The Care Quality Commission
  • Community
  • Community healthcare service

The Specialist Health Team for People with Learning Disabilities

Overall: Good read more about inspection ratings

Civic Offices, St Nicholas Way, Sutton, Surrey, SM1 1EA (020) 8770 4358

Provided and run by:
London Borough of Sutton

All Inspections

15 and 16 November 2022

During a routine inspection

Our rating of this service improved. We rated it as good because:

  • Clients, family carers and employed carers we spoke with gave very positive feedback about the service. They described caring and professional staff often going above and beyond their expectations. They were particularly positive about the aquatherapy sessions provided. Supported living services were very positive about the service provided to clients, and support and training provided to staff teams.
  • Significant improvements had been made since the previous inspection in May 2021 particularly to the governance of the service. There was an improved system for monitoring staff compliance with mandatory training. Improvements had been made in the service’s risk management systems, and monitoring, and evaluation of the team’s performance. The team had developed a clear protocol for following up on clients who missed appointments, an improved system to collect feedback from clients and stakeholders, and staff were clear about which incidents should be notified to the CQC.
  • There were systems in place to share any lessons learned from incidents, complaints, concerns and safeguarding, although there had been very few incidents and no complaints in the last year. All staff and managers were clear about how to navigate and review clients’ care and treatment records and staff knew where to store them.
  • There had been some improvements in the referral process to the service, making it easier for clinicians to make referrals through a single point of access. The criteria for referral to the service did not exclude clients who would have benefitted from care.
  • The number of clients on the caseload of the teams, and of individual members of staff, was not too high to prevent staff from giving each client the time they needed.
  • Staff understood how to protect clients from abuse and the service worked well with other agencies to do so. Staff had training on how to recognise and report abuse and they knew how to apply it. Staff followed good practice with respect to safeguarding.
  • Staff provided a range of treatment and care for clients that was informed by best-practice guidance and suitable to the needs of the clients. They ensured that clients had good access to physical healthcare and supported them to live healthier lives. Staff developed treatment plans in collaboration with clients, families and carers.
  • The teams included or had access to the full range of specialists required to meet the needs of the clients. Managers ensured that these staff received training, supervision and appraisal. Staff worked well together as a multidisciplinary team and with relevant services outside the organisation.
  • Staff felt respected, supported and valued. They said the provider promoted equality and diversity in daily work and provided opportunities for development and career progression. They could raise any concerns without fear.

However:

  • There were insufficiently rigorous systems in place to record individual risks for clients using the service, and review these regularly.
  • Improvements were needed in infection control procedures for the service to ensure that there were clear protocols for storing and laundering hoist slings, and reviewing staff compliance with infection control protocols.
  • Staff did not have training in basic life support, to support clients in the event of an emergency.
  • The service notice board at the Sutton Inclusion Centre, was not easily accessible to clients and carers, and there were no leaflets available in reception about health issues for clients/carers to access. The service did not routinely share how feedback from clients and carers was used to improve the service
  • Although decisions made in clients’ best interests were recorded, these were not always dated.
  • The auditing of service delivery could be further developed.

12 May 2021

During a routine inspection

We undertook an announced inspection of the location called The Specialist Healthcare Team for People with Learning Disabilities. This location is registered to provide the regulated activity for ‘treatment of disease, disorder, or injury’ under the London Borough of Sutton provider. The Specialist Healthcare Team for People with Learning Disabilities is made up of two completely separate services; Sutton Health and Care 0-19 Children’s Service and the Clinical Health Team for People with Learning Disabilities.

The provider is reviewing their registration as the registered name for this location does not accurately reflect the breadth of services provided. We will detail our findings separately under each service.

We only rated one service at this location; the Clinical Health Team for People with Learning Disabilities. This was because we carried out a focused inspection of Sutton Health and Care 0-19 Children's Service and only looked at two key questions. We cannot rate focused inspections when they have not been preceded by a comprehensive inspection. Sutton Health and Care 0-19 Children’s Service had not been previously inspected at this location.

