Background to this inspection
Updated
30 November 2017
We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider was meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.
We inspected the service on 24 October 2017 as an announced inspection. We gave the provider 24 hours’ notice of our inspection visit so we could be sure the manager and other members of the management team were available to speak with us. This inspection was undertaken by one inspector.
Before our inspection visit, we asked the provider to send to us a Provider’s Information Return (PIR). The document allows the provider to give us key information about the service, what it does well and what improvements they plan to make. We were able to review the information as part of our evidence when conducting our inspection.
We also reviewed the information we held about the service. We looked at information received from the local authority commissioners and the statutory notifications the manager had sent us. A statutory notification is information about important events which the provider is required to send to us by law. Commissioners are people who contract services, and monitor the care and support the service provides, when they are paid for by the local authority.
We received feedback from one person, and one person’s relative.
During the inspection we spoke with the manager and the team leader. We also contacted the director of the service. We received feedback from three care staff and a commissioner of services.
We looked at a range of records about people’s care including two people's care files in detail, daily records, and medicines records. This was to assess whether people’s care delivery met their identified needs.
We reviewed records of the checks the manager/provider made to assure themselves people received a quality service. We looked at staff files to check staff received supervision and appraisals to continue their professional development.
Updated
30 November 2017
This inspection took place on 24 October 2017. The inspection was announced. The provider was given one days’ notice of our inspection. This was to ensure the registered manager and staff were available when we visited the agency’s office.
This was the first time the service had been inspected. This service provides care and support to three people living in a ‘supported living’ setting, so that they can live in their own home 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.
There was not a registered manager in place at the time of our inspection visit. 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. However, there was a manager of the service who had applied to become the registered manager. We refer to this person as the manager in the body of this report.
Staff understood their responsibilities to protect people from the risk of abuse, and other risks that related to their care and support. However, people’s care records did not always provide enough detail to ensure risks were managed safely and consistently by staff. Staff knew people well, and there was a consistent staff team in place to support people. The manager checked staff’s suitability for their role before they started working at the service. The manager made sure there were enough staff to support people safely.
Staff offered people everyday choices about what they did each day. All of the people who used the service took part in every day local activities, or went to local day centres, as they chose. People were complimentary about staff that supported them, describing them as kind and caring.
Care was delivered based on the individual support needs of each person. Relatives were included in planning how people were cared for and supported, and people were supported by staff who had the skills to meet their needs.
People's right to make their own decisions was not always respected. People's involvement in care planning and decision making was not recorded by the provider. Mental capacity assessments were not in place to support decisions that were made in the person's 'best interests', if they lacked the capacity to make them themselves. 'Best interests' decisions were not recorded to show how decisions had been reached.
Staff knew people well and respected their privacy and dignity. The person and relative we spoke with told us they knew how to make a complaint if they needed to. The manager had procedures in place to respond to complaints in a timely way.
The provider had failed to notify us of all the important incidents that happened at the service, as required by the regulations. The manager and provider checked the quality of the service, however quality checks did not always identify where improvements were needed. Where improvements were identified the provider and manager had acted to improve the service.