Background to this inspection
Updated
9 December 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.
As part of this inspection we looked at the infection control and prevention measures in place. This was conducted so we can understand the preparedness of the service in preventing or managing an infection outbreak, and to identify good practice we can share with other services.
Inspection team
The inspection was carried out by two inspectors and an assistant inspector carried out telephone calls to people’s relatives.
Service and service type
This service provides care and support to 36 people living in seven '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 48 hours' notice of the inspection. This was because we needed to ensure someone would be available in the office to speak with us. We also needed to seek permission to visit people in their homes.
Inspection activity started on 17 September 2021 and ended on 11 October 2021. We visited the office location on 23 September 2021. Two inspectors carried out visits to four people’s homes on 22, 27, 28 and 30 September 2021. We held video calls with the provider’s representatives on 17 September, with the registered manager on 8 October and with the registered manager and divisional director on 11 October 2021.
What we did before the inspection
We reviewed information we had received about the service since registration. We sought feedback from the local authority commissioners and professionals who work with the service. 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.
We requested a number of records to review before we visited the office. These included a variety of records relating to the management of the service.
During the inspection
We held three remote video calls with representatives of the provider and the registered manager, visited the office and visited four of the supported living settings. We looked at four people’s electronic care and support plans and records. We met, spoke with and/or Makaton signed (a sign language that uses signs with speech) with 12 people who used the service. We made observations of the care and support provided to people in their homes. We spoke with 13 members of staff including the registered manager, a registered manager from another service, team leaders and divisional director. We had telephone conversations with seven of the 36 people’s representatives. We viewed four staff recruitment files and supervision information.
After the inspection
We continued to seek clarification from the provider to validate evidence found. The provider sent us documentation electronically including staff training information, supervision records and a range of records used to monitor the quality and safety of the service.
Updated
9 December 2021
About the service
Encompass Supported Living Services Central Dorchester and Bridport Division provides care and support to 36 people living in seven 'supported living' settings, including houses and flats, so that they can live as independently as possible.
Not everyone who used the service received personal care. The Care Quality Commission (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, the service was supporting 36 people with their personal care needs.
People's experience of using this service and what we found
For people living in certain geographical areas there were not enough staff employed to be able to provide people with the staff they had been assessed as needing. However, these shortfalls were being covered by regular bank or agency staff. This reflected a national picture in the social care sector. There were occasions where people had not been provided with their one to one staff support. This had impacted on a small number of people’s ability to undertake activities at home or in the community at their preferred times. One to one hours were in addition to the core staffing provided to meet people’s assessed care and support needs. These hours were for supporting people to do activities or to have staff support to travel and go out. The provider had been creative in the ways they provided people’s one to one support during the pandemic when there were restrictions on travel and attending day services. The provider had been proactive in addressing recruitment and retention at the service.
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. The service used REACH principles (nationally recognised standards underpinning good practice in ‘supported living’) to ensure people were at the centre of their care and were supported to be as independent as possible. People lived in domestic settings and received support from staff who understood their needs and preferences. Managers and staff empowered people to make their own decisions about their care and support.
Staff told us they understood their responsibilities in relation to safeguarding. Relatives and people using the service told us they felt safe.
Medicines were managed safely. People received their medicines when needed and appropriate records had been completed. We saw people had access to healthcare professionals.
Risks to individuals and the environment were well managed. The provider learned from accidents and incidents to mitigate future risks.
Staff development was supported by a thorough induction, support from the management team and training relevant to the needs of the people they cared for.
Infection control procedures were robust and measures were in place to protect people from infection control risks associated with COVID-19.
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 did support this practice.
People were supported by kind and caring staff. People were treated with dignity and respect and supported to maintain their independence.
People's care and support needs were reviewed. People and their relatives knew how to raise a complaint.
The provider's governance systems both monitored and improved the quality and safety of the service provided to people. The registered manager and provider were open and transparent and acted on any feedback given throughout the inspection.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection
This service was registered with us on 20/12/2018 and this is the first inspection.
Why we inspected
This was a planned inspection to provide the service with a rating.
Follow up
We will continue to monitor information we receive about the service until we return to visit as per our reinspection programme. If we receive any concerning information we may inspect sooner.