We carried out a review of the data available to us about Swanton Care Supported Living Office on 6 July 2023. We have not found evidence that we need to carry out an inspection or reassess our rating at this stage.
This could change at any time if we receive new information. We will continue to monitor data about this service.
If you have concerns about Swanton Care Supported Living Office, you can give feedback on this service.
About the service
Swanton Care Supported Living Office is a supported living service providing personal care to people in their own homes. The service provides support to younger adults with a learning disability, mental health need or autism spectrum disorder. At the time of our inspection there were 12 people using the service.
People’s experience of using this service and what we found
The service was able to demonstrate how they were meeting the underpinning principles of Right support, right care, right culture.
Right Support
Systems were in place to ensure the right culture was being promoted that people’s human rights were respected and their opinions were listened to and valued.
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.
There were sufficient staff to support people safely. Where there were staff vacancies the provider had a contingency plan in place to ensure people were safely and effectively supported, with minimum disruption to their lives.
People were supported to make choices and achieve their aspirations. One person told us, “Staff spend a lot of time with me and do things I like to do, cinema and that. I got a new puppy, a 3-month-old Labrador. Swanton staff support really well with the puppy as I’ve never had a puppy before, they knew it would help me, so they encouraged it.”
Staff followed the provider’s ethos to provide person-centred care that enabled individuals to develop skills and behaviours to live more independent lives. A relative commented, “Staff are very good with [Name], try different things and set goals with them, [Name]’s communication is improving, more sounds coming out, staff are inventive.”
People were provided with a variety of opportunities to be part of the community. A relative commented, “Staff look at activities [Name] would benefit from, suggest to [Name] different things, gradually they make their own mind up about it. They try various activities I hadn’t thought of.”
Records gave guidance to staff, so people received care that was completely centred and tailored to each individual.
Right Care
People were supported over a 24-hour period in their own homes. People lived individually or in small groups of no more than 2 people in houses in the community.
Care was person-centred and promoted people’s dignity, privacy and human rights. A person commented, “Staff base the support around me, and don’t push me too hard. They don’t bring males in to support me, even if short staffed, always someone from my team.”
People and most relatives were complimentary about the care provided by staff. They said staff were kind, caring and supportive of people and their families. A relative told us, “[Name] gets all their needs seen to, well cared for, staff understand [Name], they like the staff, which is really good, gets to do things and go places. I really am happy with the care” and “In so many ways [Name] has a life they wouldn’t have with me.”
Staff had received safeguarding training and were clear on how and when to raise their concerns. Where appropriate, actions were taken to keep people safe.
Staff followed effective processes to assess and provide the support people needed to take their medicines safely.
Right Culture
The ethos, values, attitudes and behaviours of leaders and care staff ensured people using services lead confident, inclusive and empowered lives. A relative commented, “Staff do treat [Name] as an adult. I’m always amazed, how good staff are, I need to recognise what potential [Name] has and what they can do.”
Staff spoke positively about working at the service and the people they cared for. Staff said the management team was very approachable and they were supported in their role.
Relatives were involved in decision making about their relative’s care but some commented there could be improvements to communication from some households to keep them up-to-date about any changes in their relative’s needs.
A governance system was in place to monitor the quality of the service through audits and feedback received from people, their relatives, staff and external agencies. A person told us, “Recently I had to do a video to say what I liked and didn’t like about the service and what they do well. They asked me questions I loved doing it.”
Processes were in place to manage and respond to complaints and concerns. Relatives said any concerns were addressed.
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 (15 August 2018)
Why we inspected
We received concerns in relation to staffing and people’s care. As a result, we undertook a focused inspection to review the key questions of safe and well-led only.
We found no evidence during this inspection that people were at risk of harm from this concern. Please see the safe and well-led sections of this full report.
You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Swanton Care Supported Living Office on our website at www.cqc.org.uk.
Follow up
We will continue to monitor information we receive about the service, which will help inform when we next inspect.
At the last inspection in September 2017 we found the provider had breached Regulation 19 Fit and Proper Person. The provider did not have robust checks in place in relation to the recruitment suitability of prospective staff members. Following the last inspection, we asked the provider to complete an action plan to show what they would do and by when to improve the key questions of Safe and Well led to at least good.
We found improvements had been made to the recruitment processes to meet the relevant regulation.
This service provides care and support to people living in the community and in a ‘supported living’ setting, so that they can live in their own home 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 was supporting three people at the time of the inspection. Two people who shared one property and another in their own home.
The property was a three-bedroom house which had been adapted so each person had their own lounge area and bedroom with private bathroom facilities. The property had a communal dining and kitchen area. As people required staff to be available over a 24 hour period one bedroom was utilised as a sleepover room.
