Background to this inspection
Updated
15 April 2016
‘We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.’
This inspection took place on 30 November and 3 December 2015 and was unannounced.
The inspection team consisted of one inspector. Before the inspection we reviewed previous inspection reports and notifications. A notification is information about important events which the home is required to send us by law. We looked at safeguarding and whistleblowing information we had received.
We spoke to four members of staff including the registered manager, administrator and support workers. We spoke to three people that lived in the service. We contacted health and social care professionals to obtain feedback about their experience of the service.
We observed care and support being provided. We looked at records held by the provider and care records held in the service. These included three people’s care records, risk assessments, staff rotas, four staff recruitment records, meeting minutes, policies and procedures, satisfaction surveys and other management records.
This was the first inspection for SeeAbility - Kent Support Service since they registered with us in 2013.
Updated
15 April 2016
The inspection was carried out on the 30 November and 3 December 2015 and was unannounced.
SeeAbility - Kent Support Service is a supported living domiciliary care service providing support to adults who have a visual impairment and additional disabilities. The service has an office within the building where people hold a tenancy agreement for their living accommodation. There were six people being supported by the service at the time of inspection.
There was a registered manager in post at the time of inspection. 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 2008 and associated Regulations about how the service is run.
There were concerns over how the service supported people in taking their own medicines. There had been a significant gap in one person who was self-administering their medicines taking life supporting medicines that the service had not initially picked up on. Additional support and risk assessments had been put in place following on from this; however this had not been reviewed in line with the agreed plan. Quality monitoring audits picked up that staff completed medication training and passed an externally verified exam had not subsequently completed an observational assessment to verify their competence.
Staff had received training specific to people’s health needs, such as training in administration of epilepsy medicines and other complex conditions. Mandatory training was up to date for all staff.
People at the service told us that they felt safe. There were safeguarding policies and procedures in place that were being followed and staff were fully aware of their responsibilities in reporting safeguarding incidents and what the procedures were for this. There was a whistleblowing policy in place and staff told us they knew how to use it if they needed to.
Risk assessments were robust but the identification of risk was not consistent and we found two risks that had not been identified. We have made a recommendation about this.
The Care Quality Commission (CQC) monitors the operation of the Deprivation of Liberty Safeguards (DoLS) which applies to care homes and how DoLS is assessed and authorised in other settings such as supported living or people’s own homes. The registered manager and staff had a clear understanding of the Mental Capacity Act 2005 and the Deprivation of Liberty Safeguards. Staff had received training on Deprivation of Liberty Safeguards and the Mental Capacity Act 2005. Care plans showed that people’s capacity was taken into account and how this affected the care they received from the service.
People had access to GPs and other health care professionals. Prompt referrals were made for access to specialist health care professionals.
People were supported and encouraged to maintain a healthy and nutritious diet. Staff would research recipes for people to cook and help them prepare meals. People were supported to control conditions like diabetes through a healthy diet.
Staff at the service knew people very well. They were able to identify when people were not well or not themselves through observing them and their behaviours. Care plans were very specific in how to support people.
People had access to Independent Mental Capacity Advocates if they required them.
People were encouraged to be as independent as possible. Some people went out to work and people regularly accessed the local community by themselves. People were supported to successfully manage their own medical conditions.
Service user guides were available in suitable formats such as braille especially for people who had a sight impairment.
Staff knew how to protect people’s privacy and dignity, such as knocking on people’s doors before entering. They made sure that confidential conversations were held in bedrooms and that the office door was shut when discussing confidential issues on the telephone.
Staff were aware of certain triggers for behaviours of people and responded appropriately by implementing strategies to help people cope.
People were involved in drawing up and reviewing their care plans. Pre assessment plans clearly fed into the current care plans.
People were able to participate in activities of their choice. If they were unable to do certain activities then they were supported to access alternatives.
People were regularly in contact with families and friends and often spent time at home with them.
People were actively involved in shaping and improving the service, both on a local and national level. On a local level, there were regular tenant meetings held and there was an annual quality assurance surveys conducted.
There was an easy read complaints procedure in place, as well as in other formats such as braille. People told us they knew how to complain and were confident in doing so. There were records of meetings and response to complaints.
The provider had systems and processes in place to audit and monitor the quality of the service which were in line with the CQC’s methodology. These had picked up recording issues in documentation. There was an action plan in place.
Staff were positive about the registered manager and the support they provided. The registered manager responded to staff suggestions and requests where it was appropriate.
The registered manager was involved with outside agencies in order to keep update to date with best practise.
The registered manager had carried out quality assurance surveys with relatives. The results from these had identified issues such as seeking clarification on how one to one support hours were being used. We spoke to health care professionals that told us they had been involved in reviewing people’s funded hours as a result of this.