Background to this inspection
Updated
3 January 2019
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 by a single inspector over one day on 28 November 2018. The inspection was announced and we gave the provider five days’ notice of the inspection because we needed to be sure people who use the service, managers and staff would be available to speak with us during our inspection.
Prior to this inspection, we reviewed information that we held about the service such as notifications. These are events that happen in the service that the provider is required to tell us about. We also used information the provider sent us in the 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. In addition, we considered information that had been sent to us by other agencies and contacted commissioners who had a contract with the service.
During our inspection we spoke in-person with all four people this provider currently supported and a range of managers and staff including, the registered manager, the regional director and two support workers. We also looked at a range of records including service delivery plans (care plans) for all four people who lived at 6 St Nicholas Glebe, three staff files and other documents that related to the overall management of this supported living service. In addition, we received written feedback from four relatives and friends of people the provider supported and three external professionals including, a project manager representing a local authority’s learning disability team, a community mental health worker and an Independent Mental Capacity Advocate (IMCA).
Updated
3 January 2019
This comprehensive inspection took place on 28 November 2018 and was announced.
St Nicholas Glebe is a supported living service that can accommodate up to six people.
On the day of our inspection four younger adults with mental health care needs and learning disabilities were living together at 6 St Nicholas Glebe. The accommodation was owned by a Housing Association and consisted of one bedroom self-contained flat and five single-occupancy bedrooms with a shared communal lounge, kitchen, toilets and showers.
People’s care and housing are provided under separate contractual agreements. This inspection only looked at people’s personal care and support as 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.
This inspection will represent the first time we have rated the service because they were newly registered with the CQC in November 2017. We have rated the service ‘Good’ overall and for all five key questions, ‘Is the service safe, effective, caring, responsive and well-led?’
The service has had the same registered manager in post since they registered with us 12 months ago. 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 received a safe service where they were protected from avoidable harm, discrimination and abuse. Risks associated with people’s needs including the environment, had been assessed and planned for and these were monitored for any changes. People did not have any undue restrictions placed upon them. There were sufficient staff to meet people’s needs and safe staff recruitment procedures were in place and used. Where people needed assistance with taking their medicine this was monitored and safely managed in line with best practice guidance. Accidents and incidents were analysed for lessons learnt and these were shared with the staff team to reduce further reoccurrence.
People received an effective service. Staff received the training and support they required including specialist training to meet people’s individual needs. People were supported with their nutritional needs. Staff identified when people required further support with eating and drinking and took appropriate action. The staff worked well with external healthcare professionals, people were supported with their needs and accessed health services when required. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice. The principles of the Mental Capacity Act (MCA) were followed.
People received support from staff who were kind and compassionate. Staff treated people they supported with dignity and respected their privacy. Staff had developed positive relationships with the people they supported, they understood people’s needs, preferences and what was important to them. Staff knew how to comfort people when they were distressed and made sure that emotional support was provided. People’s independence was promoted.
People received a responsive service. People’s needs were assessed and planned for with the involvement of the person and or their relative where required. Service delivery plans were personalised and up to date. People received opportunities to pursue their interests and hobbies, and relevant educational, vocational and social activities were offered. There was a complaints procedure and action had been taken to learn and improve where this was possible.
The service was well-led. The monitoring of service provision was effective because repeated shortfalls were identified or resolved. There was an open and transparent and person-centred culture with adequate leadership. People were asked to share their feedback about the service action was taken in response.