Archived: One Fylde (Headroomgate)

One Fylde (Headroomgate) is a domiciliary care agency and supported living service providing personal care to 139 people. At the time of the inspection there were 82 people receiving support in supported living tenancies mostly in shared houses, and 57 people supported by the home care service in their own homes.

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

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.

Based on our review of key questions safe and well led, the service was able to demonstrate how they were meeting some of the underpinning principles of Right support, right care, right culture. People supported lived in houses shared with no more than three other people maximising people’s choice, control and independence. People were supported to live inclusive and empowered lives, supported by staff with the right values and behaviours to support people living with a learning disability and/or autism to lead as full a life as possible. One family member told us, “Staff go out of their way to support (name). They are accessible on the phone and are there if I need them. . I rely on them to help me with (name) to take him out which is vital for his well being."

We had some concerns around the documentation to support people with any associated risks to their health and wellbeing and the safe management of medicines. We found people were supported by enough well-trained staff who had been safely recruited. We also found the provider had taken steps to implement changes in procedures and risk management in the pandemic and staff were knowledgeable in the changes made.

The provider did not monitor the records they kept showing the support provided to people in a comprehensive way to assure themselves of effective oversight. We had some concerns as to how the provider could evidence continuous improvement. However, staff were confident in their role and supported people in line with their wishes. The provider ensured they sought suitable advice from professionals when supporting people with more complex needs.

For more details, please see the full report which is on the CQC website at

Rating at last inspection

The last rating for this service was good (11 March 2020).

Why we inspected

This inspection was triggered in part due to safeguarding concerns raised about the provider. We completed an inspection of this service focusing on safe and well led. We have found evidence that the provider needs to make improvements. Please see the well led section of this report. The provider was developing and implementing new systems and processes and at the time of the inspection there was insufficient oversight of the day to day business to allow proactive service improvement. We have found the provider in breach of the regulation associated with good governance. The overall rating for the service has changed from good to requires improvement.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for One Fylde (Headroomgate) on our website at www.cqc.org.uk.

You can see what action we have told the provider to take at the end of this report.

Enforcement

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. We will continue to monitor the service.

We have identified a breach in relation to how the provider collected and reviewed evidence on the services provided to people, we found there was ineffective oversight to ensure concerns which may relate to the whole service were identified. We have also made recommendations in relation to the identification and management of risk and medicines management.

Please see the action we have told the provider to take at the end of this report.

Follow up

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.

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 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.

At the time of our inspection visit, One Fylde (Headroomgate) supported 72 adults with learning disabilities in supported housing and 41 adults who received domiciliary (outreach) care.

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. 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 gain new skills and become more independent.

People’s experience of using this service and what we found

People were safe and protected from the risk of abuse and avoidable harm because staff assessed and managed risk. Staff were trained in recognising potential harm and knew how to raise their concerns. People told us they felt they were safe and staff kept them safe. People usually received their medicines as they needed and staff were trained and their competency checked. Staff were recruited safely and had a thorough induction.

People were helped to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice. Staff assessed people's capacity to make decisions and supported them with decision making. Staff had the training, skills and experience to provide good care. They supported people with meal preparation where needed. They liaised with health and social care professionals and sought advice quickly if people were ill or injured.

Staff provided care that met people’s needs and preferences and respected their diversity. People and if appropriate their relatives, were involved in planning their care and encouraged to make decisions. People told us they were treated with respect and consideration.

Staff assessed people’s communication needs and were familiar with the ways people communicated. People said they knew how to complain. Where people had complained, these had been taken seriously and action taken to try to resolve these to the complainant’s satisfaction. One Fylde (Headroomgate) supported people at the end of life. Staff understood the importance of supporting people to make this as comfortable, pain free and peaceful as possible.

People said staff encouraged them to give their opinions about the service and to make decisions about their care. They told us staff listened to and acted on these. The management team monitored and audited the service to check on the quality of care. They understood and acted on legal obligations, including conditions of CQC registration and those of other organisations. The registered managers worked in partnership with other services and organisations to assist them to follow good practice.

For more details, please see the full report which is on the Care Quality Commission (CQC) website at www.cqc.org.uk

Rating at last inspection and update

The last rating for this service was requires improvement (published 12 February 2019). Since this rating was awarded the provider has merged with another organisation and altered its legal entity. We have used the previous rating and enforcement action taken to inform our planning and decisions about the rating at this inspection. At this inspection we found improvements had been made and the provider was not in breach of regulations.

Why we inspected

This was a planned inspection based on the rating at the previous provider’s last inspection. It is the first inspection of the new provider which registered with us as the new legal entity on 09 May 2019.

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.