Walsingham Support - Hertfordshire Supported Living

Walsingham Support – Home Counties Outreach Services is a supported living service providing personal care to people in shared housing in the community. At the time of our inspection there were 14 people using the service.

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, 13 people were supported with personal care.

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 not always supported to have maximum choice and control of their lives and staff did not always support them in the least restrictive way possible and in their best interests; the policies and systems in the service did not support this practice.

Staff did not always encourage people to do what they could for themselves.

Staff enabled people to access health and social care support in the community.

Right Care:

People’s risk assessments had not always been updated to ensure they reflected their current needs.

Staff understood how to protect people from poor care and abuse. The service had enough staff to meet people’s needs and keep them safe. Staff supported people to take part in activities.

Right Culture:

The service had been without a registered manager for a period and during this time the provider had not maintained oversight of the service. A manager had registered recently and identified issues with the service but at the time of our inspection these had not yet been resolved.

Staff were not all up to date with their training, and competency assessments were not always completed.

Staff knew and understood people well.

People and those close to them were involved in planning their care.

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 (26 April 2019)

Why we inspected

This inspection was prompted by a review of the information we held about this service.

Enforcement and recommendations

We have identified breaches in relation to risk assessments and incidents, staff training and governance. We have made a recommendation relating to mental capacity assessments.

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.

People’s experience of using this service:

People told us they felt safe and happy with the support staff provided to them.

People told us staff were friendly, kind and listened to them. Care plans were reflective of people`s likes, dislikes and preferences about the care they received.

People were supported to have maximum choice and control of their lives and staff support them in the least restrictive way possible; the policies and systems in the service support this practice.

The care service has been developed and designed in line with the values that underpin the Registering the Right Support and other best practice guidance. These values include choice, promotion of independence and inclusion. People with learning disabilities and autism using the service can live as ordinary a life as any citizen.

People said they were free to plan their free time and staff supported them to do what they wanted discussing what risks were involved and also how to keep safe. As a result, people went on holidays, days, attended different clubs depending on their hobbies and interests.

People were pleased that staff listened to their wishes and their choices were respected. Staff knew how to support people to live a healthy life and helped people attend their annual health checks as well as make appointments to see health professionals when there was a need for it.

Staff received training to understand current best practice and provide people with the care they needed effectively. They told us they had regular supervisions and their managers were approachable if they needed any guidance or advice.

The provider was recruiting, and, in the meantime, permanent staff vacancies were covered by agency staff. The same agency staff were booked when possible to ensure people had continuity of care and support.

The registered manager and service managers regularly audited various aspects of the service to ensure the quality of the service was monitored and improvements were made when needed. The provider`s quality team visited and audited the service on a regular basis. Improvements needed were discussed and implemented.

Rating at last inspection: Good (report published 06 June 2016).

Why we inspected: This was a planned inspection based on the rating at the last inspection. The service remained rated Good overall.

Follow up: We will continue to monitor intelligence we receive about the service until we return to visit as per our re-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

The service is required to have a registered manager. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run. The manager had recently joined the service and was not yet registered with the commission. They were waiting for their application for registration to be processed.

People felt safe and they were protected against the possible risk of safeguarding concerns or harm. Risks to individuals had been assessed and managed appropriately. There were sufficient numbers of experienced and skilled staff to care for people safely. Medicines were managed safely and people received their medicines regularly and as prescribed.

People received care and support from staff who were competent in their roles. Staff had received relevant training and support from management for the work they performed. They understood the requirements of the Mental Capacity Act (2005) and the Deprivation of Liberty Safeguards. They were aware of how to support people who lacked mental capacity. People’s nutritional and health care needs were met. They were supported to maintain their health and wellbeing and had access to and received support from other health care professionals.

The experiences of people who used the service were positive. They were treated with kindness and compassion and they had been involved in the decisions about their care where possible. People were treated with respect and their privacy and dignity was promoted.

People’s health care needs were assessed, reviewed and delivered in a way that promoted their wellbeing. They were supported to pursue their leisure activities and access the local community facilities and amenities. An effective complaints procedure was in place.

There was a caring culture and effective systems in operation to seek the views of people and other stakeholders in order to assess and monitor the quality of service provision.