We carried out a review of the data available to us about Ablegrange Supported Living on 6 July 2023. We have not found evidence that we need to carry out an inspection or reassess our rating at this stage.
This could change at any time if we receive new information. We will continue to monitor data about this service.
If you have concerns about Ablegrange Supported Living, you can give feedback on this service.
About the service
Ablegrange Supported Living is a supported living service providing personal care to 14 people with learning disabilities and autistic people. The service currently provides the service over 3 different sites which are all in close proximity.
People’s experience of using this service and what we found
The service was able to demonstrate how they were meeting the underpinning principles of right support, right care, right culture.
Right Support: Model of Care and setting that maximises people’s choice, control and independence. Staff were recruited safely and had appropriate training on how to safeguard people using the service. The provider followed current best practice guidelines to effectively manage people's medicines and risks associated with infection prevention and control (IPC). People had individual positive behaviour management plans to guide staff when people became distressed or anxious.
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. If people lack capacity to make certain decisions appropriate support is sought to support them.
Right Care: Care is person-centred and promotes people’s dignity, privacy and human rights. People were encouraged to communicate freely and accessed community for activities when they wanted to. Staff supported people to learn new skills and maintain important contacts.. People's care records were person-centred and up to date. Staff knew people well and understood their support needs which empowered people to make decisions about their care.
Right Culture: The ethos, values, attitudes and behaviours of leaders and care staff ensure people using services lead confident, inclusive and empowered lives. The staff team worked well together making sure people's rights and wishes were protected. The service had regular communication with the healthcare professionals which led towards good working relationships and empowered people to choose the way they wanted to live their lives. The registered manager led by example and people were supported to take positive risks and were supported to do more things on their own.
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 good (published 18 March 2021).
You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Ablegrange Supported Living on our website at www.cqc.org.uk .
Why we inspected
This was a planned inspection based on when the service was previously inspected.
This was a focused inspection and the report only covers our findings in relation to the Key Questions Safe, Effective and Well-led. For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating.
Follow up
We will continue to monitor information we receive about the service, which will help inform when we next inspect.
Ablegrange Supported Living provides personal care to people with learning disabilities living in their own home. People live in a home shared with others but have their own self-contained rooms.
People’s experience of using this service and what we found
During our last inspection we found that the service was not always managing behaviours that challenge the service appropriately. We found that there was a lack of robust behaviour intervention plans and there has been a lack of training for staff in have to manage such behaviours safely and pro-actively. During this inspection we found the service had addressed these shortfalls.
Staff knew how to report allegations of abuse and people told us that they felt comfortable and safe with staff. Risks in relations to receiving personal care and behaviours that challenge the service had been assessed and guidance was provided to staff in how to minimise such risks. People told us that enough staff were deployed, and records confirmed that appropriate checks had been carried out to ensure staff employed was safe to work with vulnerable adults. People who used the service did receive their medicines safely ands medicines were administered as prescribed. The service followed appropriate infection and prevention control procedures and people who used the service were protected from COVID-19. The service ensured that they learned for accidents and incidents and systems were in place to minimise such events.
People who used the service received person centred care. The registered manager was respected by the staff team and we were told that she was visible, supportive and easy to talk to. The registered manager was clear about their duty to notify the Care Quality Commission (CQC) of particular incidences in relation to the care people who use the service received.
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 guidance CQC follows to make assessments and judgements about services providing support to people with a learning disability and/or autistic people.
The service was able to demonstrate how they were meeting the underpinning principles of Right support, right care, right culture. People using the service receive person centred care and were supported to maintain their independence. People were encouraged to comment on the care and support they received. Staff demonstrated a good understanding of the needs and challenges people with learning disabilities and autism have.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection
The provider completed an action plan after the last inspection to show what they would do and by when to improve.
At this inspection not enough improvement had been made and the provider was still in breach of regulations.
The last rating for this service was requires improvement (published 25 January 2020).
Why we inspected
We carried out an unannounced comprehensive inspection of this service on 7 November 2019. Breaches of legal requirements were found. The provider completed an action plan after the last inspection to show what they would do and by when to improve the safe care and treatment and governance.
We undertook this focused inspection to check they had followed their action plan and to confirm they now met legal requirements. This report only covers our findings in relation to the Key Questions Safe and Well-led which contain those requirements.
The ratings from the previous comprehensive inspection for those key questions not looked at on this occasion were used in calculating the overall rating at this inspection. The overall rating for the service has changed from Requires Improvement to 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 Ablegrange Supported Living on our website at www.cqc.org.uk.
Follow up
We will return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.
Ablegrange Supported Living is registered to provide personal care and runs a supported living service for people with a learning disability or autistic spectrum disorder. At this inspection there were thirteen people using the service.
