Plymouth Supported Living

Updated 17 January 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 was planned to check 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.

The inspection took place on the 7, 10 and 11 December 2018 and was announced 48 hours in advance. This was to support the staff to have time to prepare people for our arrival in order to prevent unnecessary distress.

The inspection office visit activity was on the 7 and 10 of December 2018. We also made phone calls to family and staff on the 10 and 11 December 2018.

Two inspectors completed the inspection. We used information the provider sent us in the Provider Information Return. This is information we require providers to send us at least once annually to give some key information about the service, what the service does well, and improvements they plan to make.

We informally met eight of the 10 people currently living at the service. We also had a look round the buildings to observe how people’s needs were being met by the fire safety, layout and décor.

We reviewed the care and medicine records of three people, three staff recruitment files and a further three staff’s supervision, appraisal and competency checks.

We spoke with four relatives over the telephone and had email feedback from another. Three professionals gave us feedback by email. We spoke with the registered manager, deputy manager and met some staff when we visited the buildings. We spoke with four staff over the telephone.

We also reviewed how the service and provider were ensuring the quality of the service, staff training records, supervision and competency checks of staff practice. Feedback on the service such as compliments, complaints and responses to questionnaires were also read.

Updated 17 January 2019

The inspection of Plymouth Supported Living took place between the 7 and 11 December 2018. We announced the visit 48 hours before. This was to give staff the time to let people know we were coming and why.

When we last inspected the service, we found breaches of the Regulations. This was due to concerns about how the medicines were managed, how staff were being supported and, the leadership and governance. We asked the provider to tell us how they were going to put this right and checked this plan had been adhered to.

On this inspection, we found improvements; with some clarification need around medicines to ensure the records were accurate. These were all in place by the time the inspection concluded.

Plymouth Supported Living provided care and support to 10 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 people had a learning disability.

People lived in two separate parts of a complex owned by Plymouth Highbury Trust. One building was called the Lodge (where two people lived) and Highbury House (where the other eight people lived).

The care service had been developed and designed in line with the values that underpin the Registering the Right Support and best practice guidance. These values include choice, promotion of independence and inclusion. People with learning disabilities and autism using the service should live as ordinary a life as any citizen. This including us checking compliance with the national plan, ‘Building the right support’ and best practice. For example, how the service ensured care was personalised, the person moved on if needed, people’s independence and ensure people were linked with their community.

The service had a registered manager. 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. They were supported in this role by the deputy manager and trustees of the parent body Plymouth Highbury Trust.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice. People were assessed in line with the Mental Capacity Act 2005.

People were supported to be accepting of each other and of others. Their faith, sexuality and life choices were respected and explored by staff to ensure people’s right to choose how to live their lives. This included identifying those people who were vulnerable because they could not identify risk in others and putting means in place to make this part of the discussions and care planning with and for people.

People and families felt safe in their homes and with the staff who supported them. Staff knew how to keep people safe from harm and ensured they received a personalised approach to identifying if they were unhappy, depending on their communication and comprehensive abilities. People’s care plans were detailed and written with people or those relatives who knew them well. People’s medicines were administered safely.

There were systems and processes in place to minimise risks to people. These included a robust recruitment process and making sure staff knew how to recognise and report abuse. Staff were available to meet people’s needs in a timely manner.

People received effective care from staff who had the skills and knowledge to meet their needs. Staff monitored people’s health and well-being and made sure they had access to other healthcare professionals according to their individual needs. Staff ensured people had choices about how to meet their needs while balancing the need for people to eat well, keep hydrated and stay healthy. Detailed ‘hospital passports’ were in place so important information about people’s needs and communication methods was able to be shared easily with other health care professionals when needed.

People were supported by staff who were kind and caring. Where people found it difficult to express themselves, staff showed patience and understanding. Every effort was made to enable people to express themselves; this included knowing people well and using assisted technology as relevant.

The service was responsive to people’s needs and they could make choices about their day to day routines. People followed their hobbies and maintained links with the community, which provided them with mental and social stimulation. People were also supported to try new things or volunteer.

People and family could make a complaint and were confident action would be taken to address their concerns. The registered manager and trustees treated complaints as an opportunity to learn and improve. Staff knew people well and identified if people were unhappy; every effort was then made to find out why this was and put things right for the person.

The home was well led by an experienced registered manager. The registered manager and trustees had systems in place to monitor the quality of the service, seek people’s views and make on-going improvements.

Further information can be found in the full report which can be found on our website at www.cqc.org.uk