13 October 2021
During a routine inspection
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.