Background to this inspection
Updated
24 March 2020
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.
Inspection team
This 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. Salters Hill Home Care and Support is also a domiciliary care agency. It provides personal care to people living in their own houses and flats and specialist housing.
The service did not have a manager registered with the Care Quality Commission at the time of the inspection, however, a new manager was in the process of applying to become registered for the service. This means that they and the provider will be 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 wanted to obtain people’s consent to a home visit from an inspector and it is a small service and we needed to be sure that the provider’s representative would be in the office to support the inspection.
What we did before the inspection
We reviewed information we had received about the service since the last inspection. We sought 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. We used all of this information to plan our inspection.
During the inspection
We spent time with people to see how they were cared for and spoke with five people who received supported living or domiciliary care. We also spoke with five relatives about their experience of the care provided. In addition, we spoke with two provider’s representatives, the interim manager of service and the deputy manager, four care staff and a member of agency staff.
We reviewed a range of records. This included three people’s care records and multiple medication records. We saw records relating to the management of the home. These included checks undertaken by the provider’s representative and provider on the management of the home and the safety and quality of care. We also saw systems used to manage complaints and concerns and any accidents and incidents which may occur, and compliments staff had received in relation to the care they provided.
Updated
24 March 2020
About the service
Salters Hill Home Care and Support provides supported living service to people living in a large house with communal and private rooms, and large grounds. At the time of the inspection, six people were in receipt of personal care at this location. Salters Hill Home Care as Support also provides personal care to people living in their own homes, in the community. At the time of the inspection, seven people were receiving personal care in the community.
The service was a large home, bigger than most domestic style properties. The size of the service having a negative impact on people was mitigated by the building design fitting into the residential area. There were deliberately no identifying signs to indicate it was a care home. Staff were also discouraged from wearing anything that suggested they were care staff when coming and going with people.
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
There had been a change of legal entity since our last inspection and changes to the staff managing the service. There was a culture at the service which encouraged people to ask for the assistance they wanted, and staff felt supported to provide good care. The provider was working with people and families to further develop the service, based on best practice, such as registering the right support. An interim manager was in post at the time of our inspection and a new registered manager had recently been appointed.
People were cared for by staff who understood how to promote their safety and recognise abuse. People’s risks were regularly assessed, and advice from other health and social care professionals was followed so people would enjoy the best well-being possible. There were sufficient staff to care for people, and to support them to spend time out in the community when people wished. Staff supported people to have the medicines they needed to remain well. People were cared for by staff who used their knowledge and the equipment provided to reduce the likelihood of the spread of infections.
People’s and their relatives’ views were considered when staff assessed and reviewed their needs. People were cared for by staff who had undertaken training linked to the needs of the people they supported. Staff supported people to ensure they would have the right amount to eat and drink, and people were positive about how this assistance had led to good health outcomes. Where people required care from other health and social care professionals staff supported them. 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.
People were positive about the staff who cared for them and were confident to ask for the care they wanted. Staff used their knowledge of what was important to people when caring for them and involved people in decisions about their day to day care. People were supported to maintain their dignity and their right to independence was promoted by staff.
People’s, relative’s and staff’s views were considered when people’s care was planned. 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. The outcomes for people using the service reflected the principles and values of Registering the Right Support by promoting choice and control, independence and inclusion. People's support focused on them having as many opportunities as possible for them to enjoy spending time as they wished and contributing to their local communities and maintaining their independence.
Systems were in place for managing any complaints and to take learning from these. The provider had begun to explore people’s preferences for their care at the end of people’s lives, and in the event of people’s sudden death, to identify people’s wishes.
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 Good (published 22 February 2017). Since this rating was awarded the provider has altered its legal entity). We have used the previous rating to inform our planning and decisions about the rating at this inspection.
Why we inspected
This was a planned inspection based on the previous rating.
Follow up
We will continue to monitor intelligence we receive about the service until we return to visit as per our inspection programme. If any concerning information is received we may inspect sooner.