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Northamptonshire Supported Living

Overall: Requires improvement read more about inspection ratings

Suite 35, Burlington House, 369 Wellingborough Road, Northampton, NN1 4EU (01604) 239404

Provided and run by:
Autism East Midlands

All Inspections

3 October 2022

During an inspection looking at part of the service

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.

About the service

Northamptonshire Supported Living Service is a domiciliary care agency. They provide personal care to people living in their own individual flats within a supported living setting. 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 the inspection four people were receiving personal care.

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

Right support

People were supported by staff who knew them well and focused on people’s strengths and promoted what they could do. Staff supported people to access a range of healthcare services.

Restrictive practice had improved. The service worked with people to plan for when they experienced periods of distress so that their freedoms were restricted only if there was no alternative. Staff followed best practice and records were clear in identifying the need for any restrictions.

Staff supported people with their medicines in a way that promoted their independence and achieved the best possible health outcome. Staff received training on medicines and any health conditions a person may have.

People were supported with their communication. Staff were trained to understand different communication methods and provided personalised support to people. Information was made accessible in different formats, such as, easy read and pictorial.

Staff supported people to make decisions following best practice in decision-making. The service made reasonable adjustments for people so they could be fully in discussions about how they received support.

Right care

The service had enough appropriately skilled staff to meet people’s needs and keep them safe. Staff completed nationally recognised training and received regular support from managers to ensure their skills and knowledge was kept up to date.

Staff promoted equality and diversity in their support for people. They understood people’s cultural needs and provided culturally appropriate care. Care plans reflected people needs, wishes and choices.

Staff understood how to protect people from poor care and abuse. The service worked well with other agencies to do so. Staff had training on how to recognise and report abuse and they knew how to apply it.

People could communicate with staff and understand information given to them because staff supported them consistently and understood their individual communication needs.

Right culture

Oversight of service to assess, monitor and improve the service had improved. However, some systems and processes required embedding into practice. The manager had implemented new systems which were still in their infancy.

People were supported by staff who understood best practice in relation to the wide range of strengths, and needs people with a learning disability and/or autistic people may have. This meant people received compassionate and empowering care that was tailored to their needs.

People and those important to them, including advocates, were involved in planning their care. The service enabled people and those important to them to work with staff to develop the service.

Staff ensured risks of a closed culture were minimised so that people received support based on transparency, respect and inclusivity. The manager was supportive to staff and worked directly with people and led by example.

The service ensured people's behaviour was not controlled by excessive and inappropriate use of medicines. Staff understood and implemented the principles of STOMP (stopping over-medication of people with a learning disability, autism or both).

The provider, manager and staff were dedicated to achieving best outcomes for people. The provider had a clear vision for the service and promoted improvement and feedback.

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 16 March 2022) and there were multiple breaches of regulation. The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection we found improvements had been made and the provider was no longer in breach of regulations.

Why we inspected

This inspection was carried out to follow up on action we told the provider to take at the last inspection. We undertook this focused inspection to check they had followed their action plan and to confirm they now met legal requirements.

This report only covers our findings in relation to the Key Questions Safe, Effective and Well-led which contain those requirements.

For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating.

Follow up

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

14 February 2022

During a routine inspection

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.

About the service

Northamptonshire Supported Living Service is a domiciliary care agency. They provide personal care to people living in their own individual flats within a supported living setting. 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 the inspection two people were receiving personal care.

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

Right Support

People were not always supported by staff who had the skills and training to meet their needs. Not all staff had training in health conditions, medicines, learning disabilities or mental health.

Restrictive practices were not always evidenced as best practice. Debriefs did not always happen. Although staff told us restrictive practice was a last resort.

Staff supported people with their medicines in a way that promoted their independence. However, records were not consistently kept, and risk assessments were not in place when a person regularly refused their medicines.

Staff supported people to take part in activities and pursue their interests in their local area. People were supported to maintain contact with significant people. However, records did not always evidence this.

People were supported with their communication. Staff understood and supported people with their identified communication styles and formats. Information was made accessible in different formats, such as, easy read and pictorial.

Staff supported people to make decisions following best practice in decision-making. People were offered daily choices and staff respected people’s views.

Right Care

People were not supported by a consistent staff team. Due to a high turnover of staff. Staff and relatives told us this impacted people and their anxieties.

Staff promoted equality and diversity in their support for people. They understood people’s cultural needs and provided culturally appropriate care.

People received kind and compassionate care. Staff protected and respected people’s privacy and dignity. They understood and responded to their individual needs.

People who had individual ways of communicating, using body language, sounds, pictures and symbols could interact comfortably with staff and others involved in their care and support. Records clearly documented people’s communication needs.

People’s care, treatment and support plans reflected their range of needs and this promoted their wellbeing and enjoyment of life.

Right culture

The service did not consistently enable people and those important to them to develop the service. Staff did not always feel valued. People, relatives and staff had not been asked to feedback on the service offered.

People did not always receive person centred care due to the ineffectiveness of the oversight of the service.

People and those important to them, including advocates, were involved in planning their care. including how to reduce the likelihood of the person becoming distressed, for example by removing sensory triggers

The service ensured people’s behaviour was not controlled by excessive and inappropriate use of medicines. Staff understood and implemented the principles of STOMP (stopping over-medication of people with a learning disability, autism or both).

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 13 May 2021 and this is the first inspection.

Why we inspected

We undertook this inspection to assess that the service is applying the principles of right support right care right culture.

The inspection was prompted in part due to concerns received about staffing levels, risk assessments, medicine management and oversight. A decision was made for us to inspect and examine those risks.

Please see the safe, effective 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.

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 breaches in relation to staff training, restrictive practice, risk assessment and oversight at this inspection.

Full information about CQC’s regulatory response to the more serious concerns found during inspections is added to reports after any representations and appeals have been concluded.