Background to this inspection
Updated
26 July 2018
We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection checked whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.
This comprehensive inspection took place on 23, 24 and 25 May 2018 when we visited the provider’s office and some of the supported living schemes where people lived. We gave the service 48 hours’ notice of the inspection visit because the location provides a domiciliary care service and we needed to be sure that there would someone available to support the inspection.
The inspection was carried out by an inspector and an expert by experience on the first day, and only the inspector visited the service on the second and third days. An expert by experience is a person who has personal experience of using or caring for someone who uses this type of care service. Their area of expertise was in the care of people with learning disabilities.
The inspection was prompted in part by concerns relating to inconsistent and unsafe care of a person whose complex needs meant that they required consistent support and supervision by staff. This inspection examined those risks.
As part of this inspection, we contacted the two local authorities that commissioned the service to get feedback about the quality of care provided to people using the service. The inspection was completed on 8 June 2018 when we received feedback from professionals from both local authorities that the service provided good standards of care, in a compassionate and respectful way.
We used information the provider sent us in the Provider Information Return. This is information we require providers to send us at least once annually to give some key information about the service, what the service does well and improvements they plan to make. We reviewed other information we held about the service including the previous inspection report, information shared with us by the local authority and notifications the registered manager had sent to us. A notification is information about important events which the provider is required to send to us.
During the inspection, we spoke with seven people using the service, two relatives, five care staff, one team leader, and the registered manager.
We looked at care records for eight people to review how their care was planned and managed. We reviewed the provider’s staff recruitment, training and supervision processes. We checked how medicines and complaints were being managed. We looked at information on how the quality of the service was assessed and monitored. We observed how staff interacted with people in communal areas of the supported living schemes we visited.
Updated
26 July 2018
We carried out this announced inspection on 23, 24 and 25 May 2018. Between these dates and 8 June 2018, we also received feedback from professionals working for the local authorities that commissioned the service.
This service is a domiciliary care agency. It provides care and support to people living in 11 'supported living' settings (schemes) and in flats, so that they can live in their own home 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 supported people with physical disabilities, learning disabilities and/or autistic spectrum conditions. At the time of the inspection, 81 people were being supported by the service.
The care service has been developed and designed in line with the values that underpin the Registering the Right Support and other best practice guidance. These values include choice, promotion of independence and inclusion. People with learning disabilities and autism using the service can live as ordinary a life as any citizen.
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.
Constant changes to staff meant that one person did not always receive care that was safe or consistent. This put them at risk of harm. We found the provider needed to make further improvements in how they managed this person's care.
There were risk assessments in place that gave guidance to staff on how risks to people could be minimised. There were systems in place to safeguard people from risk of possible harm and action was taken to review incidents so that systems could be put in place to prevent them from happening again. People’s medicines were being managed safely.
The provider had safe recruitment processes in place. They had not used agency staff for a few months prior to the inspection as they now had sufficient permanent staff. Staff had received regular supervision and support, and they had been trained to meet people’s individual needs.
People’s needs had been assessed and their care plans took account of their individual needs, preferences, and choices. People enjoyed happy and fulfilled lives because they had been supported to pursue their hobbies and interests. They had also been supported to maintain close relationships with their family members and friends.
Staff understood their roles and responsibilities to seek people’s consent prior to care being provided. Where people did not have capacity to consent to their care or make decisions about some aspects of their care, this had been managed in line with the requirements of the Mental Capacity Act 2005 (MCA).
People were supported by kind, caring and respectful staff. They were supported to make choices about how they lived their lives. People’s health and wellbeing was promoted, and they were supported to access other health and care services when required.
The provider managed people's complaints and concerns well. They encouraged feedback from people, relatives, staff and other stakeholders. They acted on the comments received to improve the quality of the service.
The provider’s quality monitoring processes had been used effectively to drive improvements. People and staff we spoke with were happy with the quality of the service.