Warwickshire Supported Living Service

Warwickshire Supported Living Service is a domiciliary care agency which is registered to provide personal care and support to people in their own homes, with up to 24-hour support. The service is registered to provide support to younger adults with mental health needs who may have a learning disability or autistic spectrum disorder or sensory impairments. At the time of our inspection the service was supporting 4 people. 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 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.

Where people lacked mental capacity staff worked within the remit of the Mental Capacity Act. Where decisions needed to be made, the Court of Protection was referred to on behalf of people. Local multi-disciplinary teams were involved in making decisions about people’s support and any restrictions imposed on people to mitigate risks of avoidable harm.

Staff were recruited in line with the provider’s policy with pre-employment checks completed. Staff had been trained and had the skills to complete agreed support tasks

Right Care: Care is person centered and promotes people's dignity, privacy and human rights. People’s care, treatment and support plans gave staff the information they needed to provide safe care. Risk management plans provided detail on the safe actions staff should take to ensure risks of harm or injury to people were minimised and staff followed guidance.

Staff ensured people’s rights and dignity were promoted and protected within the agreed risk management plans of care. Infection, prevention and control was managed well.

People and a relative said they felt safe with staff in their homes. Staff understood how to protect people from the risks of abuse and how to report any concerns.

Right Culture: The ethos, values, attitudes and behaviours of leaders and care staff ensure people using services lead confident, inlclusive and empowered lives.

The registered manager had good oversight of the service. Quality checks took place and identified where improvements were needed and actions were taken.

The registered manager had ensured we (CQC) were informed about incidents we should be legally told about.

Feedback was sought from people, relatives and staff about how they felt about the service they received. This feedback was positive about the hands-on caring approach by staff. The registered manager was open to feedback and was willing to learn lessons and make further improvements to strengthen the quality of the service. Staff were valued and said they felt supported by the registered manager.

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 requires improvement (published 21 December 2020). Breaches of regulations 12 safe care and treatment and 17 good governance were found. At this inspection we found improvements had been made and the provider was no longer in breach of the regulations.

Why we inspected

This inspection was prompted by a review of the information we held about this service. We had also received information of concern from Ofsted. Ofsted are responsible for inspecting the care standards of children’s home and had found failings with the provider related to their children's services.

Follow up

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

Warwickshire Supported Living Service is registered to provide personal care to adults in their own homes. At the time of the inspection four people received a regulated activity of personal care as part of their 24-hour support from the provider. This included people living with mental ill health conditions and anxiety.

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

Risks were not consistently well managed. Staff did not always have the information they needed to follow a consistent approach to ensure risks of harm and injury were minimised. Some people’s physical health care conditions had no risk management plan.

Staff were trained to protect people from the risks of abuse. However, the provider’s systems and processes were not effective in managing and responding to safeguarding concerns. The provider had not consistently ensured they notified the CQC or Local Authority of specific incidents they were legally required to.

The provider’s quality assurance systems to check the safety and quality of the services were not always effective. While audits had identified issues where improvements were needed, there were no action plans or time scales of when improvements should be completed. Some areas for improvement we found had not been identified by the provider’s processes.

During July 2020, there had been a change in management and there was no registered manager at the service. A new manager had commenced and had begun to implement a service improvement plan. This included developing systems for people to give their feedback on the service and to record how people and their representatives were involved in planning their care and support.

People felt safe with staff in their homes and long-standing staff knew people well and how to support them in ways they wanted. Staff demonstrated a caring approach and people described staff as kind.

People were consistently supported by the agreed number of staff, who had been recruited in a safe way and received an induction and training. Recruitment was in progress to fill the remaining eight of the fourteen care staff vacancies.

Where people had prescribed medicines and consented to take these in line with healthcare professional’s advice, they were supported by trained care staff.

Staff understood the importance of infection prevention and control. During the Covid-19 pandemic additional training had been given and staff had access to protective equipment.

Staff followed professional mental healthcare guidance where this had been given and people were supported to access healthcare services if required.

Staff had a basic understanding of the principles of the Mental Capacity Act 2005 and understood the importance of gaining consent from people. However, staff lacked information about when they could act in a person’s best interests.

People were supported by staff to meet their nutritional and hydration needs.

Staff promoted people’s independence and maintained people’s privacy and dignity.

We reported that the registered provider was in breach of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014

These were:

Regulation 12 – Safe Care and Treatment

Regulation 17 – Good Governance

Rating at the last inspection

The service was registered with us during April 2020 and this was their first inspection.

Why we inspected

This was a responsive inspection based on the risks identified by the Local Authority and us (CQC).

Follow up

We will continue to monitor information we receive about the service until we return to visit as per our inspection programme. If any concerning information is received, we may inspect sooner.

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