Cumberland Complex

Cumberland complex is a supported living service that can support up to 38 people. At the time of our inspection it was only providing a regulated activity to one person. The building had been adapted for supported living services and was registered with the local authority as a house of multiple occupancy (HMO). The building was in the seaside town of Torquay close to local shops and the sea. People had their own rooms and there were shared dining and communal lounge facilities. There was an office on site with staff available for support if needed.

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.

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

One person was supported to have maximum choice and control of their life 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.

Since our last inspection improvements had been made in relation to medicines management, governance and how risks to people were assessed, monitored and managed.

The provider, registered manager and staff were clear about their roles and responsibilities. Quality assurance checks were in place to monitor the quality of the service provided. Medicines were managed safely, and people received their medicines as prescribed.

Staff were skilled and knowledgeable and knew how to identify and report any concerns. The provider had safe recruitment and selection processes in place. Staff were deployed effectively to meet the persons needs.

Rating at last inspection and update

The last rating for this service was requires improvement (published 30 April 2020) and there were breaches of regulation. 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

We carried out an announced comprehensive inspection of this service on 12 March 2020. 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 medicines management, risk management 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.

For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating. 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 Cumberland Complex on our website at www.cqc.org.uk.

Follow up

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

Cumberland complex is a supported living service that can support up to 38 people. At the time of our inspection it was only providing a regulated activity to three people using the service.

People lived in a building that was originally a hotel. The building had been adapted for supported living services and was registered with the local authority as a house of multiple occupancy (HMO). The building was in the seaside town of Torquay close to local shops and the sea. People had their own rooms and there were shared dining and communal lounge facilities. There was an office on site with staff available for support 24/7 if needed.

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.

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

During this inspection we found two breaches of regulation around the safe management of medicines, risk documents being kept up to date and a lack of effective quality assurance and governance systems. Nobody had been harmed because of these concerns but they were placed at risk of potential harm through a lack of quality checking and records that were not always up to date.

We signposted the registered manager and provider to our website and recent best practise guidance on how to support people with personal care as we felt they needed a refresher in this area. Most people using the service were not having support with a regulated activity, the concerns we found applied to a small minority of people having support with personal care and medicines.

People told us they were happy living in the service and felt safe. We heard how the service had supported people to change their lives and feel more confident and have greater self-worth.

Care plans were person focussed, written from the perspective of people using the service, and reviewed regularly by people. People said staff were caring and patient and listened to them.

Staff felt supported through supervision, appraisal and regular meetings. Staff training was up to date and staff had completed training relevant to the support needs of people using 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 service supported this practice.

People were supported to live healthier lifestyles and access health services where required. People were supported to improve and maintain their wellbeing, so they no longer needed the support of some community services.

There were enough staff to meet the needs of people. Staff were experienced and knew people well. New staff were recruited using a thorough recruitment system.

People were safeguarded from abuse by staff who knew how to identify and report concerns.

Where needed people were supported to link in with activities or events in the local community and make new friends.

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 05 September 2017).

Why we inspected

This was a planned inspection based on the previous rating.

Enforcement

We have identified breaches in relation to medicines, risk assessing and governance. Please see the action we have told the provider to take at the end of this 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.

Personal care was provided by an external domiciliary care agency who visited people in their own home, within the property on Braddons Hill Road East. We visited the supported living setting; people had their own rooms and shared other parts of the house including the lounge, kitchen, and dining room.

This announced inspection took place on 18 July 2017. The provider was given 48 hours’ notice because the location provides a domiciliary care service and people are often out during the day; we needed to be sure that someone would be in. One social care inspector carried out this inspection

At the last inspection, the service was rated Good overall. At this inspection, we found the service remained Good.

Why the service is rated good:

People received a service that was safe. People were protected from the risks associated with unsafe medicine administration because medicines were managed safely. The registered manager and staff understood their role and responsibilities to keep people safe from harm. Risks had been appropriately assessed and staff had been provided with clear guidance on the management of identified risks. There was enough staff to safely provide care and support to people.

The service was effective in meeting people's needs. People received effective care and support from staff that were well trained and competent. People’s health and wellbeing was promoted and people were supported to eat a balanced healthy diet. The registered manager, provider, and staff understood the principles of the Mental Capacity Act (MCA) 2005 and, worked to ensure people's rights were respected.

People received a service that was caring. People were cared for and supported by staff who knew them well. Staff were kind, caring and treated people with dignity and respect. People were involved in the planning of their care and were offered choices in how they wished their needs to be met.

The service was responsive to people's needs. People were aware of how to make a complaint and felt able to raise concerns if something was not right. People received person centred care and support which promoted their health and wellbeing and enhanced their quality of life.

People benefitted from a service that was well led. The manager and provider were open and approachable. The vision and values of the service were clearly communicated to and understood by staff.

There was an open culture where people and staff were encouraged to provide feedback. Staff felt they received a good level of support and a comprehensive quality assurance system was in place.

Further information is in the detailed findings below.

We saw that people had support plans which easy person had been involved in creating and which they had signed up to. Records showed the plans were reviewed frequently, and with each person's health or social care worker. People were encouraged to be independent and to maintain or develop life skills, in accordance with their support plans and with the aims and objectives of the service. This included receiving minimal help with their medicines, which were managed safely.

Staff received training and support which equipped them to carry out their role and meet people's needs. They were provided with procedural guidance which was easy to locate.

All records were up to date and kept securely.