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. The service worked towards ensuring that 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
Risk assessments had been documented. Risks to people’s health and wellbeing had been assessed. There was guidance for staff on how to minimise risks to people. We however, noted that the guidance and arrangements for staff regarding the management of incidents of behaviours which challenged the service was not sufficiently comprehensive. The arrangements for the management of behaviours which challenged the service was not adequate and clear to staff.
People and their relatives told us they were satisfied with the care provided. They stated that staff treated them with respect and dignity and they felt safe with staff. We observed that staff interacted well with people and were caring and attentive towards them. Staff made effort to ensure that people's individual needs and preferences were responded to.
Staff had received training on how to safeguard people and were aware of the procedure to follow if they suspected that people were subject to abuse. We received a safeguarding allegation against the service just prior to this inspection and a second one after the inspection. Both were referred to the local authority safeguarding team for follow up. One safeguarding allegation received in 2018 and investigated by the service had not been reported to the local safeguarding team or the Care Quality Commission (CQC).
People received their prescribed medicines. Staff had received medicines administration training and knew how to administer medicines safely.
Staff had been carefully recruited and essential pre-employment checks had been carried out. The service had adequate staffing levels and staff were able to attend to people’s needs.
People and their relatives told us that staff observed hygienic practices and had assisted people to keep their home clean and tidy.
Staff supported people to have a healthy and nutritious diet that was in line with their individual dietary needs and preferences.
The healthcare needs of people had been assessed. Staff supported people in accessing the services of healthcare professionals when needed.
Staff had received training and had knowledge and most skills to support people. The managers provided staff with regular supervision and a yearly appraisal of their performance. However, some staff stated that they had experienced difficulty managing incidents of behaviours which challenged the service.
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 services supported this practice.
There were arrangements for meeting the diverse needs of people. This included ensuring that people were supported with their individual, religious and cultural needs. Staff also supported people to participate in various social and therapeutic activities within the community. This ensured that people remained as independent as possible.
There was a complaints procedure and people knew how to complain. Complaints recorded had been promptly responded to.
Morale within the staff team was poor. Staff expressed a lack of confidence in their managers and did not feel that management listened to their concerns. The service had a quality monitoring system. Checks and audits of the service had been carried out. These were not sufficiently comprehensive and effective as they did not identify the deficiencies we noted and promptly rectified them. This placed people at risk of harm or of not receiving a high quality 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 June 2017). The service has deteriorated to requires improvement.
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.
Why we inspected
This was a scheduled planned comprehensive inspection.
Enforcement
We found two breaches of the Health and Social Care Act 2018 (Regulated Activities) Regulations 2014.
Full information about CQC’s regulatory response to the more serious concerns found in inspections and appeals is added to reports after any representations and appeals have been concluded.
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 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.
There was 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.
People informed us that they were satisfied with the care and services provided. They had been treated with respect and felt safe with care workers. There was a safeguarding adult's policy and suitable arrangements for safeguarding people. The arrangements for the recording, storage, administration and disposal of medicines were satisfactory. People’s care needs and potential risks to them were assessed and care workers were aware of these risks. Personal emergency and evacuation plans were prepared for people and these were seen in the care records. This ensured that care workers were aware of action to take to ensure the safety of people.
Infection control measures were in place. Care workers assisted people in ensuring that their bedrooms and communal areas were kept clean and tidy. The service kept a record of essential inspections and maintenance carried out. There were arrangements for fire safety which included alarm checks, staff fire training and risk assessments.
Care workers were carefully recruited and there were enough care workers deployed to meet people's needs. They had received essential training and were knowledgeable regarding the needs of people. Teamwork and communication within the home was good. There were arrangements for support and supervision of care workers.
People’s healthcare needs were monitored and arrangements had been made with healthcare professionals when required. The service had suitable arrangements for assisting people with their dietary needs.
There were arrangements for encouraging people to express their views and experiences regarding the care provided and management of the service. Care workers prepared appropriate and informative care plans which involved people and their representatives.
Regular meetings and one to one sessions had been held for people and the minutes were available for inspection. Care workers were able to meet the needs people. One person whose needs could not be met was awaiting transfer to appropriate accommodation.
The service assisted people in accessing suitable activities in the community. This ensured that they received social and mental stimulation. People knew who to complain to if they had concerns.
Care workers worked well together and they had confidence in the management of the service. They were aware of the values and aims of the service and this included treating people with respect and dignity and encouraging them to be as independent as possible. Audits and checks of the service had been carried out by the operations manager and the registered manager. We however, noted that these audits were not sufficiently comprehensive and have made a recommendation in respect of this.
Further information is in the detailed findings below.