Background to this inspection
Updated
20 September 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. 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
This inspection was carried out by one inspector and an Expert by Experience. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service.
Service and service type
This service provides care and support to people living in a ‘supported living’ setting, 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
The inspection was undertaken over two days and the first day was unannounced.
What we did before the inspection
We reviewed information we had received about the service since the last inspection. This included notifications the provider is required by law to send us about events that happen within the service. The provider was not asked to complete a provider information return prior to this inspection. This is information we require providers to send us to give some key information about the service, what the service does well and improvements they plan to make. We took this into account when we inspected the service and made the judgements in this report.
We used all of this information to plan our inspection.
During the inspection
We spoke with six people who used the service about their experience of the care provided. We spoke with five members of staff including the registered manager, senior care workers, care workers and the chef. We reviewed a range of records. This included five people’s care records and multiple medication records. We looked at two staff files in relation to recruitment and staff supervision. We also reviewed a variety of records relating to the management of the service, including health and safety records, audits and incidents/accidents.
After the inspection
We continued to seek clarification from the provider to validate evidence found. We looked at training data and quality assurance records and action plans sent by the registered manager.
Updated
20 September 2019
About the service
Church Road Hostel is a supported living service that can support people with mental health needs. The service provides 24-hour care and support for up to 19 people. People live independently and have their own tenancy agreements for the rooms they occupy. There were 15 people using the service at the time of our inspection. Shared areas included lounges, a dining area, bathrooms and garden. There was a main staff office with sleep in arrangements of one staff member at night.
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
Since our last inspection, a registered manager had been recruited and people and staff spoke positively about how management of the service had improved. Arrangements to monitor and assess the quality and safety of the service had been strengthened. More audits and checks were used and where issues were identified, action was taken to improve the care and support people received. The registered manager knew what was required to develop the service and was working to an effective action plan.
Risks to people’s health and wellbeing had been more fully assessed. People were involved in assessments of potential risks to their safety and in identifying measures to keep them safe. Care plans provided clear guidance for staff to follow. Staff knew the risks people faced and how to reduce these.
People were supported by a consistent team of staff who were safely recruited. Staff had undertaken further training to support them in their role and meet people’s individual needs. The registered manager had improved the arrangements for staff supervision and to check and monitor that staff had the skills to support people effectively.
People were supported to develop their daily living skills to enable them to live more independently. Further activities were available to people which aimed to reduce the risk of social isolation. Staff supported people to access the local community and maintain relationships with friends and family where appropriate.
Staff knew how to recognise and report any concerns they had about people’s care and welfare and how to protect them from abuse. Medicines were managed safely, and people had their medicines at the times they needed them.
People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible in their best interests; the policies and systems in the service supported this practice. Staff knew people well and used this knowledge to provide personalised care. Staff respected and promoted people's rights, including their right to be treated with respect and dignity.
People were supported to be healthy and eat and drink well. Staff understood how to support people with their healthcare needs and involved other professionals if people became unwell or required additional services.
People knew how to raise any concerns. Staff listened and acted on what people said and there were regular opportunities for people to contribute to how the service ran.
There was an open and inclusive atmosphere in the service and the registered manager showed effective leadership. Staff felt well supported and had confidence in the registered manager and the improvements he had made.
We have made a recommendation about the management of medicines.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection and update
The last rating for this service was requires improvement (published 4 April 2018) and there were four breaches of regulation. The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection we found improvements had been made and the provider was no longer in breach of regulations.
Why we inspected
This was a planned inspection based on the previous rating.
The overall rating for the service has changed from Requires improvement to Good. This is based on the findings at this inspection.
Follow up
We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.