and visit people with staff providing support when requested.
Right Care
People’s care plans were not always written in a person-centred manner to identify the support that was required and how the person wanted their care provided. The provider did not always investigate incidents and accidents, safeguarding concerns or complaints to enable them to identify where lessons to be learned to reduce possible risks. Risk management plans were not always developed to provide guidance on how to mitigate the identified risks.
Right Culture
The provider did not have quality assurance processes in place which enabled them to identify when improvements were required to records and the way care was provided. The provider had a recruitment process enabling them to identify new staff with the required skills and experience for the role. The provider worked in partnership with the local authority and healthcare professional involved in people’s care.
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 7 February 2019).
Why we inspected
This inspection was prompted by a review of the information we held about this service. The local authority carried out an assessment of the provider and they shared a copy of the action plan developed by the provider. You can see what action we have asked the provider to take at the end of this full report.
Enforcement and Recommendations
We have identified breaches in relation to person centred care, safe care and treatment and good governance at this inspection.
Full information about CQC’s regulatory response to the more serious concerns found during inspections is added to reports after any representations and appeals have been concluded.
Follow up
We will request an action plan from 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 continue to monitor information we receive about the service, which will help inform when we next inspect.