Barnet Supported Living Service

Updated 9 January 2019

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.’

This inspection took place on 19 & 24 September 2018 and was announced.

We gave the service 48 hours’ notice of the inspection visit because we needed to be sure that staff and people who used the service would be around.

Inspection site visit activity started on 19 September 2018 and ended on 24 September 2018. It included meeting and speaking with people who used the service, calling relatives, speaking with care workers and assessing documentation we requested. We visited the office location on both dates to see the registered manager and office staff; and to review care records and policies and procedures.

On the 19 September 2018 we visited Quartz Court and the inspection was carried out by one adult social care inspector. On 24 September 2018 we visited Quartz Court, Harrold Court and Agatha House. The inspection visit was carried out by one adult social care inspector and one expert by experience. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service.

Before the inspection we looked at information that we had received about the service and any formal notifications that the service had sent to the CQC. We used information the provider sent us in the Provider Information Return. This is information we require providers to send us at least once annually to give some key information about the service, what the service does well and improvements they plan to make.

We spoke with three people who used the service and two relatives. We spoke with the registered manager, two scheme coordinators, five care workers and the director. We looked at seven care records. We also looked at personnel records of seven care workers, including details of their recruitment, training and supervision. We reviewed further records relating to the management of the service, including staffing rotas and quality assurance processes, to see how the service was run. We received feedback from one healthcare professional.

Updated 9 January 2019

This inspection took place on 19 & 24 September 2018 and was announced. During our last inspection in December 2015 we found that the services quality assurance monitoring systems were not always effective. During our inspection in September 2018 we found that the service had addressed the issues and effective quality assurance monitoring systems were in place, which ensured the quality of care was monitored and improvements to the overall quality of care provided were made.

Barnet Supported Living Services provides care and support to people with learning disabilities living in four ‘supported living’ settings, so that they can live in their own self-contained flats as independently as possible. People’s care and housing are provided under separate contractual agreements. The Care Quality Commission (CQC) does not regulate premises used for supported living; this inspection looked at people’s personal care and support. At the time of our inspection 32 people received the regulated activity ‘Personal Care’ from Barnet Supported Living Services. People lived at five different sites, two in Barnet and three in Edgware North London. Each supported living site had shared communal areas for people to socialise or have meals together if they choose and self-contained flats. The four larger sites can accommodate a maximum of nine people and the smallest site can accommodate a maximum of three people. People who used the service had different abilities, needs and communication skills. People who used the service received personal care from approximately 59 staff, these included care workers, senior care workers, team leaders and care co-ordinators.

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.

A manager had been registered with the CQC. 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.’

We rated the service during this inspection outstanding, because staff praised the training that they received highly and told us it equipped them to undertake their role and provide excellent care and support to people who used the service. Training records showed that staff received training which was tailored towards people’s needs and ensured that people who used the service were at the centre of the service. There was a very strong focus on people maintaining their diverse cultural identity. Care assessments and care records were formulated with people’s diverse cultural needs in mind. The service tried to match staff with people who had a similar cultural understanding. The service worked very closely with various health care professionals and had achieved remarkable outcomes for some people with very complex and profound communication difficulties.

People had excellent, meaningful relationships with the staff. Independence was widely encouraged, and innovative methods were used to communicate with people as well as to support people with remaining independent. People felt able to contribute to decisions about the support

needs and always felt staff acted on their wishes. People's rights were always respected. Extra effort was made to recruit staff who showed the same interest as people who used the service to ensure staff and people were well suited and matched.

People received person centred support focused on what mattered most to them. People were fully involved with the on-going development of their support needs. People were encouraged to achieve their goals and to partake in activities that were important to them. People were provided with the information they needed, in a format they could understand, if they wished to make a complaint. People felt able to make a complaint and were confident it would be dealt with appropriately.

The service had a strong leadership presence with a registered manager who had a clear vision about the direction of the service. They were committed and passionate about the people they supported and were constantly looking for ways to improve. The service and everyone involved in the management of the service was committed to provide the best possible service and care to people. Thorough and frequent quality assurance processes and audits ensured that all care and support was delivered in the safest and most effective way possible

People felt safe with the staff who supported them, and we saw people were comfortable with staff. Staff received training in how to safeguard people from abuse and understood what action they should take in order to protect people from abuse. Risks to people's safety were identified and minimised to keep people safe. People were supported with their medicines by staff who were trained and assessed as competent to give medicines safely. Staff recorded medicines administration according to the provider's policy and procedure, and checks were in place to ensure medicines were managed safely. There were enough staff to meet people's needs effectively. The provider conducted pre-employment checks prior to staff starting work, to ensure their suitability to support people. Staff told us they had not been able to work until these checks had been completed.

People were supported to have maximum choice and control of their lives and staff did support them in the least restrictive way possible; the policies and systems in the service did support this practice. People who used the service were supported to choose, prepare and eat a nutritious, healthy, well balanced and culturally appropriate diet.