Background to this inspection
Updated
21 September 2022
The inspection
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.
Inspection team
This inspection was undertaken by two inspectors and an Expert by Experience. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service.
Service and service type
The service is a domiciliary care service and supported living service. It provides personal care to people living in their own homes. It also provides care and support to people living in nine ‘supported living’ settings, 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.
Registered Manager
This service is required to have a registered manager. A registered manager is a person who has registered with the Care Quality Commission to manage the service. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.
At the time of our inspection there was a registered manager in post.
Notice of inspection
We gave the service six days’ notice of the inspection. This was because it is a small service and we needed to be sure that the provider or registered manager would be in the office to support the inspection.
Inspection activity started on 15 June 2022 and ended on 5 August 2022. We visited the location’s office on 15, 16 and 24 June 2022.
What we did before the inspection
We reviewed the information we held about the service, including the statutory notifications we had received from the provider. Statutory notifications are reports about changes, events or incidents the provider is legally obliged to send to us. We contacted the local authority commissioning and safeguarding teams, the local NHS infection prevention and control [IPC] team, fire service and Healthwatch to request feedback. Healthwatch is an independent consumer champion that gathers and represents the views of the public about health and social care services in England.
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 used all this information to plan our inspection.
During the inspection
We spoke with five people who used the service and five relatives about their experience of the care provided. We spoke with seven members of staff including support workers, senior staff, the registered manager and a senior manager. We also shared information with the nominated individual for the service by email. 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 care records for six people including medicines records. We looked at the recruitment records for two staff and a variety of records relating to the management of the service, including policies and procedures.
Following the inspection site visits we requested additional information by email and continued to seek clarification from the provider to validate the evidence we found. We also sought advice from pharmacy inspector colleagues to discuss the inspection evidence linked to the management of medicines.
Updated
21 September 2022
About the service
Wansbeck Supported Living Service provides personal care to people, including those with a learning disability and autistic people. People live in their own bungalow so they can live as independently as possible, and the service also provides outreach support to people who live locally. At the time of our inspection 12 people were receiving a regulated activity.
We expect health and social care providers to guarantee autistic people and people with a learning disability the choices, dignity, independence and good access to local communities that most people take for granted. Right support, right care, right culture is the statutory guidance which supports CQC to make assessments and judgements about services providing support to people with a learning disability and/or autistic people.
People’s experience of using this service and what we found
Right Support
The service was not able to fully demonstrate how they were meeting the underpinning principles of Right support, right care, right culture due to the lack of knowledge by staff about this guidance.
Medicines were not always managed safely and staff were not following safe infection prevention and control (IPC) measures during the inspection. Risk assessments were completed for people. However, these had not been reviewed at the frequency identified by the provider. Systems were in place to safeguard people from abuse.
People were supported to maintain their home environment and had personalised their home to reflect their taste and preferences.
Right Care
The service did not always have enough appropriately skilled staff to meet people's needs. Staff knew people well and knew how to support people to overcome any communication barriers. Information was available to people in alternative formats to support people’s communication needs.
Staff treated people with care and kindness and supported people to take part in a range of activities. Assessments of people’s needs had been completed. However, these had not been reviewed at the time frames identified by the provider and did not always evidence people had been involved in decisions about their care or agreed to the support being provided.
Right Culture
The culture at the service was positive. Staff described ways of working which were person-centred. However, records did not always demonstrate that care plans remained relevant as they were not being regularly reviewed in line with the requirements identified by the provider.
People were encouraged to be active citizens in their local community. Feedback from people confirmed they were happy living at the service and felt safe.
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.
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 13 October 2018)
Why we inspected
This inspection was prompted by a review of the information we held about this service. The overall rating for the service has changed from good to requires improvement based on the findings of this inspection.
Enforcement
We are mindful of the impact of the COVID-19 pandemic on our regulatory function. This meant we took account of the exceptional circumstances arising as a result of the COVID-19 pandemic when considering what enforcement action was necessary and proportionate to keep people safe as a result of this inspection. We will continue to monitor the service and will take further action if needed.
We identified three breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 during this inspection. These related to safe care and treatment, staffing and good governance.
Please see the action we have told the provider to take at the end of this report.
Follow up
We will request an action plan from the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.