Background to this inspection
Updated
1 February 2019
We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection checked whether the provider is 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.
This was a comprehensive inspection.
This was an announced inspection by one inspector, which took place on 6 November 2018.
Before the inspection, the provider completed a Provider Information Return (PIR). This is a form that asks the provider to give some key information about the service, what the service does well and improvements they plan to make.
Prior to this inspection, we reviewed records held by CQC which included notifications, complaints and any safeguarding concerns. A notification is information about important events which the service is required to send us by law.
We looked around the premises and observed how people interacted with staff. We looked at care records and associated risk assessments for six people along with other relevant documentation. We looked at other records including audits, maintenance records and policies related to the running of the service. These included staff recruitment, training and supervision records, medicine records, complaints records, accidents and incidents, quality audits and policies and procedures.
During the inspection four people told us about the care they received. We spoke with five members of staff which included the registered manager and deputy manager.
Updated
1 February 2019
The inspection took place on 6 November 2018. We gave the provider notice of our intention to visit so that they could prepare people with complex needs whose routines might be disrupted by our inspection process.
South Hill provides care and support to people with learning disabilities and complex needs 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. The service comprised 11 studio flats in a large detached house with additional communal living areas, and is in Harrow. At the time of this inspection the service provided care for nine people. The people using the service had learning disabilities and varying complex needs and needed a range of support including personal care, prompting and monitoring.
Although the service accommodated more than six people, the service could demonstrate that they followed the principles and values in Building the Right Support guidance, and met the fundamental standards and other relevant regulations. These values include choice, promotion of independence and inclusion. People with learning disabilities and autism using the service can live as ordinary a life as any citizen.
A registered manager was employed at the service. 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.
At the last inspection, the service was rated Good. At this inspection we found the service remained Good.
Appropriate policies and procedures ensured people who used the service were safe from abuse and harm. People told us they felt safe. Their support plans contained various risk assessments and management plans, which ensured they were protected from harm in relation to their care. The service monitored accidents and incidents and learning from these was used to improve the service. Staff employed were appropriately checked to ensure they were suitable to work with people. There were concerns from some staff relating to staffing. They told us at times they were short staffed but we judged this was being addressed. Medicines were managed safely. People received their medicines on time.
Staff had the skills, knowledge and experience to carry out their roles. They had access to a variety of training. CQC monitors the application of the Mental Capacity Act 2005 (MCA) and deprivation of liberty safeguards. We saw that people's rights were protected because the service ensured that the requirements of the MCA 2005 were met. Applications to deprive people of their liberty lawfully had been made to prevent them from coming to any harm where they lacked capacity. Regular supervisions and appraisals were provided to support staff. People had choice of a nutritious food. Their health was monitored and if required external health care support was sought to ensure their health and wellbeing was maintained.
Staff were kind and caring towards the people they supported. They respected people’s privacy and dignity. They also recognised people's rights to confidentiality, consistent with General Data Protection Regulation (GDPR) law. Staff had a clear understanding of people's individual needs, preferences and routines. These qualities were acknowledged by people, who confirmed their privacy, dignity, independence, and preferences were respected by staff.
People’s information and communication needs were met in line with the Accessible Information Standard policy. Support plans contained clear communication guidelines explaining how each person communicated.
People received care that was responsive to their needs. The service had carried out assessments prior to people using the service to ensure people’s needs could be met. These assessments fed into support plans which then reflected how people wanted to be supported. The support plans were reviewed regularly to ensure any changes could be identified and acted on at an early stage. The assessments also highlighted people’s diversity and human rights, which we saw were respected.
People could participate in activities, interests and hobbies of their choice. People could discuss any concerns they had with the registered manager and were confident any issues raised would be addressed.
People and their relatives were happy with the way the service was run. We found the registered manager understood her role and responsibilities. There were effective quality assurance processes in place to monitor care and safety and plan on-going improvements. There were systems in place to share information and seek people’s and their relatives’ views about the running of the service.