Lewisham Nexus Service

Updated 14 February 2020

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 carried out by one inspector.

Service Type

This service provides care and support to people living in ‘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 a manager 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 manager 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 sought feedback from the local authority and professionals who work with the service. 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 used all this information to plan our inspection.

During the inspection

We spoke with nine people who used the service and five relatives about their experience of the care provided. We spoke with 15 members of staff including eight support workers, three support managers, the social inclusion manager, the service manager, the registered manager, and the nominated individual. The nominated individual is responsible for supervising the management of the service.

We reviewed a range of records. This included eight people’s care records and multiple medication records. We looked at six 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.

After the inspection

We continued to seek clarification from the provider to validate evidence found. We looked at training data and quality assurance records. We received feedback from the multi-disciplinary team who worked with the service to help plan and deliver care and support.

Updated 14 February 2020

About the service

Lewisham Nexus Service provides personal care and support to people with a learning disability who live in supported living accommodation. People lived in shared houses and flats in different areas of Lewisham. At the time of the inspection the service was providing care and support to 27 people

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.

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

People and their relatives told us they were extremely happy with the quality of care they received. There was a stable staff team in place, so people received care and support from people who knew their needs and preferences well. People consistently praised the kind and kind caring approach of the staff and our observations confirmed this. People told us, “The care is excellent, the whole house is excellent” and “The staff are amazing, I can’t thank them enough.”

There were enough staff to meet people’s health and social care needs safely and ensure they lead active and rewarding lives. Medicines were managed well by staff that received regular training. Risks to people’s safety had been assessed and measures were in place to mitigate these whilst ensuring people were supported to live full and active lives.

People’s needs were holistically assessed, and plans were in place to meet these. People were supported by a range of health and social care professionals and staff advocated on behalf of people to ensure they received the appropriate healthcare. We received positive comments from a range of health and social care professionals about how the service works in partnership to help people get the best care and support.

The service was exceptionally skilled in developing accessible communication and individual communication plans for people with communication difficulties. Care and support plans were written with a strong emphasis on people as individuals, with detailed information on their life story, likes and dislikes and things that people liked and admired about them. People were supported to have active lives and enjoy interests and activities of their choice. The service supported people to meet new people and maintain relationships.

The registered manager and nominated individual were keen to continue to build on previous achievements and improve the quality of care and support people received. The service had an established reputation for facilitating service user engagement within the organisation and with the wider community and they continued to build and improve on this.

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

Rating at last inspection

The last rating for this service was outstanding (report published 26 May 2017).

Why we inspected

This was a planned inspection based on the previous rating.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk