Background to this inspection
Updated
6 October 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
The inspection was carried out by one inspector and an expert by experience. 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 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.
Registered Manager
This service is required to have a registered manager. A registered manager is a person who has registered with the Care Quality Commission to manage the service. 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.
At the time of our inspection there was a registered manager in post.
Notice of inspection
We gave the service short notice of the inspection. This was because it is a small service and we needed to be sure that the provider or registered manager would be in the office to support the inspection.
Inspection activity started on 31 August 2022 and ended on 21 September 2022. We visited the location’s office on the 31 August 2022.
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 and professionals who worked with the service. We used all of this information to plan our inspection.
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.
During the inspection
We spoke with six people who used the service and the relative of one person. We also spoke with four members of staff including the registered manager, service manager and two support workers. During the inspection visit we looked at the management of people’s medicines and reviewed support plans.
Additional evidence, sent to us electronically, was reviewed remotely. These included; three people's care records, recruitment information, health and safety, policies and procedures as well as audit and checks of the service.
Updated
6 October 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
Next Stage St Paul's offers personal care and support to people living with mental health needs and learning disabilities and/or autistic spectrum disorders. People live independently in their own flats situated in St Paul's church, Bury. People are supported to develop their independent living skills as well as maintain their own tenancy. Staff are available throughout the day and night-time; hours of support vary depending on the assessed needs of people. At the time of our inspection there were 17 people using the service.
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.
People's experience of using this service
Work had been completed to improve the focus and structure of the service since the last inspection. A new service model was introduced providing structured staffing arrangements as well as improved support plans. Comprehensive assessments had been implemented, providing clear direction for staff helping to reduce the level of risk previously presented.
Right support – People were encouraged and supported to remain independent and were involved in the provision of care they receive. Staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.
Right Care - People received personalised care that was tailored around their likes, wishes and preferences. Information was provided in different formats depending on the individual needs of people. A review of support plans reflected this.
Right Culture - The ethos, values and attitudes of leaders and care staff helped to ensure people were encouraged to live confident, inclusive and empowered lives. In partnership with people, the team assisted them to maintain their own tenancy as well as access activities and opportunities within the local and wider community.
Systems were in place for the reporting and responding to any complaints and concerns. The registered manager liaised with relevant agencies to ensure people were protected. Where necessary, advocacy support was being explored offering people independent support.
Safe recruitment procedures were followed. A structured rota had been implemented offering more consistent support for people. Further recruitment was taking place to fill current vacancies and increase flexibility. Staff spoken with felt the new structure was working well and there was a good mix of skills within the team.
Internal and external safety checks were completed to ensure the premises was kept safe. The landlord was actively involved and took responsibility in completing all maintenance work. Relevant infection control procedures were in place in line with guidance.
The management and administration of people’s prescribed medicines was safe. Individual support plans and risk assessment were in place outlining the level of support required.
Systems were in place providing monitoring and oversight of the service. A service action plan had been drawn up exploring areas of improvement to the service. Opportunities were provided for people, staff and other parties to comment on the services provided. Staff spoke positively about the registered manager. Health and social care professionals, who also provided feedback, were complimentary about the services provided.
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 requires improvement (published 27 January 2021).
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 improvements had been made and the provider was no longer in breach of regulations.
Why we inspected
We carried out an unannounced comprehensive inspection of this service between the 17 December 2021 to 5 January 2022. Breaches of legal requirements were found. The provider completed an action plan after the last inspection to show what they would do and by when to improve areas of safe care and treatment and good governance.
We undertook this focused inspection to check they had followed their action plan and to confirm they now met legal requirements. This report only covers our findings in relation to the Key Questions Safe, Responsive and Well-led, which contain those requirements.
For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating. The overall rating for the service has changed from requires improvement to good. This is based on the findings at this inspection.
You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Next Stage St Paul’s on our website at www.cqc.org.uk.
Follow up
We will continue to monitor information we receive about the service, which will help inform when we next inspect.