Stockport Metropolitan Borough Council

Stockport Metropolitan Borough Council is a supported living service providing personal care and support to adults in a number of homes in the Stockport area. The homes varied in size, with larger homes having self-contained apartments with communal areas. The service can support up to 58 people. At the time of our inspection the service was supporting 52 people.

The service has been developed and designed in line with the principles and values that underpin Registering the Right Support and other best practice guidance. This ensures that people who use the service can live as full a life as possible and achieve the best possible outcomes. The principles reflect the need for people with learning disabilities and/or autism to live meaningful lives that include control, choice, and independence. People using the service receive planned and co-ordinated person-centred support that is appropriate and inclusive for them.

People’s experience of using this service and what we found

People were kept safe by having appropriate numbers of staff who knew them well. People were encouraged to speak up if they weren’t happy and staff were confident in raising any concerns they had. Homes were kept very clean, minimising the risk of infection.

Staff demonstrated they had the skills and training needed to support people safely. Support plans were being updated to better reflect what people wanted to achieve. People were supported well to receive support from other health services such as GPs, dentists and opticians.

People told us they got on well and liked their staff team. When the usual support workers were not working other staff who knew the person well would be on duty. People were encouraged to be as independent as possible and people told us they had become more independent since moving in to the service.

People were supported to do things that were important to them and any cultural needs or choices were respected. People had good links with community and many people had been supported to find volunteer or part time work.

The management of the service had a clear vision of how they wanted the service to improve and at the time of our inspection a number of changes were being made. Staff spoke highly of the manager and told us they felt involved in the changes and that the changes were improving the service for the people using it.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.

The service applied the principles and values of Registering the Right Support and other best practice guidance. These ensure that people who use the service can live as full a life as possible and achieve the best possible outcomes that include control, choice and independence.

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

Rating at last inspection

The last rating for this service was good (published 31 January 2017)

Why we inspected

This was a planned inspection based on the previous rating.

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.

We last inspected the service in August 2014. At that inspection we found the service was meeting all the regulations that we reviewed.

Stockport Metropolitan Borough Council provides care to people who live in supported tenancies and who require a range of support relating to their learning or physical disability, sensory impairment or mental health needs. A multi-agency health and social care team is built around the service to provide on-going support to meet the social care and health needs of the people supported by the service. The service is based in Stockport, Greater Manchester.

There was a registered manager in place. 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. The registered manager was present during the inspection.

Following our site visit additional information was received in relation to referrals to health care services, restrictions on visits and how the service monitored and managed incidents and complaints. Further details about this can be found in the body of the report.

The people who used the service had a range of learning disabilities which meant we were unable to speak to all the people who used the service. However, those we did talk to were happy with the care they received. One person told us “I love it here, it’s really nice. All the staff are kind”.

Medicines were administered by staff who had been given appropriate training to ensure that they were given safely.

We saw that suitable arrangements were in place to help safeguard people from abuse, there was a safeguarding policy in place and all members of staff were aware of the whistle-blowing procedure.

The care records we looked at showed that where risks to people's health and well-being had been identified appropriate plans had been put into place to minimise the risk of harm.

People were supported by sufficient numbers of suitably trained staff. We saw that recruitment procedures ensured staff had the appropriate qualities to protect the safety of people who used the service and we saw they received the training and support required to meet people’s needs.

The staff we spoke with had an in- depth knowledge and understanding of the needs of the people they were looking after. We saw that staff provided respectful, kindly and caring attention to people who used the service. A visiting relative told us staff were approachable and would listen to any concerns, and respond appropriately.

People’s needs were assessed and care and support was planned and delivered in line with their individual care needs and preferences. People had detailed, individualised support plans in place which described all aspects of their support needs.

Where people who used the service did not have the capacity to make their own decisions, the service ensured that decisions taken were in line with the principles of the Mental Capacity Act 2005. Best interest decisions and any consultation undertaken were recorded as to why the decision was taken in the best interests of the person.

Where possible people were supported to do their own shopping for food and received help to prepare their meals. Care records showed that attention was paid to what people ate and drank, and where people had been assessed as having a risk associated with eating and drinking, such as choking, specialist assessment and advice was followed.

We saw that staff formed positive relationships with people and demonstrated a good knowledge of their physical, social and emotional needs. They demonstrated a good understanding of the background and history of people who used the service and were able to help them to consider their future options.

Where people had difficulty communicating staff were patient listeners. They showed understanding of people's particular communication styles and how to interact positively with the people who used the service.

The care and support people received was reviewed on a regular basis and any people who had an interest in the person’s well-being was invited to attend and comment. Where necessary the service would arrange for an advocate to represent the person’s views on service delivery.

People were supported to pursue their hobbies and interests and had their own activity plan with a timetable of activities.

To help ensure that people received safe and effective care, systems were in place to monitor the quality of the service provided and there were systems in place for receiving, handling and responding appropriately to complaints.

We considered the evidence collected under the outcomes and addressed the following questions: Is the service safe? Is the service effective? Is the service caring? Is the service responsive? Is the service well led?

Below is a summary of what we found. Please read the full report for the evidence supporting our summary.

Is the service safe?

We saw that people were treated with respect by staff. People we spoke with who used the service told us they felt safe and had no concerns about the support they received.

We saw that there were effective measures in place to identify and manage the risks of abuse, and where allegations of abuse were made, the service responded appropriately.

We saw that there were systems in place to safely recruit staff. This included carrying out appropriate pre-employment checks when new staff were employed by the service.

Is the service effective?

We saw records to show that assessments were carried out with people who used the service to identify risks to the person's health, safety or well-being and the support they required. People's care plan records provided clear guidance to care staff in how to deliver care.

We saw that staff were supported in their role by the management team and were provided with training to enable them to carry out their role competently.

Is the service caring?

Before someone started using the service, they were invited to spend some time at their prospective tenancy so they could experience the environment and meet support staff and other people who lived there.

We saw that staff treated people with respect and warmth and the support we observed was provided in a sensitive, personal way. The people we spoke with made positive comments about the care they received.

Is the service responsive?

We saw that people's care plan records reflected their individual needs. People who used the service and their representatives had been involved in developing their care plans, which had been regularly reviewed to ensure they met the person's needs. We saw that staff received training to meet the individual needs of the people they supported.

Is the service well led?

The staff we spoke with told us the management team was approachable and supportive. Staff were provided with information about the needs of the people they supported, which provided them with guidance in how to deliver people's care.

We saw that there was an established management structure in place with clear lines of accountability. We also saw that there was a system in place to identify risks to people who used the service and monitor the quality of the service that people received. There was a complaints process in place and information about how to complain was available to people who used the service.

The person we spoke with told us they were happy with the care they received. They told us they were encouraged to live an independent lifestyle and the staff were there to assist them if needed.

The person we spoke with told us the staff were very friendly and helpful. They told us that they were initially nervous around a new member of staff but had now got to know them very well. They also told us they felt safe around the staff and told us they would speak to the senior staff or manager if they had any issues or concerns.