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Shine Supported Living - South East Requires improvement

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

Reports


Inspection carried out on 18 November 2019

During a routine inspection

About the service

Shine Supported Living - South East is a supported living service registered to provide personal care. The service provided care and support to four people with a learning disability or other complex needs living in supported living' settings, so that they can live in their own home as independently as possible. 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. Two people were in receipt of personal care when we visited.

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

The management of risk around people’s health was not consistently safe. Management of constipation and risks associated with choking and falls were not well managed. The service relied on a high number of agency staff who may not support people for a number of days. Information was not robustly handed over and documentation did not record important information to share with staff. Although accidents and incidents were recorded and analysed for trends and patterns, action was not always taken to prevent repeated incidents. Lessons were not always learnt or embedded.

Staff did not always have reliable information to refer to when supporting people. Support plans contained duplicated information, staff found them difficult to navigate through and some important information was missing. Recommendations from healthcare professionals were not always acted on, meaning people did not always receive effective person-centred care.

Communication between staff needed to improve so important information relating to people was not missed. The provider and registered manager had failed to identify the concerns we found at this inspection around management of constipation, choking, and falls. The provider had failed to ensure ratings were conspicuously displayed on their website. Although some agency staff worked frequently at the service, they did not receive any formal supervision and were not engaged in meetings or other ways to provide feedback.

People received their commissioned hours of support. There was a safeguarding policy in place and staff said they were confident any concerns would be dealt with if raised. Medicines were managed safely. Before people were offered a service, the registered manager conducted assessments to ensure needs could be met and staff had the right training. People were supported to eat and drink and maintain a healthy weight. People were supported to visit health apportionments with healthcare professionals.

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. The service applied the principles and values of Registering the Right Support and other best practice guidance. These ensure that people who use the service can live as full a life as possible and achieve the best possible outcomes that include control, choice and independence.

We observed staff talking to people in a kind and respectful way. People diversities were assessed and supported. People were supported to go on outings and participate in activities they enjoyed. Consideration had been given to how information was presente

Inspection carried out on 17 September 2018

During a routine inspection

The inspection took place on 17 and 21 September 2018 and was announced.

Shine Supported Living - South East is a supported living service registered to provide personal care. The service provided care and support to 5 people with a learning disability living in ‘supported living’ settings, so that they can live in their own home as independently as possible.

In supported living services 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 service is based in Herne Bay. Two people live in one bungalow and three people live in the bungalow next door. The manager’s office is based in a separate building behind one of the houses.

This is the first inspection since the service registered with CQC in November 2017. At this inspection we rated this service is rated as ‘Requires Improvement’ as we identified breaches of the Health and Social Care Act 2008 (Regulated Activities) 2014 and the Care Quality Commission (Registration) Regulations 2009.

At the time of the inspection the registered manager had not de-registered with CQC but had left the service the week before. There was a new manager in place who had not yet registered with CQC and had not had time to make an impact on the running of the 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.

The care service has not 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.

Risks to people’s health and well-being were not consistently assessed and fully mitigated. Some risks had been assessed but others had not. Support plans were long and complex, the service used agency staff who did not always know people well and care and support was not always consistent.

Medicines were not consistently managed safely. There were restrictions to people that were not the least restrictive option to keep people safe. The service was not delivered in line with the Mental Capacity Act 2005 (MCA) legal framework as some people were deprived on their liberty and the provider had failed to seek lawful authority.

Staff had not undertaken all of the relevant training needed to support people with their assessed needs. Support was not always available to assist people to develop their communication skills as staff did not have access to the appropriate training. Staff had not had supervision with a line manager for some time. Previously the service had senior support workers in place, however there were none in post at the time of the inspection. Staff did not always feel supported or informed by the provider.

People were not always supported to express their views about their care. Some people were non-verbal and needed support to communicate. We made a recommendation about this.

The support provided did not consistently meet peoples assessed needs and preferences. Support was not always personalised.

Notifications of important events were not always sent to CQC when they should have been. The providers checks on the quality of the service did not always identify concerns and where concerns were identified these were not always acted upon. Relatives were involved in planning peoples care but were not always informed by the provider about important changes to the service such as regular staff leaving.

There was a complaints process in place and people and their relatives knew how to complain. The co