Mencap - Trowbridge

Mencap – Trowbridge is a supported living service providing support to people with a learning disability and/or autism living in their own homes. At the time of the inspection there were 30 people using the service in 10 houses based in Wiltshire and Gloucestershire.

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

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 the Care Quality Commission follows to make assessments and judgements about services supporting people with a learning disability and autistic people and providers must have regard to it.

Right Care:

There were some effective quality systems in place. However, in one home the checks did not identify the concerns we found on inspection in relation to people's medicines.

Medicines were not always managed safely. Medicine profile sheets did not have information about people’s allergies, nor did they show how and where people preferred to take their medicine.

There was a high dependency on agency staff at one home which meant people were not always being supported by staff that knew them well. However, other homes were being supported by regular staff who knew people.

Right Support:

People were mostly supported to have 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. The provider had not always recorded they had consulted and involved people in decisions, such as choices around healthy eating.

People and their relatives told us they were happy and felt the staff supported them safely.

People had comprehensive care and support plans in place.

Right Culture:

There was a new registered manager in post who demonstrated their understanding of supporting people in a least restrictive and person centred way. We saw people were involved in their support plans and in 1 service we saw that most of their culture was person centred.

Relatives told us they felt involved in peoples’ care and were listened to by staff.

Staff received training through an electronic system and face to face. All new staff were expected to complete the care certificate.

For more details, please see the full report which is on the Care Quality Commission (CQC) website at www.cqc.org.uk

Rating at last inspection

The last rating for this service was Good (published 19 November 2018).

Why we inspected

This inspection was prompted by a review of the information we held about this service.

We received concerns in relation to how people were being supported and lack of regular staff. 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.

Mencap - Trowbridge, provide supported living services for 30 people in five ‘supported living’ locations. This service provides care and support to people, 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.

This was the service’s first inspection under their current registration since moving address. At our last inspection on 20 and 21 December 2016, we found all areas to be rated as good.

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. Registering the Right Support CQC policy

There was a registered manager in post. 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.

People were safeguarded and staff knew how to recognise the signs of abuse and how to address any concerns they had. People had risks assessed, which balanced their rights to freedom as well as keeping them safe. People’s medicines were managed safely.

Staff understood the principles of the Mental Capacity Act (2005) and how to apply its principles when supporting people. Staff were supported through regular one to one supervision and had access to regular training and personal development.

People’s needs were assessed and a multi-disciplinary support plan developed to meet those needs. The service was responsive to people’s changing needs and support plans were regularly reviewed.

The staff were very caring and treated people with respect and dignity. People were fully encouraged to be involved in their care and treatment and in making daily choices. The service was committed to promoting people’s independence.

There were quality assurance audits in place to monitor the service and improvements were continuously sought. People and their relatives were encouraged to give feedback to facilitate change. There was a clear ethos of promoting person centred values and inclusion throughout the staff team.