Encompass Care Supported Living Services

Sandhills is a supported living service that provides support and personal care to nine people in two flats in a converted house. There is a separate office to the two flats. Each flat has a shared kitchen, dining area, bathroom and lounge. The service was previously registered with CQC as a care home and changed to a supported living service in April 2019.

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

Relatives and professionals said this was an exceptional service that really had the best interests of people at its heart. They described the support people received service as outstanding. The exemplary values of the service promoted people's independence and meant they lived meaningful, fulfilled lives. There was a very strong ethos to support people to develop skills in all aspects of their lives and be included as valued members of the community.

People received a personalised service from friendly, supportive staff. People said they really liked the staff and enjoyed being with them. Staff knew people's needs and preferences very well. Relatives spoke highly of the staff team and registered manager and said they made sure people had enjoyable experiences and a happy and varied social life.

The responsive care and support people received had a positive impact on their lives. There was an emphasis on personalised, meaningful activity that was based on people’s interests and experiences. People took part in activities both at home and in the local community.

People were encouraged to make their own decisions and staff understood how people communicated their choices. Staff made sure that people were treated with dignity and respect and in a way that was free from discrimination.

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.

The outcomes for people using the service reflected the principles and values of Registering the Right Support by promoting choice and control, independence and inclusion. People's support focused on them having as many opportunities as possible for them to gain new skills and become more independent.

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

Staff received core and specialist training and support to assist people in the right way with their individual preferred lifestyles.

Staff praised the culture of the registered manager and staff team. They were all committed to providing high quality, person-centred support for people to be able to live purposeful lives.

There had been significant improvements in the way the service was managed. The provider had addressed the previous shortfalls in the overall governance of the service.

The service was well led by a registered manager that was approachable and respected by the people, relatives, professionals and staff. There were robust quality assurance systems in place to drive improvement and ensure the home offered a safe, effective, caring and responsive service.

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 requires improvement (published 21 March 2018). This rating was whilst the service was a care home. This rating was whilst the service was a care home and the shortfalls related to heating and hot water management issues. We have used the previous rating to inform our planning and decisions about the rating at this inspection.

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 and the date of the change of services provided.

Follow up

We will continue to monitor information we receive about the service until we return to visit as per our reinspection programme. If we receive any concerning information we may inspect sooner.

There was a registered manager in post. 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.

At the last inspection, the service was rated Good. At this inspection we found the service Required Improvement.

Quality assurance systems were ineffective. There was an interruption to the supply of heating and hot water. The heating and water system had been inoperative since October 2017. People and staff at the Sandhills raised concerns about the lack of heating and hot water to the home. The provider had not taken timely and corrective action to ensure the continuing supply of hot water and heating to the service for a number of months.

Small portable heaters had been used whilst the main heating system was out of action. Risk assessment were in place in regard the portable heaters. The registered manager told us although people had not had access to hot water in bathrooms, people living at Sandhills were supported to have personal care from electric showers which continued to supply hot water.

The registered manager told us they felt supported by the provider, however they told us although there was continual quality monitoring of the service by email and via their on line computer system they had not received a formal monitoring visit from the provider since January 2017. However following the inspection the provider evidence that two full monitoring visits had taken place at the service during May and September 2017, and the home had received monitoring visits by the board of trustee in December 2017 and were planned.

People were protected from abuse because staff understood how to keep them safe, including more senior staff understanding the processes they should follow if an allegation of abuse was made. All staff informed us concerns would be followed up if they were raised. People received their medicines safely. There were enough suitable staff to meet people’s needs. Risk assessments were carried out to enable people to retain their independence and receive care with minimum risk to themselves or others.

Staff received training to ensure they had the skills and knowledge required to effectively support people. People were supported to eat and drink according to their likes and dislikes. People who lacked capacity had decisions made in line with current legislation. People are supported to have maximum choice and control of their lives and staff support them in the least restrictive way possible; the policies and systems in the service support this practice. People and their relatives were continuously involved in the assessment and planning of their care through regular review meetings.

Staff were kind and patient. People were involved in decisions about the care and support they received. People received care and support which ensured they were able to make choices about their day to day lives.

People were supported to engage in activity programmes. People knew how to complain and there were a range of opportunities for them to raise concerns with the registered manager and designated staff.

Further information is in the detailed findings below.

People were encouraged to express their views and were involved in decisions about both their own care, and the running of the home.

People's care needs were assessed and care and support was delivered in a timely and respectful manner.

Staff were trained in safeguarding and knew how to identify abuse and how to report it.

There were enough staff to meet people's needs although vacant posts had made covering the rotas difficult for a sustained period of time, and on a few occasions the home had been short staffed.

The provider had an effective system in place to identify, assess and manage risks to the health, safety and welfare of people who used the service and others.

There was a relaxed atmosphere in the home and people were at ease in the company of the staff supporting them. There were robust recruitment systems in place, and we noted staff were friendly and polite and interacted confidently with people. One person said, I'm happy here and wouldn't want to change anything."

We noted that people were encouraged to express their views using various methods of communication. People were involved in planning their care and making decisions about their support and how they spent their time. Each person who used the service had a 'leisure companion'. This was a staff member who spent time doing one to one activities with people. This could involve trips to the local community, or in house activities helping people with personal development skills.

The provider had systems in place to ensure people were involved in the quality monitoring processes for this service. People were encouraged to share their views and opinions to help improve the standard of care provision.