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This service was previously registered at a different address - see old profile

Inspection Summary

Overall summary & rating


Updated 1 February 2019

This was an announced inspection which took place on 9, 10 and 14 January 2019. We had previously carried out an inspection in November 2017 and found that service was good in the domains of caring and responsive but requires improvement in the safe, effective and well-led domains. The service was rated as requires improvement overall. At the last inspection we identified three breaches of the Health and Social Care Act (HSCA) 2008 (Regulated Activities) Regulations 2014.

The breaches we identified at that time were in relation to failure to deploy sufficient numbers of suitably qualified, competent persons to deliver care; a failure to ensure staff received appropriate support, training, professional development, supervision and appraisal; and quality assurance systems were not effective in identifying and generating improvements in relation to the shortfalls we identified. We also made recommendations about staff awareness of safeguarding protocols and record keeping for mental capacity assessments. Following the inspection, we asked the provider to complete an improvement plan to show what they would do and by when to improve the key questions, is the service safe, effective and well-led to at least good.

At this inspection we found that improvements had been made and have rated the service good in all domains.

Zeno is registered to provide personal care to people in their own homes. The service specialises in providing support to people with a learning disability and complex needs. Support is provided both to individuals and to people living in small group settings. At the time of our inspection there were 46 people using the service.

The provider had a registered manager in place as required by the conditions of their registration with the Care Quality Commission (CQC). A registered manager is a person who has registered with the CQC 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 service had a manager who was registered with the Care Quality Commission and was qualified to undertake the role. They demonstrated a commitment to delivering quality care to people with complex support needs.

Staff had been safely recruited and there were enough staff to meet people's needs.

Staff received induction, training, supervision and appraisal to help ensure they were able to deliver effective care.

People told us they felt safe and there were appropriate safeguarding polices in place, and safeguarding concerns were fully investigated.

People’s records demonstrated that the service was working within the principles of the Mental Capacity Act. People had individual capacity assessments which were detailed and decision specific.

Quality assurance systems in place were used to drive improvements within the service. These included audits of care records, staff training and development, medicines and environmental checks.

Information from accidents, incidents, safeguarding and complaints were analysed for themes and trends and action taken to minimise future risks to people.

People received support from consistent staff teams who knew them well and worked creatively to support their needs.

People who used the service, depending on their ability, were responsible for household tasks in their own homes with support from staff as necessary. Independence and choice was promoted.

Systems were also in place to reduce the risk of cross infection, dependent on individual needs, and the homes we visited were clean.

People’s care records and risk assessments were person-centred and detailed and staff told us they provided them with all the guidance necessary to best support people.

People were supported to have daily access to a wide range of community activities.

People were supported to communicate according to their communi

Inspection areas



Updated 1 February 2019

Risk assessments were in place which guided staff on how to manage a wide variety of risks.

Suitable systems were in place to enable the safe recruitment of staff.

There were appropriate safeguarding and whistleblowing policies in place.



Updated 1 February 2019

Staff accessed a wide range of training to support them in their job role and felt supported within their roles.

The service was working within the Mental capacity framework and appropriate assessment and consideration of capacity were in place and authorisation where restrictions were required.

The environment had been adapted to meet the needs of the people.



Updated 1 February 2019

People and relatives were very positive about the support staff provided.

We observed staff support people in a positive way.

People had choice within their daily lives and their independence was promoted.



Updated 1 February 2019

People were supported to access the community and a range of activities which were person centred and based on their interests.

Care records were detailed, holistic and person-centred.

New technology was used to help support and promote independence.



Updated 1 February 2019

There were systems for auditing and oversight. Analysis of themes and trends was completed and subsequent lessons learnt.

Staff were very positive about working for the provider.

There were a variety of forums in which people, families and staff could give their views which including family forums, reviews and meetings and newsletters.