Background to this inspection
Updated
6 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.
The inspection took place on 23 and 24 October 2018 and was announced. The provider was given four days’ notice because we needed to ensure somebody would be available to assist us with the inspection.
The inspection was carried out by one inspector. Inspection site visit activity started on 23 October and ended on 2 November 2018. We visited the service on 23 and 24 October 2018 to see people who used the service, the registered manager and staff team and to review care records and policies and procedures. After the site visit was complete we then made calls to people’s relatives and staff who we were unable to talk with at the site visit.
Before the inspection we reviewed the information the Care Quality Commission (CQC) held about the service. This included notifications of significant incidents reported to the CQC. We contacted the local authority to support our planning of the inspection.
We spoke with three people and two relatives. We also spoke with seven staff members. This included the registered manager and six support workers. We looked at four people’s care plans, three staff recruitment files, staff training files and records related to the management of the service. We managed to speak with one health and social care professional who was visiting a person during the inspection.
Updated
6 December 2018
This comprehensive inspection took place on 23 and 24 October 2018 and was announced. This was the first inspection since the provider registered with the Care Quality Commission (CQC) in November 2017.
This service provides care and support for up to 12 people living in a ‘supported living’ setting, 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 the inspection, eight people were using the service. The service specialises in providing care to people who have mild learning disabilities, mental health problems, autism or social difficulties.
There was a registered manager in post at the time of our inspection. A registered manager is a person who has registered with the Care Quality Commission (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 provider followed safer recruitment procedures and staff had the necessary checks to ensure they were suitable to work with people using the service. Although we found there were suitable numbers of staff to meet people’s needs, there were some occasions where staff had worked excessively long shifts.
People who required support with their medicines received them safely from staff who had completed medicines training and been observed supporting people. Staff completed appropriate records when they administered medicines and these were checked by staff and audited monthly to minimise medicines errors. However, we found some minor improvements were needed with how information about people’s medicines had been recorded.
People and their relatives told us they felt safe using the service and staff had a good understanding of how to protect people from abuse. Staff were confident that any concerns would be investigated and dealt with.
People’s risks were managed effectively and detailed risk management plans had been completed. Staff had access to the appropriate advice and guidance to support people safely.
Staff completed a programme of induction, training and supervision to support them in their role. Staff were knowledgeable about people’s needs and how best to support them.
People were supported to be fully involved with the planning and cooking at mealtimes. Staff encouraged people to have a balanced diet and were aware of people’s preferences and nutritional needs.
People were supported to access healthcare services and staff were aware of people’s health and wellbeing. The staff team worked closely with a range of health and social care professionals, such as GPs, social workers and psychiatrists.
The staff team had spent time with people to get to know them and built positive relationships. People told us that staff were kind and caring and respected their privacy and dignity.
People were involved in planning how they were supported and were able to make decisions about their care. Care records were person centred and developed to meet people’s individual needs and discussed regularly during key work sessions.
There was evidence that cultural requirements and people’s sexual orientation were considered when discussing people’s care and support and making sure these needs were met. People were supported to access the community and encouraged to take part in activities and events they were interested in.
There was an accessible complaints procedure in place and people and their relatives knew how to make a complaint if they wanted to. People and their relatives could share their views about the service and said they would feel comfortable contacting the management team if they needed to.
People and their relatives spoke positively about how well the service was managed and had confidence in the management team. Staff spoke highly of the working environment and the support they received from management, which they felt promoted a positive culture.
There were a range of quality assurance systems in place to monitor the quality of the service provided and understand the experiences of people who used the service. The provider involved people and their relatives in monitoring their services and staff teams discussed their findings.