Plymouth Support Service

Updated 12 July 2023

The inspection

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 Health and Social Care Act 2008.

Inspection team

The inspection was completed by one inspector and an expert by experience. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service.

This service provides care and support to people living in 9 ‘supported living’ settings, 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.

Registered Manager

This provider is required to have a registered manager to oversee the delivery of regulated activities at this location. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Registered managers and providers are legally responsible for how the service is run, for the quality and safety of the care provided and compliance with regulations.

At the time of our inspection there was a registered manager in post. They were supported by service managers, who were responsible for the day to day management of the different settings.

Notice of inspection

We gave a short period notice of the inspection because some of the people using it could not consent to a home visit from an inspector. This meant that we had to arrange for a ‘best interests’ decision about this.

Inspection activity started on 5 May 2023 and ended on 9 May 2023. We visited the location’s office on 9 May 2023.

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. We used the information the provider sent us in the provider information return (PIR). This is information providers are required to send us annually with key information about their service, what they do well, and improvements they plan to make. We used all this information to plan our inspection.

During the inspection

We visited 3 supported living settings, met 9 people and spoke with 4 people. We observed how staff interacted with, and supported people. We also spoke with 12 staff including the registered manager, service managers, deputy manager and support staff. We reviewed the care records for 3 people as well as a range of records relating to the management and oversight of the service, such as audits and meeting minutes. We also spoke with 12 relatives by phone.

Updated 12 July 2023

About the service

Plymouth Support Service is a domiciliary care agency which provides personal care to people who have learning disabilities or complex needs. At the time of our inspection, the service was providing care and support to 27 people in 19 different supported living settings. In the accommodation we visited, some people lived in self-contained flats, and others in houses. People had their own bedroom and shared bathrooms, as well as shared communal areas.

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 people with a learning disability and autistic people respect, equality, dignity, choices and independence and good access to local communities that most people take for granted. ‘Right support, right care, right culture’ is the guidance CQC follows to make assessments and judgements about services supporting people with a learning disability and autistic people and providers must have regard to it.

Right Support:

People were supported to be independent and they had control over their own lives. The care model focused on people’s strengths and promoted what they could do. People made choices and took part in meaningful activities.

People who experienced periods of distress had proactive plans in place to guide staff on how to support them at these times. People were able to socialise in the communal living areas and enjoyed the privacy of their own rooms when they wanted to

Reasonable adjustments were made for people so they could participate fully in discussions about their support.

People could access specialist health and social care support in the community

People were supported to make decisions by staff who used best practice in decision-making and communicated with people in ways that met their needs. 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 supported people with their medicines in a way that promoted their independence and achieved good health outcomes.

Right care

Staff actively promoted equality and diversity in their support to people. People received kind and compassionate care from staff who protected and respected their privacy and dignity. Staff had a detailed understanding of people’s needs.

People were protected from abuse and poor care and any concerns were robustly addressed. Staff involved people and ensured individualised risk assessments were undertaken. Where appropriate positive risk taking was encouraged and enabled. The service had enough appropriately skilled staff to meet their needs and keep them safe.

People were able to communicate with staff as staff understood their individual communication needs.

People’s support plans reflected their range of needs and this promoted their wellbeing and enjoyment of life.

People enjoyed undertaking activities and pursued interests that were tailored to them. They were given the opportunity by staff to actively engage and try new activities. Staff supported changes that individuals might want to make.

Right culture

Managers and senior staff modelled good practice and led by example. People received good quality care and support from trained staff who were able to meet their needs and wishes.

People were supported by staff who understood best practice in relation individuals’ needs. This meant they received compassionate and empowering care that was tailored to their needs.

Staff knew and understood people well and were responsive to any requests, maximising people’s opportunities to have control over their lives.

Staff regularly evaluated the quality of support given, involving the person, their families and other professionals as appropriate.

There was a culture of improvement and inclusivity within 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 the service at the previous premises was good, published on 6 September 2019.

Why we inspected

We completed this inspection to provide a rating for this previously unrated service.

Recommendations

We have made recommendations in relation to advising people about safe medicines storage, supporting people to identify meaningful targets and developing clear pathways to achieving them and ensuring each accommodation was treated as the person’s home.

Follow up

We will continue to monitor information we receive about the service, which will help inform when we next inspect.