23 May 2019

During a routine inspection

About the service:

The Specialist Health Team for People with Learning Disabilities is made up of staff from a range of health care professions, including nurses, speech and language therapists, physiotherapists, psychologists and behavioural analysts and music and drama therapists. The service aims to reduce health inequalities for people with learning disabilities in the London Borough of Sutton and improve their quality of life. The service works directly with people and also with professionals within GP practices, hospitals and care homes to improve the way they support people with learning disabilities. At the time of our inspection over 200 people were using the service.

The service is registered for ‘treatment of disease, disorder and injury’ because healthcare professionals treat people with learning disabilities in their own homes or within care homes.

People’s experience of using this service:

People, relatives and health and social care professionals were positive about the support people received from the provider. People and relatives told us staff were caring, understood people’s needs and were well-trained. Social care professionals told us the service worked well in partnership with them and met the needs of individuals well.

People were provided with the support and interventions they required to take greater control of their lives and become more independent, reduce social isolation, make informed decisions and have greater access to health care services.

Staff were experts in their fields who understood their roles, worked well as a team and felt well supported by the provider. Staff received the training they needed to maintain their professional registrations.

People, relatives, professionals and staff found the service to be well managed and our inspection findings supported this. However, the person registered with us as manager was no longer in post. The service was about to be restructured and the provider told us a new manager would register with us as soon as possible. The service received consistency of day to day management from two team managers since our last inspection.

People were safeguarded from abuse and the service supported safeguarding referrals and investigations regarding people using the service and other providers.

The provider checked they recruited only staff who were suitable to work with people with learning disabilities and there were enough staff to support people.

Staff supported people in line with the Mental Capacity Act when they suspected they lacked capacity to make decisions relating to their treatment.

A process was in place to investigate and respond to concerns or complaints.

Rating at last inspection:

The last inspection of this service by CQC was on 20 October 2016 and we rated the service Good.

Why we inspected:

This was a planned inspection in line with our inspection schedule based on rating at our last inspection.

Follow up:

We will continue to monitor the service through the information we receive. We will inspect in line with our inspection programme or sooner if required.

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

20 October 2016

During a routine inspection

This inspection took place on 20, 21, 25 and 26 October 2016 and was announced. The last Care Quality Commission (CQC) inspection of the London Borough of Sutton’s Specialist Health Team for People with Learning Disabilities was carried out on 30 and 31 October 2013, where we found the service was meeting all the regulations we looked at.

Sutton’s specialist clinical health team is multi-disciplinary and is made up of staff from a range of health care professionals, including nurses, speech and language, physio and occupational therapists, psychologists, behavioural analysts and music and drama therapists.

The principal aim of the service is to reduce health inequalities for local people with learning disabilities. The provider achieves this by supporting and advising people with learning disabilities and their families about how to access mainstream health care services, reducing hospital admissions and unnecessary GP appointments, empowering people to take greater control over their lives, promoting independence and enabling people to make informed decisions and by reducing social isolation.

The clinical health team also works closely with local care homes for people with learning disabilities, GP practices and NHS Hospital Trusts to raise health and social care providers’ awareness about the specific health care related needs and issues people with learning disabilities face. In addition, the team works in partnership with local mental health and learning disability services through the use of positive behavioural support (A way of supporting people who display behaviours that challenge services) and training to provide effective responses where challenging behaviour arises. At the time of our inspection approximately 270 adults with learning disabilities and their families/informal carers received a service from Sutton’s clinical health team.

The service had a registered manager in post. A new manager was appointed in April 2015 and they were in the process of applying to become the service’s 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.

Feedback we received from staff about the impact of the new service manager and their leadership style was positive. However, the provider does not have a clear vision for the service and staff still do not know or understand what the clinical health team will look like in the future. Managers advised us that funding for the team from the Clinical Commissioning Group (CCG) has been agreed, although the future role of the service remains uncertain which continues to adversely affect staff morale and the high levels of staff turnover the team has experienced in the last two years. We discussed these issues with the team’s management who were confident a CCG decision about what the new organisational structure of the clinical health team will look like in the future is pending.

