Congleton Supported Living Network

Updated 30 July 2022

The inspection

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Health and Social Care Act 2008.

Inspection team

Two inspectors, a member of the CQC medicines team and an Expert by Experience carried out the inspection. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service.

Service and service type

This service provides care and support to people living in six ‘supported living’ settings, so that they can live 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.

The service had a manager registered with the Care Quality Commission. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.

Notice of inspection

We gave the service 24 hours’ notice of the inspection. This was because the service is small and people are often out and we wanted to be sure there would be people at home to speak with us.

Inspection activity started on 10 June and ended on 4 July 2022. We visited the location’s office on 10, 13 and 20 June 2022. As part of our inspection we conducted site visits to four of the six shared supported living properties.

What we did before inspection

We reviewed information we had received about the service since the last inspection. This included any notifications (events which happened in the service that the provider is required to tell us about). We used the information the provider sent us in the provider information return (PIR). This is information providers are required to send us annually with key information about their service, what they do well, and improvements they plan to make. We also used information gathered as part of monitoring activity that took place on 24 Feb 2022 to help plan the inspection and inform our judgements. We used all of this information to plan our inspection.

During the inspection

We spoke with five people who used the service and seven relatives about their experience of the care provided. Some people who used the service who were unable to talk with us and used different ways of communicating including using Makaton, pictures and their body language.

We spoke with nine members of staff including the registered manager, seven members of the staff team and the nominated individual. The nominated individual is responsible for supervising the management of the service on behalf of the provider

We reviewed a range of records. This included eight people’s care records and five medication records. We looked at three staff files in relation to recruitment and staff supervision. A variety of records relating to the management of the service, including policies and procedures were reviewed.

After the inspection

We continued to seek clarification from the provider to validate evidence found.

Updated 30 July 2022

We expect health and social care providers to guarantee people with a learning disability and autistic people respect, equality, dignity, choices and independence and good access to local communities that most people take for granted. ‘Right support, right care, right culture’ is the guidance CQC follows to make assessments and judgements about services supporting people with a learning disability and autistic people and providers must have regard to it.

About the service

Congleton Supported Living Network is registered as a homecare agency to provide personal care to people who have a learning disability and/or autistic spectrum disorder in their own homes. 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.

At the time of the inspection there were 14 people receiving personal care in six different ‘supported living’ settings with 24/7-hour support.

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

The service was able to demonstrate how they were meeting most of the underpinning principles of right support, right care, right culture.

Right Support

The service had enough staff to meet people's needs and keep them safe. The provider had experienced some recruitment challenges and were considering the use of agency staff to ensure staffing numbers were maintained. However overall staff turnover was low, which supported people to receive consistent care from staff who knew them well.

Staff supported people to take part in activities and pursue their interests in their local area and to interact online with people who had shared interests. Since the last inspection changes had been made to provide a more a flexible service and to support people to consider alternatives to day care centres. Staff supported people to make decisions following best practice in decision-making.

Staff supported people with their medicines in a way that promoted their independence and achieved the best possible health outcome.

The service gave people care and support in a safe, clean, well equipped, well-furnished and well-maintained environment that met their sensory and physical needs. People had a choice about their living environment and were able to personalise their rooms.

Right Care

Governance processes were not fully effective, to help keep people safe, protect people’s rights and provide good quality care and support. They had not maintained full oversight or identified some of the issues found at this inspection, including oversight of training records and care records.

Staff had training on how to recognise and report abuse, however this had not always been fully applied. The provider had not ensured systems to review incidents were fully effective, as they had not identified themes requiring further action, to ensure people were fully protected.

Staff and people cooperated to assess the risks people might face. Where appropriate, staff encouraged and enabled people to take positive risks. However, care records did not always reflect the actions taken to mitigate these risks.

People received kind and compassionate care. Staff protected and respected people’s privacy and dignity. They understood and responded to their individual needs.

People could communicate with staff and understand information given to them because staff supported them consistently and understood their individual communication needs.

Right culture

Staff knew and understood people well and were responsive. People’s support plans reflected their range of needs and this promoted their wellbeing, however support plans did not always fully reflect people’s goals or aspirations.

Overall, people led inclusive and empowered lives because of the ethos, values, attitudes and behaviours of the management and staff.

People and those important to them, including advocates, were involved in planning their care.

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 Requires Improvement (Published on 25 December 2019)) and there were two of breaches of regulation. The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection we found some improvements had been made, however, the provider remained in breach of one regulation. The service remains rated requires improvement.

Why we inspected

This inspection was prompted by a review of the information we held about this service. We undertook this inspection to assess that the service is applying the principles of Right support right care right culture.

Enforcement

We are mindful of the impact of the COVID-19 pandemic on our regulatory function. This meant we took account of the exceptional circumstances arising as a result of the COVID-19 pandemic when considering what enforcement action was necessary and proportionate to keep people safe as a result of this inspection.

We have identified one breach of regulation in relation to good governance at this inspection.

Please see the action we have told the provider to take at the end of this report.

Follow up

We will meet with the provider following this report being published to discuss how they will make changes to ensure they improve their rating to at least good. We will work with the local authority to monitor progress. We will return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.