Background to this inspection
Updated
15 December 2018
We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.
This inspection was conducted over two days on 8 and 9 October 2018 and was announced. We gave the provider three days’ notice of the inspection because managers are sometimes out of the office supporting staff or visiting people who use the service. We needed to be sure that managers would be available to speak with us during our inspection.
The inspection team consisted of one inspector and an expert-by-experience. The expert-by-experience had personal experience of caring for someone with a learning disability.
Before the inspection, we reviewed all the information we held about this service. This included previous inspection reports and notifications the provider is required by law to send us about events that happen within the service. Due to technical problems, the provider was not able to complete a Provider Information Return. This is information we require providers to send us at least once annually to give some key information about the service, what the service does well and improvements they plan to make. We took this into account when we inspected the service and made the judgements in this report.
During our inspection we spoke in-person with four people the provider supported and a range of managers and staff who worked for the service including, three locality (registered) managers, two area managers, a training manager, a team leader and a support worker. We also made telephone contact with the relatives of four people the provider supported. Records we looked at included eight people’s plan for life (care plan) and a range of staff files and other documents that related to the overall management of the service. Furthermore, we received written feedback about the service from a relative and six external community health and social care professionals including, three members of local authority Community Learning Disability Health Team (CLDHT), two occupational therapists and a clinical psychologist.
Updated
15 December 2018
This comprehensive inspection took place on 8 and 9 October 2018 and was announced.
Brandon Trust Supported Living - Trident Business Centre, Tooting is a supported living service that provides personal care and support to younger and older adults with a learning disability or autism who live in their own individual or group home. Support provided ranges from a couple of hours to 24 hours cover. At the time of our inspection the provider was supporting 71 people who lived in 20 different supported living settings in the South London Boroughs of Southwark, Wandsworth and Croydon.
People’s care and housing are provided under separate contractual agreements. The landlords in most cases were Housing Associations. The Care Quality Commission (CQC) does not regulate premises used for supported living.
The supported living 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 the promotion of choice, independence and inclusion, so people with learning disabilities and autism can live as ordinary a life as any citizen.
At our last inspection of this service in April 2017 we rated them 'Good' overall and for all five key questions. In October 2017 Brandon Trust Supported Living - Trident Business Centre, Tooting reregistered with the CQC and therefore this inspection will represent the first time we have rated them, although most people the provider supports, managers and staff, and their processes and systems remain the same.
At this inaugural inspection of Brandon Trust Supported Living - Trident Business Centre, Tooting, we have rated them 'Good' overall and for four out of the five key questions, while we have awarded them an ‘Outstanding’ rating for the key question, ‘Is the service caring?’
The service has six registered managers (known as locality managers) in post, who were in day-to-day charge of between one to three supported living settings each. A registered manager is a person who has registered with the CQC to manage a service. Like registered providers, they are 'registered persons'. Registered persons have a legal responsibility for meeting the requirements in the Health and Social Care Act and associated Regulations about how the service is run.
People the provider supported, their relatives and professional representatives were all extremely complimentary about the standard of the service they, their loved ones or clients received from Brandon Trust Supported Living - Trident Business Centre, Tooting.
People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible. Staff were caring and treated the people they supported with the utmost respect and dignity. Staff ensured people's privacy was always maintained particularly when they supported people with their personal care needs. Staff consistently demonstrated warmth, respect and empathy in their interactions with people they supported. People had positive relationships with staff, who took time to get to know them. People were supported to maintain relationships with those that mattered to them. Staff were aware of the communication needs and preferences of the people they supported. This enabled people to express their views and make informed decisions and choices about the care and support they received.
People received personalised support that was responsive to their individual needs. People were involved in planning the care and support they received. Each person had an up to date, personalised plan for life (care plan), which set out how their specific care and support needs should be met by staff. Staff communicated with people in appropriate and accessible ways. People were supported to live active life’s and pursue meaningful social, educational and vocational activities that reflected their social interests. People were encouraged to maintain relationships with people that mattered to them.
Managers at all levels provided good leadership. People the provider supported, their relatives and staff were complimentary about the leadership approach of all the managers. They said managers were highly regarded and easy to contact and speak to. Managers at all levels ensured the provider’s values and vision for the home were fully embedded in the service's systems and processes and demonstrated by staff through their behaviours and actions. There was clear oversight and scrutiny of the service. They used well-established quality assurance systems to ensure all aspects of the service were routinely monitored and could be improved for people they supported. This helped them to check that people were consistently experiencing good quality care and support. Any shortfalls or gaps identified through these checks were promptly addressed.
The provider had an open and transparent culture. People felt comfortable raising any issues they had about the provider. The service had arrangements in place to deal appropriately with people's concerns and complaints. The provider also routinely gathered feedback from people using the service, their relatives and staff. This feedback alongside the provider's own audits and quality checks was used to continually assess, monitor and improve the quality of the supported living service they provided.
People told us they were safe. Staff knew how to recognise and report suspected abuse and neglect to protect people they supported from the risk of harm. The provider had suitable arrangements in place for checking the suitability and fitness of new staff employed to work at the service. Staffing levels were continuously monitored by managers and senior staff to ensure people experienced consistency and continuity in their care and that their needs could always be met. Staff followed appropriate guidance to minimise identified risks to people's health, safety and welfare. Where people needed assistance with taking their medicine this was monitored and carried out safely.
People were supported by staff that had the right skills and knowledge to fulfil their roles effectively. Managers encouraged and supported staff to deliver high quality care and recognised and rewarded them when they demonstrated excellence in the work place. Staff said they felt supported by their line managers and co-workers. Staff adhered to the Mental Capacity Act 2005 Code of Practice. People were supported to eat healthily. People received the support they needed to stay healthy and to access healthcare services.