14 September 2021
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 inspection was carried out 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 the service 48 hours’ 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. We also needed to assess the risks associated with COVID 19 and how we could ensure everyone remained safe during the inspection.
Inspection activity started on 10 May 2021 and ended on 27 May 2021. We visited the office location on 10 May 2021.
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.
During the inspection-
We spoke with four members of staff including the registered manager, senior support workers and support workers. We reviewed a range of records. This included three people’s medication records, quality systems and two staff files in relation to recruitment and staff supervision.
After the inspection –
We spoke with three relatives about their experience of the care provided. We spoke with one further staff member. We reviewed three care records, training records and quality assurance records. We continued to seek clarification from the provider to validate evidence found.
14 September 2021
About the service
Elderberry Mews and Mulberry Court is a supported living service providing personal care to three people at the time of the inspection. The service is split into two units known as Elderberry Mews and Mulberry Court.
People receive personal care in their own self- contained flats which are all in one building where the offices are situated. Many people received 24 hour care and support.
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. The service was supporting three younger adults living with a learning disability, autistic people and mental health needs.
People’s experience of using this service and what we found
Whilst people’s care plans were in the most part detailed we found improvements were needed to ensure they contained all the relevant details to support people safely.
We found that there had been improvements made around the quality and safety of the service following our last inspection. However, we identified additional areas that needed further improvement and that the new systems introduced needed to become embedded into practice.
People were supported by staff who had received training around safeguarding and knew the appropriate action to take should they have concerns. Staff were recruited safely.
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.
Staff felt well supported in their roles and told us they received appropriate training and supervision.
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. Staff we spoke with knew people and their needs well and told us of recent achievements people at the service had made. We received mixed feedback from relatives about the culture of the service.
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 requires improvement (Published 26 February 2020). We found a continued breach of regulation 17 which relates to how the service is monitored for quality. We placed conditions on the providers registration for monthly reports. At this inspection we found that improvements had been made. However further areas of improvement were identified, and the provider was still in breach of regulations. The service remains rated requires improvement. This service has been rated requires improvement for the last three consecutive inspections.
Why we inspected
This inspection was prompted in part by concerns we received. We received concerns in relation to meeting people’s needs, concerns with staff competency, concerns around the effectiveness of the management of the service and Infection prevention and control concerns. As a result, we undertook a focused inspection to review the key questions of safe, effective 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 remained the same. This is based on the findings at this inspection.
We have found the service needs to make improvement. Please see the safe and well led sections of the 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 Elderberry Mews and Mulberry Court on our website at www.cqc.org.uk.
We will request an action plan for the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.