Background to this inspection
Updated
22 October 2019
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
The inspection was undertaken by one inspector.
Service and service type
This service provides care and support to people living in three ‘supported living’ settings, 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 two managers 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 48 hours’ notice of the inspection. This was because it is a small service and we needed to be sure that the provider or registered managers would be in the office to support the inspection.
What we did before the inspection
We reviewed information we had received about the service since the last inspection. 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 sought feedback from the local authority and professionals who work with the service. We also asked Healthwatch Rochdale for their views on the service. Healthwatch is an independent consumer champion that gathers and represents the views of the public about health and social care services in England. We used all of this information to plan our inspection.
During the inspection-
We spoke with eight members of staff including the two registered managers, the lead forensic practitioner, front line managers and care workers. People using the service were not able to tell us about their experience of the care provided. With appropriate permission we visited one person in their home to observe how staff supported them. We spoke with three relatives of people who used the service.
We reviewed a range of records. This included two people’s care records and one person’s medication records. We looked at two staff files in relation to recruitment and staff supervision. A variety of records relating to the management of the service, including policies and procedures were reviewed.
Updated
22 October 2019
About the service
MacIntyre Greater Manchester provides a supported living service to people living in their own homes. 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 the service provided a supported living service where personal care was provided to three people in three individual homes.
The service has been developed and designed in line with the principles and values that underpin Registering the Right Support and other best practice guidance. This ensures that people who use the service can live as full a life as possible and achieve the best possible outcomes. The principles reflect the need for people with learning disabilities and/or autism to live meaningful lives that include control, choice, and independence. People using the service receive planned and co-ordinated person-centred support that is appropriate and inclusive for them.
The Secretary of State has asked the Care Quality Commission (CQC) to conduct a thematic review and to make recommendations about the use of restrictive interventions in settings that provide care for people with or who might have mental health problems, learning disabilities and/or autism. Thematic reviews look in-depth at specific issues concerning quality of care across the health and social care sectors. They expand our understanding of both good and poor practice and of the potential drivers of improvement.
As part of thematic review, we carried out a survey with the registered managers at this inspection. This considered whether the service used any restrictive intervention (restraint, seclusion and segregation) when supporting people. The service used some restrictive intervention practices as a last resort, in a person-centred way, in line with positive behaviour support principles.
People’s experience of using this service and what we found
People were supported to have maximum choice and control of their lives and staff supported people in the least restrictive way possible and in their best interests. The policies and systems in the service supported this practice.
The outcomes for people using the service reflected the principles and values of Registering the Right Support by promoting choice and control, independence and inclusion. People's support focused on them having as many opportunities as possible for them to gain new skills and become more independent.
People were protected from the risk of abuse. Risks were well managed and detailed records were kept of care and support provided. Medicines were managed safely. Safe systems of staff recruitment were in place. There was continuity of care because people were supported by staff who knew them well.
There were sufficient staff to meet people’s needs and staff received the induction, training and support they needed to carry out their roles. People's nutritional needs were met. Staff worked proactively to plan how people could access health care in a way that suited their needs.
Staff and the registered managers knew people well. People told us staff were gentle, kind and friendly. Staff spoke about people with fondness, compassion and a genuine pride in the achievements people who used the service had made.
Care records, including positive behaviour support (PBS) plans, were detailed and person centred. Activities were based on people's individual interests, hobbies and wishes. People's routines, preferences and individual communication styles and methods were identified and respected.
People were positive about the registered managers and the way the service was run and organised. The registered managers were enthusiastic and shared a passionate commitment to providing responsive, person centred, individualised support to people. Staff were highly motivated and shared this enthusiasm, commitment and passion. There were good systems of daily, weekly and monthly quality assurance checks and audits.
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 (published April 2017).
Why we inspected
This was a planned inspection based on the previous rating.
Follow up
We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.