Background to this inspection
Updated
24 January 2023
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 Health and Social Care Act 2008.
Inspection team
The inspection was carried out by one inspector.
Service and service type
This service provides care and support to people living in 5 ‘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.
Registered Manager
This provider is required to have a registered manager to oversee the delivery of regulated activities at this location. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Registered managers and providers are legally responsible for how the service is run, for the quality and safety of the care provided and compliance with regulations.
At the time of our inspection there was a registered manager in post.
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. The provider was not asked to complete a Provider Information Return (PIR) prior to this inspection. A PIR is information providers send us to give some key information about the service, what the service does well and improvements they plan to make. We used all this information to plan our inspection.
During the inspection
We spoke with 1 person who used the service in person and with another by telephone. We spoke with 5 staff; the registered manager, deputy manager, a senior support worker and two support workers. We looked at 2 people’s care and medicines records. We looked at 4 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
24 January 2023
About the service
Support by Heart Ltd is a supported living service providing personal care to people. The service provides support to younger adults with physical disabilities, learning disabilities or autistic spectrum disorder. The service consists of five separate supported living premises, with 22 people using them at the time of inspection, although only 2 people were receiving support with the regulated activity of personal care. 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.
People’s experience of using this service and what we found
We expect health and social care providers to guarantee people with a learning disability and autistic people respect, equality, dignity, choices and independence and good access to local communities that most people take for granted. ‘Right support, right care, right culture’ is the guidance CQC follows to make assessments and judgements about services supporting people with a learning disability and autistic people and providers must have regard to it.
Right Care: Care was not always person centred. Care plans did not cover sexuality or information about developing independent living skills. Risk assessments did not cover all significant risks people faced.
Medicines were managed in a safe way and people had access to relevant health care services. People were supported to live healthy lives and eat a balanced diet.
Right Culture: The culture of the service did not always promote safe care. Quality assurance systems were in place, but these were not always effective. For example, they had failed to identify the shortfalls in care plans and risk assessments that we found.
People were supported to express their views about the service. Staff and people spoke positively about the registered manager. Systems were in place for dealing with when things went wrong, such as a complaints procedure and the review of accidents and incidents.
Right Support: People lived in ordinary houses that were part of the local community. Steps had been taken to safeguard people from the risk of abuse. There were enough staff to meet people’s needs, and robust staff recruitment practices were in place.
People were supported to have maximum choice and control of their lives and staff them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection
This service was registered with us on 7 August 2020 and this is the first inspection.
Why we inspected
This inspection was prompted by a review of the information we held about this service.
Enforcement
We have identified breaches in relation to care plans, risk assessment and quality assurance processes at this inspection.
Follow up
We will request an action plan from the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.