Background to this inspection
Updated
6 April 2019
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. This inspection was planned to check whether the provider was meeting the legal requirements and regulations associated with the Act, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.
Inspection team:
The inspection team consisted of one inspector.
Service and 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. The Care Quality Commission does not regulate premises used for supported living; this inspection looked at people’s personal care and support.
The service currently provides support to people in a number of shared and individual dwellings and provides some outreach support to people to improve their access to the community. Staff provide some sleep in cover at night where contracted and there is a 24 hour on call service.
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 to ensure there would be someone at the office and to arrange visits to people that use the service. Due to unforeseen circumstances the inspection did not go ahead when planned but was rescheduled.
The inspection site visit took place over one day on the 1 March 2019.
What we did:
Before the inspection: We looked at information already known about this service which included previous inspection reports, notifications which are important events the service are required to tell us about. We gained feedback from the service from share your experience and emailed commissioners but got limited response. We reviewed the provider information return. This is information we require providers to send us at least once annually 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.
On the day of our inspection we went to the registered office and met with the registered manager, the deputy manager and the quality assurance officer. We then went to meet a number of people receiving a regulated activity. They have their own housing tenancies managed through a housing association. We met and spoke with four people, one relative and two staff on site and spoke with a further three staff following the inspection. We reviewed three care and support plans, looked at medicine records, staff records and other records relating to the management of the business. Following the inspection, we received a robust and up to date action plan the service are working towards.
Updated
6 April 2019
About the service: Craegmoor Supporting You in East Anglia is registered to provide personal care to people living in their own homes. Its provides a regulated activity to nine people with varying needs including autism, mental health issues and, or learning disabilities. Support ranged from an outreach service, to a 24-hour service.
People’s experience of using this service:
¿ We have rated the service as good overall but requires improvement in well led. There were systems in place to review the service in respect of compliance and risk. We found however there were a number of issues which had not been identified at the time of the inspection. Health and safety audits had identified concerns but these had only been put in place recently.
¿Some people were living in poor standards of accommodation which could have an impact on their health and safety. This was a landlord issue but we discussed this with the service who told us how they were supporting people to raise these issues with the landlord or advocating on their behalf.
¿ The provider had identified that not all their staff training was adequate in terms of supporting people who behaviour might challenge. We found that some staff were not confident in supporting people who had behaviours which could impact negatively on themselves or others. Staff had e-learning around managing and deescalating behaviours but agreed this was not in sufficient depth, or give them the necessary confidence.
incident management was in place but information not clearly collated too see if additional actions might help reduce the level of incidents. Behavioural plans and risk assessments did not show how other health care professionals had been involved. Gaps in record keeping were identified and clear processes were not in place for every situation.
¿People spoken with were happy with the service they received and staff enhanced their experiences by providing care and support in a timely way around their assessed needs. This was reflected in people’s support plans.
¿ The service engaged with people about the service and their wider care issues.
¿ People felt safe and staff were supported in their role to help them deliver effective care and support. Clear records of induction were not seen on each staff file we looked at but the registered manager was aware of this and showed us how they were addressing it. Staff recruitment and induction was sufficiently
¿ Staff training was an area for development to ensure all staff had been assessed as competent in the work place and felt confident in their job role.
¿The service was well planned to ensure staff were available to provide the support needed and emergency situations had been assessed and planned for.
¿ Risks were managed and we found systems in place to help ensure people had their medicines as required. Audit tools were not fit for their current purpose and medicines records were not audited as often as the service said they should be. This was an oversight which the registered manager told us how they would address.
¿People had capacity to make decisions and their consent was recorded. They were involved in their support and encouraged to be autonomous and independent.
Rating at last inspection: (Good) the last report was published on 05 August 2016.
Why we inspected This was a scheduled planned inspection based on the previous rating.
Follow up: Going forward we will continue to monitor this service and plan to inspect in line with our re-inspection schedule for those services rated Good.