Explicit Care Solutions Office

Explicit Care Solutions Office is a supported living service providing personal care to people with mental ill health. This service provides care and support to 21 people living in three 'supported living' settings in Haringey and Enfield.

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. 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

Staff compliance with infection prevention and control requirements (specifically mask wearing and screening visitors) was inconsistent.

We found one person whose dignity and privacy were compromised. Other people were satisfied with the support they were receiving from this service. They said staff were kind and helpful.

The service worked well with health and care professionals to meet people's health and care needs. Medicines were managed safely.

Staff supported people to develop their independence. People were able to follow their own chosen lifestyles and daily routines. Staff were trained to meet the needs of the people they were supporting. We observed staff interacting with people. People were comfortable around staff and staff were aware of people’s individual needs and preferences.

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.

Systems were in place to promote continuous improvement. People benefited from a stable staff team who were well supported and worked well as a team.

The provider had a quality assurance system in place to check that the service was running safely and meeting people’s needs.

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 26 October 2018). At this inspection the rating has changed to requires improvement.

Why we inspected

The inspection was prompted in part by concerns reported to us about people’s safety. The information CQC received about an incident indicated concerns about safeguarding people from abuse. This inspection examined those risks. We found that, at the time of the inspection, people were safeguarded from those risks.

The overall rating for the service has changed from good to requires improvement based on the findings of this inspection.

We have found evidence that the provider needs to make improvements. Please see the Safe and Caring key question sections of this full report.

The provider has taken some action to mitigate the risks immediately.

Enforcement and recommendations

We have identified a breach of regulation in relation to treating a person with dignity and respect.

We have made two recommendations. One is that to ensure consistent infection prevention and control measures and the other is to provide staff with further training in understanding mental illness. You can see what action we have asked the provider to take at the end of this full report.

Follow up

We will request an action plan from the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.

Explicit Care Solutions Office provided support to 12 people, living in three ‘supported living’ settings, 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. At the time of our inspection eight people were being supported with personal care.

There was a registered manager at this service. 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 told us they felt the service was safe, staff were kind and the care received was good. We found staff had a good understanding of their responsibility with regard to safeguarding adults.

Risk assessments were in place which provided guidance on how to support people safely. There were sufficient numbers of suitable staff employed by the service. Staff had been recruited safely with appropriate checks on their backgrounds completed. People were supported with medicines.

Staff undertook training and received regular supervision to help support them to provide effective care. Staff we spoke with had a good understanding of the Mental Capacity Act 2005 (MCA). MCA is a legislation protecting people who are unable to make decisions for themselves. People had capacity to make decisions for themselves.

Person centred support plans were in place and people were involved in planning the care and support they received.

People had access to a wide variety of activities within the community. People’s cultural and religious needs were respected when planning and delivering care. Discussions with staff members showed that they respected people’s sexual orientation so that lesbian, gay, bisexual, and transgender people could feel accepted and welcomed in the service.

The provider had a complaint procedure in place. People knew how to make a complaint.

At the time of our inspection the service did not have any people receiving end of life care. The nominated individual advised us that the service would update the support and risk assessment records so end of life wishes could be explored.

Staff told us the registered manager was supportive. People liked the registered manager and found her helpful. The service had various quality assurance and monitoring mechanisms in place.