The Care Quality Commission
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  • Homecare service

Independent Supported Living and Disabilities Ltd Also known as ISLAD

Overall: Good read more about inspection ratings

24 Ragstone Road, Slough, Berkshire, SL1 2PU

Provided and run by:
Independent Supported Living and Disabilities Ltd

All Inspections

27 February 2019

During an inspection looking at part of the service

About the service:

Independent Supported Living and Disabilities Ltd (ISLAD) primarily provides personal care to adults with learning disabilities or autism spectrum disorder in their own homes or in supported living settings. Some older adults with dementia also receive personal care in the community. Care was provided to people in Berkshire and Devon. At the time of our inspection, 128 people received personal care.

People’s experience of using this service:

People told us they received good care from ISLAD staff. People were protected from abuse and neglect. When needed, incidents were recorded and investigated and actions taken to prevent recurrence. People had access to an active social life and there were sufficient staff to support them to live life as individually as possible. The governance arrangements covering the Devon area were clear and ensured legal accountability for care provided to people in the relevant ‘supported living’ settings. There was a positive workplace culture at all of the houses we visited. Staff told us they were well-supported. The senior management team and local managers were approachable, knowledgeable and transparent in their approach.

Rating at last inspection:

At our last inspection, the service was rated good. Our last inspection report was published 14 October 2017.

Why we inspected:

This was a focused, responsive inspection. The inspection was triggered by concerns we received about ISLAD’s operational arrangements with two unregistered providers that supported people with personal care in the Devon area. We inspected key questions “Is the service safe?” and “Is the service well-led?”

Follow up:

We will continue to monitor the service to ensure that people receive safe, compassionate, high quality care. Further inspections will be planned for future dates.

For more details, please see the full report which is on our website at www.cqc.org.uk

14 September 2017

During a routine inspection

Independent Supported Living and Disabilities Ltd (ISLAD) provide support to up to 17adults with learning disabilities or autistic spectrum disorder. People lived in self-contained flats all based on one location. 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. On the day of our visit there were 14 people using the service however, only three people received support with personal care.

The registered manager has been registered since June 2017. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act and associated Regulations about how the service is run.

People’s preference and choices in regards to end of life care was not captured, and staff had not attended the relevant training. We have made a recommendation for the service to seek current best practice on how to capture people's preferences and choices in relation to end of life care.

People spoke positively about the caring nature of staff. Comments included, “They (Staff) treat me alright. They listen to me” and “When I came home staff welcomed me with balloons, cards and flowers.” We observed people were relaxed and comfortable with staff who cared and supported them. Most people said staff treated them with respect and dignity. Feedback was provided to management where people felt this did not always occur.

Most people said they felt safe from harm. Where people stated they felt unsafe we saw the provider had taken appropriate action. People said they knew what to do if they felt unsafe. For example, “No one harms me, I will tell staff.” We have made a recommendation for the provider to seek current guidance on how to offer support and information to people who have become distressed after incidents have occurred.

Staff knew how to ensure people were kept safe from harm and had received the appropriate training. Appropriate risk management plans in place promoted people’s safety and helped them to maintain their independence. People felt staff responded promptly to their care and support needs. This was supported by our review of the staff roster. Medicines were administered safely.

Staff had the knowledge and skills to meet people’s care and support needs. The service ensured they were appropriately inducted; trained and supervised. People said staff sought their agreement before delivering care. For example, a person commented, “Yes, they (staff) ask me first (for permission before care and support took place).” Care records showed people’s consent had been sought. We found the service worked in line with Mental Capacity Act 2005. People were supported to have nutritious meals and to maintain good health.

People had their needs assessed before they moved into the service. People felt staff was responsive to their needs. For example one person commented, “I had difficulty with having a shower, so I asked for a stool. Staff got me one.” Care plans and risk assessments were regularly reviewed and kept up to date. The service ensured that people had access to the information they needed in a way they could understand. People were encouraged and supported to develop and maintain relationships with people that mattered. People felt confident to make a complaint if they needed to. Staff said they would ensure all complaints received were recorded and referred to their line manager.

Most people said they had faith in the service. Staff felt they were provided with feedback from managers in a constructive and motivating way. The service took a pro-active approach to ensure the quality assurance systems in place were effectively monitored and reviewed. However, these were not being monitored in line with current legislation. There were systems in place to capture and monitor complaints. People said they had the opportunity to provide feedback about the services provided.

