We inspected the service on 2 June 2016 and the visit was announced. We gave notice of our inspection because we needed to be sure somebody would be available at the office.Smith Crescent Supported Living Service provides domiciliary care for up to nine people with learning disabilities in their own homes. At the time of our inspection nine people were using the service. The office is located in another of the provider’s locations and is close to one of the houses.
At the time of our inspection there was a manager in place. This person was in the process of registering to become the registered manager. It is a requirement that the service has a registered manager. 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 and their relatives felt safe with the support offered. Staff understood their responsibilities to support people to keep safe and to protect them from abuse. They dealt with accidents and incidents appropriately. The provider had made sure that people were being protected from avoidable harm. This was because they were assessing risks to promote people’s health and well-being. For example, where people could have shown behaviour that challenged, staff had guidance available to them.
People received support from staff who had been checked before they had started to work for the provider. This had helped the provider to make safer recruitment decisions about the suitability of prospective staff. Relatives were satisfied with the availability of staff supporting their family members and we found that cover for staff absence had been managed.
People received their medicines as prescribed in a safe way. Staff were trained in how to administer people’s medicines and were regularly checked for their continued competency to do so. Staff knew what to do should a mistake occur when handling medicines.
People were receiving support from staff who had the appropriate skills and knowledge. Staff received regular training and the provider had plans in place to enhance this further. Staff met regularly with their supervisor to discuss their work and to receive guidance and support to enable them to provide good support to people. Staff had received an induction when they had started to work for the provider so that they knew about their responsibilities.
People were being supported in line with the Mental Capacity Act (MCA) 2005. The provider had assessed people’s mental capacity where this was necessary and made decisions in people’s best interests. Staff understood their responsibilities under the Act and were aware of the need to make applications to the appropriate body where they had sought to deprive a person of their liberties.
People were supported to maintain a balanced diet and had access to healthcare services when required. People made decisions about their health where they could and staff knew how to monitor their well-being.
People received support from staff who showed kindness and compassion. Their dignity and privacy was being protected including the safe storage of their care records. Staff knew people’s communication preferences and the provider had made information easier to read. For example, pictures were used to aid people’s understanding. People were being supported to be as independent as they wanted to be by staff who knew their preferences. People had been involved in decisions about their support and had information on advocacy services that could help them to speak up.
People or their representatives had contributed to the planning and review of their support. People, where they could, had chosen how often to review their support and were involved in checking that their support continued to meet their needs. People had support plans that were person-centred. This meant that the support people received was focused on them as individuals. Staff knew about the people they were supporting including their interests and hobbies. People were taking part in activities of their own choosing including accessing the gym and undertaking voluntary work.
People and their relatives knew how to make a complaint. The provider had a complaints policy in place and followed this when a complaint had been received.
Relatives described the service as well-led. People, their relatives and staff had opportunities to give feedback to the provider. The manager had taken action where necessary following the feedback received. The manager had also arranged for quality checks of the service to take place to make sure that it was of a high standard. For example, checks on people’s medicines and their care records had been undertaken.
Staff told us that they were supported and we saw that the provider had processes in place to make sure that this occurred. Staff understood their responsibilities including reporting the poor practice of their colleagues should they have needed to.
There was a shared vision of the service by the manager and staff members. This included protecting the privacy of people and offering them choices in the daily lives. We found that the manager incorporated this vision into their practice and were aware of their responsibilities.