Tower Project

Updated 11 February 2022

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 Care Act 2014.

Inspection team

This inspection was carried out by one inspector.

Service and service type

This service provides care and support to people living in a ‘supported living’ setting, 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.

The service had a manager registered with the Care Quality Commission. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.

Notice of inspection

We gave the service 24 hours’ notice of the inspection. This was because the service is small and people are often out and we wanted to be sure there would be people at home to speak with us.

What we did before inspection

We reviewed information we had received about the service. We sought feedback from the local authority and professionals who work with the service. We used the information the provider sent us in the provider information return. This is information providers are required to send us with key information about their service, what they do well, and improvements they plan to make. This information helps support our inspections. We used all of this information to plan our inspection.

During the inspection

People using the service had complex needs, some of whom were non-verbal. We spoke with relatives about their experience of the care provided. We spoke with two members of staff including the, registered manager and support worker.

We reviewed a range of records. This included one person’s care records, including care plan, associated risk assessments and medicine records. We looked at two staff files in relation to recruitment and staff supervision.

After the inspection

We continued to seek clarification from the provider to validate evidence found. We looked at training data and quality assurance records. We reviewed policies and procedures and records related to the running of the service. We contacted additional staff and professionals but we were not able to obtain feedback

Updated 11 February 2022

About the service

The Tower Projects is a ‘supported living’ service that provides personal care to people living with a learning disability and/or autism. Each person has their own room with shared lounge, garden, kitchen and dining area. The service provides 24-hour support.

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. At the time of our inspection one person was receiving personal care.

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

We found there were not always enough staff to safely support people at night. Where a waking night staff member was required, records showed this had not been provided. This may have put one person at risk of harm as staffing levels were not in line with funded one to one care at night. Systems for monitoring the service were not always effective in identifying the issues found during our inspection. Audits were not always recorded. This meant we could not identify where learning had taken place to drive improvements.

People received their medicines from trained and competent staff. However, guidelines were not always in place for the use of ‘as required’ medicines. We have made a recommendation about medication management.

People using the service received care and support from staff who knew them well. Relatives and staff were complimentary about the way the registered manager ran the service, and how approachable they were. Relatives told us they felt safe with care staff who treated people with dignity and respect. People were involved in decisions about their care.

People received care from staff who understood their needs and knew them well.

People's nutritional needs were met and people were given choice of what to eat and drink. Staff worked with other healthcare professionals to meet people's health needs. Staff followed good infection control practices to keep people safe from the risk of the spread of infection.

Staff received training and supervision to assist them to carry out their role. Effectively.

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.

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 statutory guidance which supports CQC to make assessments and judgements about services providing support to people with a learning disability and/or autistic people.

The service was able to demonstrate how they were meeting the underpinning principles of Right support, right care, right culture. The registered manager and staff demonstrated a commitment to people and strong person-centred values. Peoples choices were respected and staff supported them to achieve good outcomes. The environment promoted choice, control and independence in a respected and dignified setting.

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

Rating at last inspection

This service was registered with us on 2 March 2020 and this is the first inspection.

Why we inspected

This was a planned comprehensive inspection.

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 monitor the service.

We have identified two breaches of the Health and Social Care Act 2008 (Regulated Activities) 2014 in relation to staffing levels and quality assurance systems.

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

Follow up

We will request an action plan from the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.