Oldham

Oldham is a supported living service providing personal care. The service provides support to autistic people and people with a learning disability living in their own homes, some of whom had a history of offending. People had their own tenancy agreements for their flats or homes. Several flats were in the two buildings situated next to each other, where there was also an office for the service. Some people shared a flat, having their own bedroom and sharing the kitchen, lounge and bathroom. Other people lived on their own. Most people had the support of waking night staff. At the time of our inspection there were 18 people using the service.

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.

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.

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

Right Support

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. There were enough staff to meet people’s needs. Staff had training and support for their roles and knew people well. Staff had been safely recruited. Staff supported people to be independent and involved in daily activities where possible. People were supported to maintain a healthy diet.

Right Care

People received their medicines as prescribed. People’s needs were assessed before moving to the service and a transition period was used to review their support needs and ensure their needs were being met. Person-centred support plans and risk assessments were in place and regularly reviewed. People’s wishes for their end-of-life care were recorded where they had wanted to discuss this.

Right Culture

People were positive about their support, and we observed good interactions between people and staff throughout the inspection. People were asked for their feedback on their care and they and, where applicable their families, were involved in planning and agreeing their care. People’s cultural needs were being met. Staff enjoyed working at the service and felt able to raise any ideas or concerns they had with the management team. A quality assurance system was in place and incidents were reviewed to identify any lessons learnt. The registered manager understood the duty of candour.

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 16 March 2018).

Why we inspected

This inspection was prompted by a review of the information we held about this service.

Follow up

We will continue to monitor information we receive about the service, which will help inform when we next inspect.

We found the following examples of good practice.

The service was closed to visitors except for the provision of health and social care to people that could not be done well by telephone or video calls.

Visitors entered by appointment only. They had their temperatures taken on arrival and staff then accompanied them to a specific meeting room away from people’s flats.

People had access to equipment such as the pool table and table football. Staff monitored its use and cleaned the equipment in between uses.

Further information is in the detailed findings below.

This was the first rated inspection for the service. This inspection was conducted on the 20 and 21 February 2018 and was announced in line with our guidance to ensure staff were present at the service.

There was no registered manager in post. A registered manager is a person who has registered with the Care Quality Commission (CQC) 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 manager had been in post since October 2014. However, there was a person appointed at the service who had sent in an application to be registered and was to be interviewed on the 07 March 2018.

We made a recommendation that staff look at best practice guidelines for obtaining the last wishes of people who used the service.

Staff we spoke with were aware of how to protect vulnerable people and had safeguarding policies and procedures to guide them, which included the contact details of the local authority to report to.

Recruitment procedures were robust and ensured new staff should be safe to work with vulnerable adults.

Risk assessments for health needs or environmental hazards helped protect the health and welfare of people who used the service but did not restrict their lifestyles.

Staff were trained in the administration of medicines and managers checked the records to help spot any errors and keep people safe.

Staff were trained in infection control topics and issued with personal protective equipment to help prevent the spread of infection.

Staff received an induction and were supported when they commenced employment to become competent to work with vulnerable people. Staff were well trained and supervised to feel confident within their roles. Staff were encouraged to take further training in health and social care topics.

People were supported to take a healthy diet if required and staff were trained in nutrition and food safety.

The service were of aware of how to protect a person’s rights by following the principles of the Mental Capacity Act.

We observed a good rapport between people who used the service and staff. People were supported by a regular staff team who knew them well.

Staff were able to use their skills to communicate with people.

Personal records were held securely to help protect people’s privacy.

There was a complaints procedure for people to raise any concerns they may have.

People were assisted to attend meaningful activities.

Plans of care gave staff clear details of what care people needed. People helped develop their plans of care to ensure the care they received was what they wanted.

There were systems in place to monitor the quality of service provision and where needed the manager took action to improve the service.

The office was suitable for providing a supported living/domiciliary care service and was staffed during office hours. There was an on call service for people to contact out of normal working hours.