Archived: Main Office

About the service

Waters End provides care and support to people living in a 'supported living' setting, so that they can live as independently as possible. This inspection looked at the personal care and support provided to the two people that were using the service.

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. This ensures that people who use the service can live as full a life as possible and achieve the best possible outcomes. The principles reflect the need for people with learning disabilities and/or autism to live meaningful lives that include control, choice, and independence. People using the service receive planned and co-ordinated person-centred support that is appropriate and inclusive for them.

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

Sufficient staff were available to support people and they were safeguarded from harm, by trained staff who understood their role in reporting any concerns. Risk assessments were undertaken to minimise risks and keep people safe. People received their medicines when needed and recruitment checks were completed prior to employment. People were supported to keep their home clean.

The service applied the principles and values of Registering the Right Support and other best practice guidance. These ensure that people who use the service can live as full a life as possible and achieve the best possible outcomes that include control, choice and independence. People were supported to take reasonable risks which enabled them with opportunities to lead a full life. People spent their day as they preferred and were supported to take part in social activities of their choice to enhance their well-being.

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. Staff understood the support people needed to make decisions when they were unable to make specific decisions independently. Mental capacity assessments and best interest decisions were undertaken where people needed support to make specific decisions. This demonstrated that people’s rights were upheld, and they were supported in the least restrictive way possible.

People were supported as needed, to ensure their preferences and dietary needs were met. People were supported to access healthcare services and received coordinated support, to ensure their preferences and needs were met.

Information was available in an accessible format to support people’s understanding. People maintained relationships with their family and friends and were encouraged to give their views about the service. This included raising any concerns they had. People and their representatives were involved in their care to enable them to receive support in their preferred way.

There were systems in place to monitor the quality of the service and these were used effectively to enable the provider and registered manager to drive improvement.

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 17 September 2018). At this inspection we found improvements had been made.

Why we inspected

This was a planned inspection based on the previous rating.

Follow up

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.

The care service has been developed and designed in line with the values that underpin the Registering the Right Support and other best practice guidance. 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.

At the time of our visit the manager, who was also the provider, was in the process of registering to be the registered manager. They had been the manager since April 2018. 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.

Systems were in place to monitor the quality of the service being provided though these had not always been effective.

Risks associated with people’s care and support had not always been identified or assessed.

Pre- employment checks had not always been carried out in a timely manner.

The manager was in the process of identifying and providing the training the staff team needed in order to maintain the knowledge and skills required to meet people’s needs.

Relatives of the people using the service felt they were safe with the support workers who provided their care and support. The staff team were aware of their responsibilities for keeping people safe from avoidable harm and knew the actions to take should they be concerned for anyone.

There were suitable numbers of staff available to meet people’s care and support needs.

People were supported with their medicines in a safe way and as prescribed by their GP. Protocols were in place for medicines prescribed as and when required and a homely remedies protocol was being developed.

Protective personal equipment was available and used and the staff team ensured peoples home environment was clean and tidy.

There were arrangements in place to make sure action was taken and lessons learned when things went wrong to improve the service provided.

People’s care and support needs had been identified and plans of care had been developed for each person using the service. The staff team knew the needs of the people they were supporting well.

The staff team supported people to make decisions about their day to day care and support. They were aware of the Mental Capacity Act (MCA) 2005 and Deprivation of Liberty Safeguards (DoLS) ensuring people's human rights were protected.

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's food and drink requirements had been identified and a balanced diet was being provided. People received on-going healthcare support and had access to the relevant healthcare services.

People told us the staff team were kind and they treated people in a caring and respectful manner.

An end of life policy was in place. This showed the staff team how to provide the personal and emotional care people deserved as they approached the end of their life.

People knew who to talk to if they had a concern of any kind and were confident any concerns they had would be taken seriously and acted upon by the manager and the staff team.

A business continuity plan was available to be used in the event of an emergency or untoward event.

People were able to have a say and to be involved in how the service was run.

The manager was aware of their registration responsibilities including notifying CQC of significant incidents that occurred at the service.

Further information is in the detailed findings below.