Background to this inspection
Updated
21 May 2021
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 Care Act 2014.
This was a focused inspection to check on specific concerns we received about care and support at two schemes run by the provider.
Inspection team
The inspection was undertaken by one inspector.
Service and service type
This service provides care and support to people living in a ‘supported living’ setting, 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 a short period notice of the inspection because some of the people using it could not consent to a home visit from an inspector. This meant that we had to arrange for a ‘best interests’ decision about this. In addition, the service is small and we needed to be sure the provider or registered manager would be in the office to support the inspection.
What we did before the inspection
We received information of concern from people connected with the service. We also reviewed information we had received about the service and considered feedback from the local authority. The provider was not asked to complete a provider information return prior to this inspection. This is information we require providers to send us to give some key information about the service, what the service does well and improvements they plan to make. We took this into account when we inspected the service and made the judgements in this report. This information helps support our inspections. We used all of this information to plan our inspection.
During the inspection
In addition to the office visit, we visited one scheme where we saw the extent of the care and support provided to one person. We were unable to visit the second scheme we had received concerns about, due to the complex needs of the person/people living there. We also spoke with three staff members, the registered manager and a provider representative. We considered five staff recruitment files, two people's care files and medicines records. A variety of records relating to the management of the service, including policies and procedures were also reviewed.
After the inspection
We continued to seek clarification from the provider to validate evidence we found at inspection. We also requested further information including staff training records and infection control prevention policies.
Updated
21 May 2021
Blue Ribbon is a supported living service. At the time of inspection, it was providing care and support to 12 people with learning disabilities and autism who may display behaviour that present as challenging.
The service provides support to people who live in their own homes. People were tenants in houses located in residential streets. People had their own bedrooms and bathrooms and often shared the communal areas and gardens. Sometimes staff members stayed at these homes overnight and supported people 24 hours a day
People’s experience of using this service and what we found
The inspection occurred during the COVID-19 pandemic. Infection prevention and related control measures required some improvement. A thorough staff testing and vaccination policy was required and we have made a recommendation about this in the 'Safe' section of the report.
Staff members had been recruited safely and the provider had robust recruitment processes and policies.
People were safeguarded from situations in which they may experience harm. Risks to people's safety had been thoroughly assessed, monitored and managed so they were supported to stay safe. People received support from an experienced and consistent team of staff who knew them well. One person who was able to give us feedback indicated to us that they felt safe. We were unable to gain feedback from other people due to their complex needs.
Staff received safeguarding training and had a good understanding of the principals involved in acting when abuse was suspected.
People's needs were met through assessments and support planning. The service worked with relatives, health and social care professionals to achieve positive outcomes for people. Staff and management had good knowledge and skills and this ensured people's needs were met.
People's medicines were managed and administered safely.
Staff described being supported by the registered manager and provider. There were quality assurance systems and processes to monitor the service and drive improvements.
The service's ethos was to put the person at the centre of the plan, action and outcome of care and support. We observed good examples of this person-centered approach at inspection.
We expect health and social care providers to guarantee autistic people and people with a learning disability the choices, dignity, independence and good access to local communities that most people take for granted. Right Support, right care, right culture is the statutory guidance which supports CQC to make assessments and judgements about services providing support to people with a learning disability and/or autistic people.
This service was able to demonstrate how they were meeting the underpinning principles of Right support, right care, right culture.
People's care and the setting where they lived helped them to have choice and, where appropriate, independence. The service and staff member's approach to support was person-centred and allowed people to live with dignity and privacy. The whole ethos of the service also allowed staff to support people to ensure they were included in decisions to live empowered lives. The service and staff supported people around all of these principals.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection and update
The last rating for this service was rated 'Good' (published 1 November 2019).
Why we inspected
We received concerns in relation to people's support and staffing. As a result, we undertook a focused inspection to review the key questions of 'Safe' and 'Well-led' only.
We reviewed the information we held about the service. No areas of concern were identified in the other key questions. We therefore did not inspect them. Ratings from previous comprehensive inspections for those key questions were used in calculating the overall rating at this inspection.
We found no evidence, during this inspection, that people were at risk of harm from these concerns. Please see the 'Safe' section of this full report.
You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Blue Ribbon on our website at www.cqc.org.uk.
Follow up
We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.