People told us overall they were happy with the support they received from Sutton’s clinical health team for people with learning disabilities. People were provided with the support and interventions they required to take greater control of their lives and become more independent, reduce social isolation, make informed decisions and have greater access to health care services. Our discussions with people receiving a service, their relatives and community based health and social care professionals supported this.

The team appropriately safeguarded people from abuse. Managers and staff knew what constituted abuse and who to report it to if they suspected people were at risk. They had all received up to date training in safeguarding adults at risk. Risks to people’s safety were identified and health care plans were in place to minimise those risks. The provider had checked the suitability and fitness of staff to work for the service. Staff knew how to help other health and social care professionals, such as staff who worked in care homes for people with learning disabilities, manage medicines safely.

Staff supported people in line with their preferences and ensured they were involved in decisions about the support and health care interventions they received. Where appropriate, staff liaised with people’s relatives and involved them in discussions about people’s health care needs. Managers and staff were aware of when they needed to assess people’s capacity to make decisions.

Staff had developed good working and professional relationships with people they supported. The multidisciplinary clinical health team had a good mix of knowledge, skills and experience to support and signpost people receiving a service from the team, their families and other health and social care professionals working in the local community. Staff training was on-going, which included professional development for specific disciplines of staff. Staff were also supported by their managers through a programme of regular team and clinical meetings, one-to-one supervision sessions and annual appraisals.

Management used feedback from people the team supported, their families and other health and social care providers to adjust the service and improve its delivery so they continued to meet the health care needs of local people with learning disabilities. People felt comfortable raising any issues they might have about the service with managers and staff. Complaints or concerns raised about the service were investigated and, where necessary, appropriate action taken to resolve the issue.

The service had governance systems in place. The team worked closely with local care homes for people with learning disabilities, GP practices and two hospital trusts by providing them with training, advice and guidance about how to support people with learning disabilities and to help reduce r barriers to accessing mainstream health care services.

30, 31 October 2013

During a routine inspection

During our inspection we spoke with ten people who attended a weekly 'healthy lifestyle' club that was facilitated by the clinical health team, three members of the 'Speak Up Sutton' group, and a person who sat on the team's interview panel. They told us they were happy with the health related support and advice they received from the various professionals they had come into contact with. All the people we met at the 'healthy lifestyle' club told us these classes had taught them how to eat and live much healthier lives. One person said 'the club is excellent. You can dance and learn what's good to eat'. Another individual told us 'I come here every week; so I must be getting fitter'.

We also talked with the team's registered manager, three heads of discipline (which included the community nursing, speech and language therapy and quality assurance managers), two community nurses, a speech and language therapist, a drama therapist and three support worker staff.

We found people who accessed the clinical health team's services received appropriate support and advice from a wide range of suitably experienced and qualified health and social care professionals. The provider also had effective systems in place to routinely monitor the quality of the support and advice people with learning disabilities, their family carers and support workers received.

27, 28 February 2013

During a routine inspection

This review was carried out over two and a half days during which time we spoke with six people who received services from the London Borough of Sutton's specialist health team, the registered manager, various heads of service, four health care professionals, a carer, and three hospital based 'staff' nurses. We met people who used the service and members of the health team in groups as well as on a one-to-one basis. We also visited the health team's main offices, which were located in Sutton, and spent a morning at St Helier hospital with the services community nurse.

People who used the service told us they were happy with the support and advice they received from members of Sutton's specialist health team. People also told us these health care professionals treated team with respect and dignity. One person said 'I am happy with the support I sometimes get from Sutton", and another person told us 'the staff are lovely'you can talk to them about anything'.

We found people received appropriate support and advice from suitably trained and experienced health care professionals. The provider had also developed some effective systems to routinely assess and monitor the quality of the support and advice people using the service and their representatives received from Sutton's specialist health team.