Background to this inspection
Updated
23 December 2022
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 Health and Social Care Act 2008.
Inspection team
The inspection team on the first day consisted of an inspector and inspection manager. One inspector returned to the service on the second day to visit people in their homes and to gather their views about the service
Service and service type
This service provides care and support to people living in three ‘supported living’ settings, 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.
Registered Manager
This service is required to have a registered manager. A registered manager is a person who has registered with the Care Quality Commission to manage the service. 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.
At the time of our inspection there was not a registered manager in post. The previous manager resigned from their post in January 2022. A new manager began working at the service in August 2022. They told us they would apply to become the registered manager of the service.
Notice of inspection
We gave the service 24 hours’ notice of the inspection. This was because the service is small, and people are often out and we wanted to be sure there would be people at home to speak with us.
Inspection activity started on 21 September 2022 and ended on 26 October 2022. We visited the location’s office on 21 September 2022.
What we did before the inspection
We reviewed information we had received about the service since the last inspection. We sought feedback from the local authority and professionals who work with the service. The provider was not asked to complete a Provider Information Return (PIR) prior to this inspection. A PIR is information providers send us 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.
During the inspection
We spoke with four people who used the service and two relatives to gather their views about the service. We spoke with four members of staff including the manager, deputy manager, a care worker and the nominated individual. The nominated individual is responsible for supervising the management of the service on behalf of the provider.
We reviewed a range of records. This included four people's care, risk management and medicine records. We looked at four staff files in relation to recruitment and a variety of records relating to the management of the service, including policies and procedures.
Updated
23 December 2022
About the service
Transform is a supported living accommodation providing the regulated activity of personal care across three supported living settings in South East London. The service provides support to people living with mental health, learning disabilities, visual impairment and autistic people. At the time of this inspection 11 people were using the service.
People’s experience of using this service and what we found
We expect health and social care providers to guarantee people with a learning disability and autistic people respect, equality, dignity, choices and independence and good access to local communities that most people take for granted. ‘Right support, right care, right culture’ is the guidance CQC follows to make assessments and judgements about services supporting people with a learning disability and autistic people and providers must have regard to it.
Right Support:
Staff focused on people's strengths and promoted what they could do, so people had a fulfilling and meaningful everyday life. People were supported by staff to pursue their interests and achieve their aspirations and goals. Staff supported people to take part in activities and pursue their interests in their local area and to interact with people who had shared interests.
Staff supported people with their medicines in a way that promoted their independence and achieved the best possible health outcome.
Right Care
Staff promoted equality and diversity in their support for people. Staff understood how to protect people from poor care and abuse. The service worked well with other agencies.
Right culture
People led inclusive and empowered lives because of the ethos, values, attitudes and behaviours of the management and staff.
However, people said their views were not always taken into consideration and acted upon. Records were not always accurate and complete and did not always include relevant information.
We made a recommendation about infection prevention and control.
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 27 August 2019).
Why we inspected
This inspection was prompted by a review of the information we held about this service. The overall rating for the service has remained good based on the findings of this inspection. However, we have found evidence that the provider needs to make improvements. Please see the safe and well led sections of this full report.
You can see what action we have asked the provider to take at the end of this full report.
For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating.
You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Transform on our website at www.cqc.org.uk.
Enforcement and Recommendations
We have identified breaches in relation to regulation 17 (good governance) at this inspection. We have made recommendation about infection prevention and control.
Please see the action we have told the provider to take at the end of this report.
Follow up
We will request an action plan from the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.