Normanshire-Supported Living Services

About the service

Normanshire-Supported Living Services is a supported living service providing personal care to people living with a learning disability or autism. At the time of this inspection there were 3 people using the service living in one house sharing a bathroom, kitchen, lounge and garden.

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

Right Support:

The model of care and the setting maximised people’s choice and control. People had their own bedroom and shared the facilities. People were protected from the risks associated with the spread of infection and were supported to take their medicines safely. People were encouraged to make choices and decisions in accordance with their level of understanding.

People’s risks were assessed in a person-centred way. Care plans and risk assessments were regularly reviewed and involved relatives and advocates as appropriate. People who may become anxious or distressed had proactive plans in place to reduce the need for restrictive practices.

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.

Right Care:

Care was person-centred and promoted people’s human rights. People were protected from abuse and poor care. Relatives confirmed they were included in decision making about their relative’s care. People were supported to achieve their goals and aspirations by a staff team who knew them well.

People had their communication, cultural and spiritual needs met. Staff engaged people in activities in accordance with their individual care plans. People were supported to maintain links with their family.

Right Culture:

The managers had an open door policy and overall relatives and staff spoke positively about the management of the service. Relatives and staff confirmed they would be able to raise concerns to enable improvements to be made to the service.

The provider ensured staff had training in learning disability and autism so they could support people in a person-centred way. Governance systems ensured people were kept safe and received care in line with their personal needs and preferences. Relatives were asked by the provider about their opinions of the service. Staff worked with healthcare professionals to improve outcomes for people.

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 good (published 16/02/22).

Why we inspected

This inspection was prompted in part due to a review of the information we held about the service and in part to concerns received about the general care and treatment of people using the service. A decision was made for us to inspect and examine those risks. As a result, we undertook a focused inspection to review the key questions of safe, responsive and well-led only. For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating.

The overall rating for the service has remained good based on the findings of this inspection. We found no evidence during this inspection that people were at risk of harm from these concerns. Please see the safe, responsive and well-led sections of this full report.

Follow up

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

Normanshire - Supported Living Services Ltd provides personal care and support in three settings to people with learning disabilities and autism or physical disabilities. Six people were receiving personal care at the time of the inspection.

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 guidance CQC follows to make assessments and judgements about services supporting people with a learning disability or autistic people.

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

¿ People and their relatives told us they were not always aware they could choose their care provider.

¿ Staff did not always know how to provide person-centred care to people who had behaviours that could challenge themselves or others.

¿ People had proactive plans in place to reduce the need for restrictive practices but these were not always followed.

¿ People made choices and took part in some activities which were part of their planned care and support. Staff supported people to make goals but people were not fully supported to achieve these or to update them as often as they liked.

¿ Staff had training to support them in their roles but the provider had not ensured all staff had received training about supporting autistic people and people with a learning disability.

¿ People’s needs were assessed and they were supported to have choices about their day to day 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.¿

¿ People felt the management team was approachable and felt listened to.

¿ Staff told us they did not use restrictive practices to manage people’s behaviour if they became distressed.

¿ People had access to specialist support to meet their changing needs.

¿ People were protected from abuse and poor care. The service had enough staff to meet people’s needs.

¿ People’s care, treatment and support plans, reflected their cognitive and functioning needs.

¿ People and those important to them, worked with leaders to develop and improve the service.

¿ People were supported by staff whose understanding about best practice in relation to learning disability and/or autism varied.

Why we inspected

This was a planned inspection based on the previous rating.

Rating at last inspection

The last rating for this service was inadequate (published 24 October 2019). We undertook a targeted inspection of the service in September 2020 to check the provider had made improvements where we had found breaches of the Regulations. We do not provide a rating of the service during targeted inspections.

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 discharge our regulatory enforcement functions required to keep people safe and to hold providers to account where it is necessary for us to do so.

We have identified three recommendations in relation to person-centred care, training and independence.

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

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.

Normanshire - Supported Living Services Ltd provides personal care and support in three settings to people with learning disabilities and autism who may have behaviour that challenges services. Five people were receiving personal care at the time of the inspection.

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

The service was well-led. The provider completed a range of audits to monitor the quality of the care provided and made improvements when shortfalls were found. Staff and people’s relatives told us the service managers were approachable and listened to feedback.

People’s relatives told us their loved ones felt safe at the service. The provider had assessed the risks people faced and had made referrals to professionals when people needed more support. We made a recommendation about the quality of the care plans to minimise the risk of pressure sores.

Incident and accidents were recorded appropriately and staff understood how to escalate concerns about people’s safety and wellbeing.

Staff were recruited safely, and they told us there were enough staff working at the service to meet people’s needs. The service had implemented a range of new measures to prevent the spread of infection.

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

Rating at last inspection (and update)

The last rating for this service was inadequate (published 24 October 2019) and there were two breaches of the regulations regarding staffing and good governance. The service was placed in special measures. The provider completed an action plan after the last inspection to show how they would improve. At this inspection we found improvements had been made and the provider was no longer in breach of these regulations.

Why we inspected

We undertook this targeted inspection to check whether the breaches in relation to Regulation 17 and 18 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 had been met and to check on a specific concern we had about people’s safety. The overall rating for the service has not changed following this targeted inspection and remains inadequate.

CQC have introduced targeted inspections to follow up on Warning Notices or to check specific concerns. They do not look at an entire key question, only the part of the key question we are specifically concerned about. Targeted inspections do not change the rating from the previous inspection. This is because they do not assess all areas of a key question.

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.

Special Measures:

The overall rating for this service has not changed and is inadequate and therefore the service remains in ‘special measures’. This means we will keep the service under review and, if we do not propose to cancel the provider’s registration, we will re-inspect within 6 months to check for significant improvements.

If the provider has not made enough improvement within this timeframe. And there is still a rating of inadequate for any key question or overall rating, we will take action in line with our enforcement procedures. This will mean we will begin the process of preventing the provider from operating this service. This will usually lead to cancellation of their registration or to varying the conditions the registration.

For adult social care services, the maximum time for being in special measures will usually be no more than 12 months. If the service has demonstrated improvements when we inspect it. And it is no longer rated as inadequate for any of the five key questions it will no longer be in special measures.