15 February 2023
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 Health and Social Care Act 2008.
The inspection was carried out by one inspector.
Service and service type
This service provides care and support to people living in 6 ‘supported living’ settings, so 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.
This provider is required to have a registered manager to oversee the delivery of regulated activities at this location. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Registered managers and providers are legally responsible for how the service is run, for the quality and safety of the care provided and compliance with regulations.
At the time of our inspection there was a registered manager in post.
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 make sure there would be people at home to speak with us.
Inspection activity started on 27 January 2023 and ended on 1 February 2023. We visited the service on 27 and 31 January 2023.
What we did before the inspection
We used the information the provider sent us in the provider information return (PIR). This is information providers are required to send us annually with key information about their service, what they do well, and improvements they plan to make. We also sought feedback from the local authority. We used all this information to plan our inspection.
During the inspection
We spoke with 8 people living at Four Meadows, and 3 relatives about their experience of the support provided. We spoke with 9 members of staff including the registered manager, the HR manager and HR administrator, 4 care members of staff, the estates and maintenance manager, and the nominated individual. The nominated individual is responsible for supervising the management of the service on behalf of the provider.
We reviewed a range of records. These included 3 people's care records, 3 people's medication records, and 3 staff files in relation to recruitment, training and supervision. We also reviewed a variety of records relating to the management of the service, including staffing rotas, premises management records, policies, procedures and quality assurance records.
15 February 2023
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.
About the service
Four Meadows is provided by The Lantern Community and is a supported living service providing personal care to 23 people at the time of the inspection. This service provides care and support to people living in 6 ‘supported living’ settings, so that they can live in their own home as independently as possible. People’s care and housing are provided under separate contractual agreements. People shared their homes with volunteer support workers called co-workers. CQC does not regulate premises used for supported living; 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
People and relatives told us how they or their family member could choose how they wanted to live and received the support they needed to do this. Staff encouraged and supported people’s choice and independence.
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 encouraged and supported to maintain a healthy lifestyle and supported to enjoy a wide variety of hobbies and interests which maintained their sense of well-being.
Risks were well managed with the least possible restriction and people were well supported to maintain and develop an independent lifestyle and lead active lives.
Care and support were provided according to people’s individual needs and wishes. Staff ensured people’s privacy and dignity were respected. People felt safe with staff and enjoyed spending time with staff who they knew well. Staff had a good understanding of people's care needs and ensured care and support was personalised.
Risk assessments provided up to date guidance and information for staff. They gave clear information for how staff could ensure people made informed choices and lived their best lives.
Staff had training on how to recognise and report potential abuse. There were enough staff on each shift to ensure people were supported safely. Staff received a robust induction and completed specialist training, to ensure their knowledge remained current.
People, relatives and staff had confidence in the leadership of the service and felt it was well-led. The registered manager and provider-maintained oversight of the service through regular conversations with people, relatives and staff as well as through a programme of quality assurance audits to ensure the service was working to the provider’s policies and procedures.
The provider’s monitoring processes were effective in helping to ensure people consistently received good quality care and support. Staff and volunteers knew and understood people well and were responsive to their needs. People and those important to them were involved in planning their care.
The registered manager demonstrated joint working with health professionals which provided specialist support to people, involving their families and other professionals as appropriate. Staff demonstrated good understanding around providing people with person centred care and spoke knowledgably about how people preferred their care and support to be given.
People, relatives and staff felt confident in raising any concerns with the registered manager and told us any concerns would be listened to and acted upon.
Staff and relatives spoke of an open, supportive and friendly culture within the service, that placed people and their needs at the heart of the service.
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 7 March 2018).
Why we inspected
This inspection was prompted by a review of the information we held about this service. As a result we undertook a focused inspection to review the key questions of safe and well-led only.
For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating.
The overall rating for this service has remained good based on the findings of this inspection.
You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Four Meadows on our website at www.cqc.org.uk.
We will continue to monitor information we receive about the service, which will help inform when we next inspect.