“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.”
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.’
The provider had policies and procedures in place to keep people safe. Staff were trained in safeguarding.
The registered manager maintained a log of all incidents and ensured lessons learnt were disseminated to staff. People had access to easy read information about how to recognise and report abuse.
Risks to people were assessed with control measures in place for staff support and guidance. The environment was checked for safety. Electrical and gas safety certificates were in place. Fire detection systems were monitored regularly.
Medicines were managed safely by trained staff whose competency to administer medicines was checked regularly.
The provider ensured staffing levels met the needs of people who used the service. Staff were appropriately trained and received regular supervisions and appraisals.
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.
Staff supported people with their nutritional needs to maintain a healthy and varied diet. People had access to health care professionals when necessary.
Staff treated people with dignity and respect and helped to maintain people’s independence by encouraging them to care for themselves where possible. Staff supported people with privacy.
Care records were written in a person-centred way. People’s individual wishes, needs and choices were considered. People’s care and support was reviewed on a regular basis.
Activities were arranged for people who used the service based on their likes and interests and to help meet their social needs. People had a weekly activity planner which they helped develop.
The provider had an effective complaints procedure in place and people who used the service and relatives were aware of how to make a complaint.
The provider provided information in an easy read format for people.
The registered manger and staff worked with other stakeholders. Community links were maintained with people accessing local amenities.
The provider had an effective quality assurance process in place. Staff said they felt supported by the management team. People who used the service, family members and staff were regularly consulted about the quality of the service via meetings and surveys.
The service currently provides personal care for five people who have a learning disability and who may be on the autistic spectrum. Some people lived in small groups in a house whilst other people may live with family or carers.
The service had a registered manager in place who was on leave at the time of our visit. 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. The registered manager worked across another of the provider’s services. On a day to day basis the service was managed by a full time manager and deputy manager as well as a team leader. We were told that the full time manager would take over the registered manager’s role in their own right once the registered office had moved to a new location.
We undertook this visit following safeguarding concerns that were raised to the local authority safeguarding team regarding care plans and a staffing issue. This safeguarding concern has now been investigated and closed by the local authority following the completion of an action plan by the provider.
We found the service had not undertaken robust recruitment checks to ensure prospective staff members had the relevant background to work in the service. In the five staff files we viewed not all staff had appropriate references, application forms, interview records or evidence of identity. We asked the deputy manager who was on duty on the day of the inspection to address these deficits straight away.
There were systems and processes in place to protect people who used the service from the risk of harm. Staff were aware of different types of abuse, what constituted poor practice and action to take if abuse was suspected. Appropriate checks in were in place in relation to the health and safety of people and staff.
Risk assessments were in place for people using the service and for staff members. Staff members told us of the systems they followed in case of an emergency as they sometimes worked alone.
Staff told us that they felt supported. There was a regular programme of staff supervision. Records of supervision were detailed and showed the service manager worked with staff to identify their personal and professional development areas. We spoke with one new member of staff who spoke highly of their induction and support.
Staff had been trained and had the skills and knowledge to provide support to the people using the service. There were enough staff on duty to provide support and ensure people’s needs were met. Staff were aware of the requirements of the Mental Capacity Act [2005] and the Deprivation of Liberty Safeguards [DoLS] which meant they were working within the law to support people who may lack capacity.
Appropriate systems were in place for the management of medicines so that people received their medicines safely.
There were positive interactions between people who used the service and staff. We saw that staff treated people with dignity and respect. Staff were attentive, showed compassion, were patient and gave encouragement to people.
People’s nutritional needs were met, with them being involved in shopping and decisions about meals.
People were supported to maintain good health and had access to healthcare professionals and services. We saw they were supported and encouraged to have regular health checks and were accompanied by staff to appointments.
Assessments were undertaken to identify people’s support needs. People had [where possible] been involved in the development of their person centred plan.
Staff encouraged and supported people to access activities within the community and also to maintain family relationships.
The provider had a system in place for responding to any concerns and complaints. Staff told us they knew if people were unhappy and would take action to resolve this.
There were systems in place to monitor and improve the quality of the service provided. We saw the service had an action plan following the recent safeguarding concern where deficits were found in relation to care plans and risk assessments. The new management team had clear actions and deadlines to work on service improvements and we saw considerable work had been undertaken to address these areas for improvement. Staff told us that the service had made recent improvements and they felt it was now a more open, inclusive and positive culture.
We identified one breach of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 entitled Fit and proper persons employed. You can see what action we told the provider to take at the back of the full version of the report.