We carried out a review of the data available to us about Next Stage 'A Way Forward' - St Pauls Court on 6 July 2023. We have not found evidence that we need to carry out an inspection or reassess our rating at this stage.
This could change at any time if we receive new information. We will continue to monitor data about this service.
If you have concerns about Next Stage 'A Way Forward' - St Pauls Court, you can give feedback on this service.
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.
Next Stage – St Paul's offers support to people living independently within 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 15 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 and what we found
The purpose and focus of the service needed to be re-established as well as improvements in the quality and safety of support. It was felt a period of implementation and review was needed to help reduce risks and provide confidence in the new service model.
Following conclusion of two recent safeguarding investigations the service has been asked to provide assurance that systems are in place where people have specific support arrangements, so they are kept safe.
Risk management plans and support files were not sufficiently detailed, reviewed and updated to reflect the current and changing needs of people, helping to minimise potential risks to people and others.
The admissions and assessment process was under review so only those people who can be effectively and safely supported will be offered a placement at the service. To assist this, specific areas of training were to be provided and ‘matching’ of people and staff to help provide more structured and effective support.
People spoke positively about the support they received and their relationships with staff, who were described as ‘friendly but professional’. Whilst people’s routines had been impacted on due to the pandemic, alternative activities and opportunities were being explored.
Staff said there was good communication and teamwork. The new manager was said to be approachable, responsive and supportive of the team.
Clear systems were in place with regards to the management of people’s medication. Training and assessments of competency were completed to check staff understood their responsibilities. Where shortfalls had been found through the audits and checks, appropriate action had been taken.
Systems and process to help minimise the risk of cross infection were in place. Staff used personal protective clothing when supporting people as well as additional cleaning within the building.
The manager maintained a record of any issues or concerns brought to their attention and any action taken where necessary.
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 November 2019).
Why we inspected
We received concerns in relation to the safe care and treatment of people, particularly in relation to risk management. As a result, we undertook a focused inspection to review the key questions of safe, responsive 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.
The overall rating for the service has changed from good to requires improvement. This is based on the findings at this inspection.
We have found evidence the provider needs to make improvement. Please see the safe, responsive and well-led sections of this full report.
You can see what action we have asked the provider to take at the end of this full report.
You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Next Stage – St Pauls on our website at www.cqc.org.uk.
Enforcement
We have identified breaches in relation to the risk management, support plans and areas of governance at this inspection.
We are mindful of the impact of the COVID-19 pandemic on our regulatory function. This meant we took account of the exceptional circumstances arising as a result of the COVID-19 pandemic when considering what enforcement action was necessary and proportionate to keep people safe as a result of this inspection.
Please see the action we have told the provider to take at the end of this report.
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.
Next Stage – St Paul’s offers support to people living independently within 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 15 people using the service.
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
The service applied the principles and values of Registering the Right Support and other best practice guidance. People's support focused on helping them to achieve the best possible outcomes, which included having choice and control as well as opportunities to gain new skills and become more independent.
The staff team placed great emphasis on social inclusion both within the local and wider communities. Packages of support varied depending on the individual needs of people. People were thrilled about living in their own flats as well as learning new independent living skills, gaining voluntary and paid employment and making friendships with other people at St Pauls.
People felt staff respected difference and treated them as individuals. Staff sensitively explored people’s emotional needs such as, religious and cultural needs and gender and sexuality. Staff worked collaboratively with other agencies providing advice and support to people on maintaining their health and well-being. People’s medicines were managed and administered safely.
Comprehensive assessments were used to develop personalised support plans and risk assessments. These focused on minimising areas of concern whilst promoting positive risk taking so people remained as independent as possible. 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 helped to maintain a safe environment. Additional support and safety checks were carried out by the landlords housing officers situated at St Pauls.
Staff had been safely recruited. A thorough package of induction and training was provided to support staff in developing the skills needed to safely and effectively deliver the support people wanted and needed. Staff spoke enthusiastically about their role and clearly understood what was expected of them. Staff said they now ‘enjoyed coming to work’ and felt valued as a member of the team.
Staff felt considerable improvements had been made to the overall management of the service. The registered manager was described as a ‘strong leader’ and ‘committed’ in supporting the team to achieve the best outcomes for people.
Robust quality monitoring systems were in place to identify and act on any areas of improvement. It was evident from our discussions the staff and management team they had a strong commitment in delivering the highest standards of care and support.
Clear systems were in place for the recording and responding to any safeguarding issues or complaints and concerns. These were responded to appropriately.
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 5 November 2018 and this is the first inspection.
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.