Precious Homes Birmingham

Precious Homes Birmingham provides personal care to people in their own flats within a supported living setting. The service provides personal care to younger adults who have a learning disability and or autistic spectrum disorders. At the time of the inspection there were seven people receiving personal care at the service.

Not everyone who used the service received personal care. CQC only inspects where people receive personal care. This is help with tasks related to personal hygiene and eating. Where they do we also consider any wider social care provided.

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

The provider had systems and processes in place to support the delivery of care and the safety of the service. However, these were not always used effectively to provide a consistent standard of care for people.

Potential risks to people’s safety were not always identified in relation to the safety of the environment. Infection control practices in relation to COVID-19, required improvement to ensure guidelines were understood and consistently followed to protect people and staff.

Staff understood how to safeguard people from harm and escalate concerns to relevant professionals. People and their relatives told us they felt safe at the service. More specific guidance for the use of, 'as required' medicines was needed to ensure people had these medicines safely.

Measures were in place to reduce the risk of infection during the COVID-19 pandemic. People’s safety was promoted through changes made to the layout of the premises to support social distancing.

Staff knew the risks to people’s safety and these were identified and managed. Relatives felt whilst people were safe and well cared for, consistency of good practice amongst staff, needed to improve. Accidents and incidents were analysed to identify causes, patterns or trends so that people’s support was identified to reduce such incidents.

There were enough care staff to meet people's needs. Maintaining safe staffing levels had been a challenge due to the COVID-19 pandemic, the provider had a contingency plan to determine safe minimum levels of staffing.

The provider had identified shortfalls and had a service improvement plan they were working to. They acknowledged there had been a period of inconsistent leadership which had impacted on the quality of people’s experiences. People, relatives and staff expressed confidence in the new manager. The manager confirmed that additional new senior posts were being created so that people and staff had the support they needed.

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 09 April 2019).

Why we inspected

We received concerns in relation to the management of people’s medicines, finances, infection control and staffing levels. As a result, we undertook a focused inspection to review the key questions of safe and well-led only.

We reviewed the information we held about the service. No areas of concern were identified in the other key questions. We therefore did not inspect them.

Ratings from previous comprehensive inspections for those key questions were used in calculating the overall rating at this inspection.

The overall rating for the service has changed from good to requires improvement. This is based on the findings at this inspection. You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Precious Homes Birmingham on our website at www.cqc.org.uk.

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.

Precious Homes Birmingham operates a supported living service and provides personal care to younger adults living with a learning disability and/or autism and mental health issues. People live within a purpose- built building that is separated into 22 individual, self-contained flats with shared communal areas and cafe. The service is registered to support 22 people and at the time of the inspection 21 people were living there.

Services for people with learning disabilities and/or autism

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

People were supported by staff who knew their needs well. Staff supported people with their medicines safely. People were safe living at the service. Staff knew how to protect people from harm and reduce the risk of accidents and incidents. At the time of our site visit, we found there were enough numbers of staff on duty to meet people’s needs to keep them safe. There were systems in place to learn from incidents and accidents.

People who had recently moved into the service had been assessed before being accepted to ensure the provider could meet their needs. Assessments addressed the person’s physical and health needs and what was important to them. Staff had received training which helped them to deliver personalised care. Our observations showed people looked happy.

Staff spoken with were knowledgeable about people’s care and support needs. Staff enjoyed their work and had developed a good rapport with the people they supported. Staff encouraged people’s independence and protected their privacy.

Whilst on site, people looked comfortable and we saw positive interactions between people and staff.

The provider’s systems to monitor the quality and safety of the service had been effective at identifying where the registered provider needed to make improvements. People were involved in the development of the service and were given opportunities to feedback to the provider about their experiences living at the service.

The outcomes for people using the service reflected the principles and values of Registering the Right Support by promoting choice and control, independence and inclusion. People's support focused on them having as many opportunities as possible for them to gain new skills and become more independent.

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 09 April 2019)

Why we inspected

The inspection was prompted in part due to issues identified at another service managed by the provider and safe management of risks to people, particularly self-harming. A decision was made for us to inspect the provider’s services and examine those risks.

We found no evidence during this inspection that people were not supported safely living at the Precious Homes Birmingham sites.

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.

People’s experience of using this service:

People felt safe and were supported by staff who understood how to report concerns and manage risks to keep people safe. Staff were recruited safely and people were supported by a regular team of staff. Medicines were given in a safe way and lessons were learnt when things went wrong.

There were systems in place to monitor the quality of the service. People were given opportunity to feedback on the quality of the service. People spoke positively about the management structure at the service and felt confident that concerns raised would be taken seriously.

Rating at last inspection: Good (Report Published 31 October 2018)

Why we inspected: The inspection was brought forward due to information of concern being received. The concerns related to the safety and care provided to people by staff employed by the provider.

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

This service provides care and support to people living in a ‘supported living’ setting in 22 ordinary flats, so that they can live in their own home as independently as possible. The 22 ordinary flats are split into two units known as Falcons Lodge and Robins view. 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 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.

At the time of our inspection there was no registered manager in post. However, two people were managing each of the two units and had applied to CQC to become registered with us. 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 supported by staff who were aware of their responsibilities to raise any concerns they may have in terms of people's health and wellbeing. Where safeguarding concerns had been raised, they had been responded to an acted on appropriately. Staff were aware of the risks to people and were provided with information to assist them in managing those risks safely. People were supported to take their medicines as prescribed, and staff competency checks were in

place to ensure staff followed correct procedures. Accidents and incidents were reported and responded to in a timely manner.

Pre-assessment processes in place provided staff with the information they needed to support people effectively and to meet their needs. Staff had received an induction and training that provided them with the skills to meet people's needs. 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 said staff were kind and caring and were respectful of their choices. People's preferences were taken into account, and staff ensured people’s privacy and dignity was maintained. People were supported by staff who knew them well and what was important to them. People were supported to promote their independence. There was a system in place to record people's complaints which people and relatives knew about.

The service had not been consistently well led since it became registered with CQC. People and health professionals did not always say they felt the service was well managed or well led. One part of the service had a high turnover of managers which resulted in problems with the quality and consistency of care. The staff now felt supported by the management team. Audits were in place to assess the quality of care of various areas within the service, but these had always been effective in the past. The provider had a clear vision for the development and growth of the service and had recently invested in new technology to assist with this.