Archived: Somerset LD Services 5

Updated 24 September 2016

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 24 and 25 August 2016 and was announced. The provider was given 48 hours’ notice because the location provides personal care and a supported living service for adults who live in their own homes, and who are often out during the day. We needed to make sure the registered managers were available to meet us. We asked them to make arrangements for us to visit people in their own homes. The inspection was carried out by one inspector.

Before the inspection we sent out questionnaires to people who use the service, staff, relatives and health and social care professionals. We asked the provider to complete a form called a Provider Information Return (PIR). This is a form that asks the provider to give some key information about the service, what the service does well and the improvements they plan to make.

During the inspection we met with three registered managers. We looked at the domiciliary care service which provides personal care and support to people living in their own homes in the community. We also visited four houses shared by people who had a tenancy agreement for the rooms they occupied. We spoke with, or observed staff interacting with, 33 people during our inspection. We also spoke with 15 staff.

During the inspection we looked at a range of records the provider is required to maintain. These included service user support plans, medicine administration records, staff rotas, staff recruitment files, staff training records, meal planning records, and quality monitoring records. We also looked at records of accidents, incidents, compliments and complaints and safeguarding investigations.

Updated 24 September 2016

The inspection took place on 24 and 25 August 2016 and was announced. We gave the service 48 hours’ notice because we wanted to meet the registered managers and needed to be certain they would be available during the inspection. This also gave the registered managers sufficient time to ask some people if they would be willing for us to visit and speak with them in their homes. The service was previously inspected on 12 February 2014 when we found the service was fully compliant with all regulations covered in the inspection. During this inspection we found no breaches of regulations and we found people received a good service.

Somerset LD Services 5 specialises in providing supported living and domiciliary care services to adults who have a learning disability or autistic spectrum disorder. The agency provides services in Taunton, Bridgwater and surrounding areas. The provider told us they supported 150 people in a range of settings. Some people lived in their own homes and received a domiciliary care service, and others lived in shared houses and bungalows and received support from staff on either a shared or one-to-one basis. During this inspection we visited four shared houses and bungalows in the Taunton, Williton and Bridgewater areas. We also looked at the domiciliary care service, although the registered managers told us this part of the service was in the process of being re-organised and moved to another of the provider’s registered services.

The service provided other forms of social care support which are not included within CQC's registration requirements for a supported living service, such as housekeeping, shopping, attending appointments and other independent living skills. We met some service users while they were attending a day centre run by the provider. People's accommodation was provided by separate housing providers or landlords, usually on a rental or lease arrangement. The housing services are not regulated or inspected by CQC. People could choose an alternative support service provider if they wished while continuing to remain in their current accommodation.

There were two registered managers in post. A third registered manager was in the process of de-registering. They shared the responsibility of managing the supported living service to people living in 13 shared houses and bungalows. 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.

People told us they felt safe. Comments included, “Yes, I feel safe here” and, “All the staff here are kind. I know this place – all the staff are good.” Staff had received training on safeguarding adults and knew how to identify and report any suspicion of abuse. .

People received reliable and consistent support from a stable and well trained staff team. Each shared house had a team of staff based there. People could choose the staff they wanted to support them. They had been consulted and involved, as far as they were able, to draw up and agree a plan of their support needs. Each person either held, or had access to their support plans and records of their health and personal care needs. Staff were expected to read the support plans and provide support in accordance with the person’s wishes. People told us there were enough staff employed to meet their needs. Risks to each person’s health and welfare had been assessed, regularly reviewed, and staff knew how to support people to minimise the risks

People were supported and encouraged them to learn new skills and gain independence. For example one person was looking forward to moving to new self-contained accommodation in the near future. A relative of another person told us, “She has learned a lot since she moved in there.”

Each person received support to help them manage their medicines safely. Most people held their own medicines in secure storage in their rooms, although a few people had asked for their medicines to be stored securely elsewhere in their house. Staff had received appropriate training on safe administration of medicines and their competence was checked regularly. Records of medicines received, administered or returned to the pharmacy were well maintained.

People were supported by staff who had received a range of training that provided them with the knowledge and skills to meet each person’s health and personal care needs effectively. Staff received regular supervision and support. They were positive and enthusiastic and told us they enjoyed their jobs. Comments included “I am really, really impressed with the set-up. Everything flows really smoothly” and “I cannot say anything against it. It’s wonderful. We work as a team. We get good support. The tenants are at the centre of everything we do.”

Each person was supported by staff to receive regular health check-ups and treatment from doctors and health professionals. Staff knew how to identify potential health problems and supported people to seek medical attention promptly.

Where people lacked the mental capacity to make certain decisions the service ensured their human rights were protected. All of the interactions we observed between people who used the service and the staff were friendly and caring. Staff sought people’s consent before providing support. People were offered choices on all aspects of their daily routines.

People led active lives. Staff had supported each person to help them identify and plan the activities they wanted to participate in each week. People were supported to participate in activities in their local communities, including work, education and leisure activities. They went on group or individual outings and also enjoyed a range of activities in their own homes. We heard about parties, outings and holidays. People were also supported to keep in touch with friends and families. For example, one relative told us, “We visit every five weeks. It’s her home. We ring every Saturday.” Another relative told us “We are always welcomed.” They also said “They bring her to us on a regular basis, once a week.”

The service was well led. A relative praised the management team, saying “(Manager’s name) is amazing. Staff are fantastic. I can’t fault them. We trust them implicitly.” The provider had an effective quality monitoring system to ensure standards of service were maintained and improved. People were involved and consulted about all aspects of the service.