Background to this inspection
Updated
22 May 2021
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.
Service and service type
Chosen Care Supported Living service provides care and support to people living in 10 ‘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. Chosen Care Supported Living also provides domiciliary care. As none of the people using the domiciliary care service were in receipt of a regulated activity at the time of the inspection, domiciliary care was not included in this inspection.
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. The National Care Group had recently de-registered the service ‘Face2Face’ and all regulated activity was transferred to Chosen Care Supported Living. The former registered manager of Face2Face was responsible for managing the newly combined service and had applied to be registered manager. The outgoing registered manager had applied to transfer their registration to another of the provider’s services.
Notice of inspection
We gave a short period of notice of the inspection because some of the people using the service needed support to consent to a home visit from an inspector. Inspection activity started on 26 April 2021 and ended on 10 May 2021. We visited the office location on 28 and 29 April 2021.
What we did before the inspection
We reviewed information we had received about the service since the last inspection. This included notifications about important events at the service and feedback from the local authority quality improvement team. We used the information the provider sent us in the provider information return. This is information providers are required to send us with key information about their service, what they do well, and improvements they plan to make. This information helps support our inspections. We used all of this information to plan our inspection.
During the site visit
We observed staff supporting people in two supported living settings. We spoke with five people who used the service. We spoke with eight members of staff including the regional manager, area manager, the manager (current), registered manager (outgoing), both service managers, and two support workers. We reviewed a range of records. This included five people’s care records and several medication records. We looked at three staff files in relation to recruitment. A variety of records relating to the management of the service were reviewed including audits and safety checks.
After the site visit
We continued to seek clarification from the provider to validate the evidence found. We spoke with two people who used the service and another seven people’s relatives. We received feedback from eight professionals who regularly work with the service. We spoke with four staff members; two senior support workers and two support workers. We looked at staff training and supervision data, quality assurance records and policies.
Updated
22 May 2021
About the service
Chosen Care Supported Living is a supported living and domiciliary care service providing personal care and support to adults with a variety of needs. This includes learning disabilities, autistic spectrum disorder and mental health needs. At the time of the inspection, 22 people using the service were receiving the regulated activity ‘personal care’. A further 21 people were receiving support which was not regulated by CQC.
Personal care was being provided to people in 10 supported living houses located in the suburbs of Gloucester. Each house could accommodate between two and five people who had their own bedroom and access to shared communal spaces.
People's experience of using this service and what we found
People felt safe and supported and were happy with the service they received. Risks to people had been assessed and detailed support plans were in place. Staff followed people’s support plans and provider policies to keep people safe, for example, in relation to COVID-19. Outcomes for people were good and the feedback we received from relatives and health care professionals reflected this. Significant progress had been made in meeting some people’s health and anxiety related needs, where previously people had experienced challenges and obstacles in these areas.
People were supported by the provider to ensure their accommodation was safe, suitable for their needs and was well maintained.
We expect health and social care providers to guarantee autistic people and people with a learning disability the choices, dignity, independence and good access to local communities that most people take for granted. Right Support, right care, right culture is the statutory guidance which supports CQC to make assessments and judgements about services providing support to people with a learning disability and/or autistic people.
This service was able to demonstrate how they were meeting the underpinning principles of Right support, right care, right culture. People were enabled to participate in reviews of their needs and have their voice heard. This was done through effective planning and use of a variety of communication methods, such as social stories. People were supported to develop life skills including cooking and managing their emotions. This enabled them to live meaningful lives in the community, including accessing mainstream services and maintaining relationships with others who were important to them.
People and staff benefitted from a highly inclusive culture and leaders who were committed to good outcomes for people. The management team were supported by the provider whose systems, governance and quality work had undergone significant investment and improvement. These improvements had been embedded since our last inspection. Comments from professionals included, “Overall really positive steps are being taken” and “They are getting to grips with everything.”
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, at the previous premises where the service was known as 'Chosen Court', was Requires Improvement (published 8 February 2020) with two breaches of regulation. At this inspection we found improvements had been made and the provider was no longer in breach of regulations.
Why we inspected
This inspection was carried out to follow up on action we told the provider to take at the last inspection. We carried out an announced focused inspection of this service on 21 November 2019. Breaches of legal requirements were found. The provider completed an action plan after the last inspection to show what they would do and by when to improve safe care and treatment and good governance.
We undertook this inspection to check whether the Warning Notices we previously served in relation to Regulation 12 and Regulation 17 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 had been met. This report only covers our findings in relation to the Key Questions Safe and Well-led which contain those requirements.
We reviewed the information we held about the service. No areas of concern were identified in the other key questions. We therefore did not inspect them. The ratings from the previous comprehensive inspection for those key questions not looked at on this occasion were used in calculating the overall rating at this inspection.
The overall rating for the service has changed from Requires Improvement to Good. This is based on the findings at this inspection.
You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Chosen Care Supported Living on our website at www.cqc.org.uk.
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.