Background to this inspection
Updated
25 February 2020
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 three assistant inspectors.
Service and service type
This service provides care and support to people living in supported living settings, based in Bedfordshire, Buckinghamshire and Milton Keynes, so people 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 three managers 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
This inspection was announced. We gave the service 24 hours’ notice of the inspection. This was because we needed to obtain information towards planning the inspection and arrange dates to visit the head office and people living within some of the supported living settings.
The inspection activity started on 7 January 2020 and ended on 23 January 2020. We visited the office location on 10 and 21 January. We carried telephone interviews with staff on the 7, 8 and 9 January. We visited people in supported living services based in Bedfordshire, Buckinghamshire and Milton Keynes on the 13, 14 and 15 January. We carried out telephone interviews with relatives of people using the service on 22 and 23 January 2020.
What we did before the inspection
We reviewed information we had received about the service. We sought feedback from the local authority and professionals involved in monitoring the care people using 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 in making the judgements in this report.
During the inspection
We met with 10 people using the service and carried out telephone interviews with four relatives about their experience of the care provided. We spoke with 26 staff members, which included support workers, senior support workers, service managers and the three registered managers.
We reviewed a range of records. This included five people’s care records and multiple medication records. We looked at six staff files in relation to recruitment, training and staff supervision. A variety of records relating to the management of the service, including policies and procedures were reviewed.
Updated
25 February 2020
About the service
Choice Support Bedfordshire, Buckinghamshire and Milton Keynes is a supported living service. The service is registered with the Care Quality Commission (CQC) to provider the regulated activity personal care.
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. At the time of this inspection 90 people were receiving personal care within the Bedfordshire, Buckinghamshire and Milton Keynes supported living services.
People’s experience of using this service and what we found
People received safe care and were protected against avoidable harm, neglect and discrimination. Risks to people’s safety were assessed and strategies were put in place to reduce the risks.
People received support from staff who appropriately recruited. They were supported by regular, consistent staff who knew about them and their care needs.
Systems were in place to manage medicines and support people to self -administer their medicines. Systems were in place to control and prevent the spread of infection. The provider investigated incidents to ensure lessons were learnt when things went wrong, to continually improve the service people received.
People’s needs, and choices were assessed before they received a care package. Staff received induction and ongoing training that enabled them to have the skills and knowledge to provide effective care.
People were supported to eat and drink enough to maintain their health and well-being. Staff supported people to live healthier lives and access healthcare services. People were supported to attend healthcare appointments as and when required. Staff worked with other healthcare professionals to provide consistent care and support.
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.
Staff had built up caring and compassionate relationships with the people they provided care to. People and relatives, where appropriate, were involved in the planning of people’s care and support. People's privacy and dignity was maintained.
Support plans provided personalised care. There was a complaints procedure in place and systems to deal with complaints effectively. The service provided appropriate end of life care to people when required.
There were systems in place to monitor the quality of the service and actions were taken, and improvements were made when required. The service worked in partnership with outside agencies. People, relatives and staff were encouraged to provide feedback, which was analysed and acted upon.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Why we inspected
This was a planned inspection based on the previous rating.
Rating at last inspection
The last rating for this service was Good (published 20 December 2018). Since this rating was awarded the registered provider of the service has changed. We have used the previous rating to inform our planning and decisions about the rating 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.