28 January 2020
We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Care Act 2014.
The inspection was carried out by two inspectors.
Service and service type
This service provides care and support to people living in a ‘supported living’ setting, so that they can live 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 did not have a manager registered with the Care Quality Commission. This means that the provider are legally responsible for how the service is run and for the quality and safety of the care provided.
Notice of inspection
We gave the service 24 hours’ notice of the inspection. This was because the service is small and people are often out and we wanted to be sure there would be people at home to speak with us.
Inspection activity started on 16 December 2019 and ended on 17 December 2019. We visited the office location on 16 December 2019.
What we did before the inspection
We reviewed information we had received about the service since the last inspection. We sought feedback from the local authority and professionals who work with the service. We used the information the provider sent us in the provider information return (PIR). This is information providers are required to send us with key information about their service, what they do well, and improvements they plan to make. This information helps support our inspections. We used all of this information to plan our inspection.
During the inspection
We spoke with one person who used the service and their relative about their experience of the care provided. We spoke with four members of staff including the provider, nominated individual, senior care worker and care worker. The nominated individual is responsible for supervising the management of the service on behalf of the provider. We reviewed a range of records. This included one person’s care records and medication records. We looked at three staff files in relation to recruitment and staff supervision. A variety of records relating to the management of the service, including policies and procedures were reviewed.
After the inspection
We continued to seek clarification from the provider to validate evidence found. We looked at risk assessments for staff.
28 January 2020
About the service
Guardian Supported Living Ltd is a supported living service providing personal care to people with learning disabilities, autistic spectrum disorders, physical disabilities, mental health difficulties and sensory impairments. At the time of the inspection one person was receiving personal care.
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 people don’t receive personal care we also consider any wider social care provided.
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. The principles reflect the need for people with learning disabilities and/or autism to live meaningful lives.
People’s experience of using this service and what we found
The provider had failed to ensure risk assessments were put in place following allegations of abuse and the providers audit systems had not identified the risk assessment was missing. Care plan reviews did not identify where information was conflicting. Staff’s health conditions were not discussed as part of the recruitment process. The previous CQC inspection ratings were not displayed in line with legal requirements.
There was one person living at the service on the day of the inspection who received personal care. Because of this and the fact we want to protect this person’s rights to a private life, the report will provide an overview rather than specific examples.
The person felt safe and staff had good knowledge of safeguarding processes. There were enough staff to support the person safely. The person received their medicines as prescribed.
The 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.
The person was treated with kindness and compassion. They were encouraged to express their views and make decisions. Their privacy and dignity was maintained.
The person was involved in decisions about their care. Their communication needs were met. They were supported to follow interests, build and develop social skills and take part in activities.
The service applied the principles and values of Registering the Right Support and other best practice guidance. These ensure the person using the service can live as full a life as possible and achieve the best possible outcomes that include control, choice and independence.
The outcomes for the person using the service reflected the principles and values of Registering the Right Support by promoting choice and control, independence and inclusion. The person’s support focused on them having as many opportunities as possible for them to gain new skills and become more independent.
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 requires improvement (published 4 January 2019)
Why we inspected
This was a planned inspection based on the previous rating.
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.