25 & 26 June 2015

During a routine inspection

Independent Supported Living and Disabilities Ltd (ISLAD) provides support to up to 17 adults with learning disabilities or autistic spectrum disorder. People live in accommodation that contain a cluster of seven flats. Staff offices are located within close proximity which enables easy access for people who require support. On the day of our visit there were 16 people using the service.

The registered manager has been registered since May 2013. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act and associated Regulations about how the service is run.

People said they felt safe from abuse and were aware of what to do if they had concerns. This was because the service ensured information about how to report safeguarding concerns was in a format that people could easily understand. The service brought external agencies to talk to people about how they could keep safe both in their homes and out in the community. Staff demonstrated their understanding of the service’s safeguarding policy and knew how to ensure people were protected from abuse. Where risks were identified appropriate measures were put in place to minimise them and they were regularly reviewed. There was sufficient staff to provide care and support to people; this was evidenced in the staff rota reviewed and observations during our visit. Safe recruitment practices were in place which ensured staff recruited was of good character. Appropriate measures were in place to ensure staff administered medicines to people safely. The service ensured a contingency plan was in place in the event of unforeseeable circumstances.

People received effective care from staff who had the knowledge and skills to carry out their job roles. This was because staff received effective induction, training, supervision and appraisal. Staff understood the relevant requirements of the Mental Capacity Act (2005) and the training matrix confirmed they had received appropriate training. Consent was sought before care and support was carried out and where people lacked capacity to give consent, agreements clearly documented who should be involved in the decision making process. People were supported to have enough to eat and drink. The service worked in partnership with other health professionals to ensure people received effective care and support. This was evidenced in people’s health action plans.

People said staff were caring and treated them with respect and dignity. We observed people responding to people with respect and concern. Staff demonstrated a good understanding of people’s needs, hobbies and interests. Care records evidenced how people were involved in their care, given choice and were encouraged to be independent. The service ensured people’s communications needs were met. We have made a recommendation about staff training on the subject of end of life care.

People said the service was responsive to their needs. This was observed during our inspections and in the care records reviewed. We saw care plans and risk assessments were regularly reviewed and updated. Reviews of care were undertaken with people and those involved in their care. Care records clearly captured people’s preferences and wishes and staff provided care and support in order to help people reach their desired outcomes. People said they were involved in decisions made about their care and support needs. This was evidenced in key worker meeting notes we reviewed. The service took a pro-active stance in encouraging people to participate in meaningful activities. During our visit people were either at work, on a social excursion, or involved in an activity of their choice. People knew how to make a complaint if they had concerns.

People, a relative and staff spoke positively about the service and said it was managed well. They told us management was supportive and listened to them. Systems were in place to manage, monitor and improve the quality of the service provided. Staff were aware of their responsibilities in ensuring the quality of the service was maintained. Regular team meetings showed management highlighting the areas that required further improvement. Support was given to staff to enable to them know what to expect from an inspection from the Care Quality Commission and how to evidence the required standards. The service had a system to capture complaints; we noted all complaints were responded to appropriately. Positive feedback was received from people, staff and health care professionals however, we saw no documentary evidence to show what action was taken as result of negative feedback.

13 November 2013

During a routine inspection

One person told us, “I say that I agree”, when staff members wanted to obtain consent. Another person commented, “I can change my mind”, in reference to giving consent. This showed the service sought consent from people and people were able to give consent and withdraw consent if they wanted to.

People told us they were able to choose what care they received. “One person told us, “I get choice. They (staff) help me with getting dressed; I choose what I want to wear.” This showed people who used the service were given choice and were supported in their decisions.

A staff members’ response to alleged abuse was appropriate and in line with the safeguarding policy. They commented, “I would raise my concerns to my manager, they would then complete a referral form and send this off to the safeguarding team. This showed staff members would respond appropriately to suspected abuse.

Disclosure Barring Service (DBS) checks were undertaken. One staff commented, “I had to complete an application, and wait for my DBS and references to come back before I could start work.” This showed staff members were only allowed to start work after a full and satisfactory DBS had been received.

Residents’ meeting note recorded residents wanted a mirror to be placed in the main communal area of the main entrance. We saw this request was actioned. One person commented, “I love the mirror.” This showed the service sought feedback from people who used the service and responded to them.