Mediline Supported Living Greater Manchester

Mediline Supported Living Greater Manchester is a service which supports adults who have a learning disability, through supported living and domiciliary care provision. The regional office for this service is located in the Levenshulme area of Greater Manchester. At the time of the inspection the service supported approximately 131 people in either their own homes or a supported living setting.

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.

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. People using the service receive planned and co-ordinated person-centred support that is appropriate and inclusive for them.

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

People were safe due to the systems in place to safeguard people from potential abuse or exploitation. Measures were in place to minimise risks, both general and specific to individuals.

Staff were recruited safely and there were sufficient staff to meet the needs of people who used the service. Agency staff were not used. Staff received medicines training and their competency to administer medicines was checked. Measures were in place to help prevent the spread of infection.

Staff new to care completed the Care Certificate when they commenced employment. The Care Certificate is a set of standards that staff are expected to adhere to. Staff received regular supervision and appraisals from their line manager throughout their employment.

People were encouraged to maintain good health and well-being, and the service supported people to access their GP and attend regular health checks.

Some people had been supported to live in their homes for many years. The service explored ways in which properties could be adapted so that people with changing needs could continue to live there.

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. People told us they were happy with their support and were treated with respect. Relatives were also complimentary of the service and its staff.

People were treated as individuals and support was delivered according to their specific needs and wishes. People participated in a range of activities. These included trips out in the local community, attending social groups and other events.

People could raise a concern or make a complaint in various ways and the service produced easy read formats of leaflets to help with this.

There was a clear management structure and line management responsibilities. The registered manager understood their role and responsibilities in relation to the duty of candour. This is a set of expectations about being open and transparent when things go wrong.

Surveys were sent out annually to assess people’s level of satisfaction with the service. Relatives and friends’ surveys also demonstrated a high level of satisfaction with the service.

The service operated an open-door policy. Ways to improve the quality of care further were considered and explored. Quality service audits were carried out on each individual property. These were completed by other registered managers or independent service managers to help ensure impartiality.

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 January 2017). Since this rating was awarded the provider has altered its legal entity. We have used the previous rating to inform our planning and decisions about the rating at this inspection.

Why we inspected

This was a planned 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.

North West Community Services (GM) Limited provides a range of support and care services to people with a learning disability, older people and those with mental and physical disabilities. This is done through a range of tailored services, including outreach, supported living, day services and domiciliary care. There is an office base and staff provide people with a range of care and support including with; personal care, medicines management, shopping and domestic help.

At the time of the inspection 119 people lived independently and received care and support from the service.

The service had 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.

We visited one service and found staff did not always follow safe working practices within the administration and recording of medicines procedures. We watched a staff member prepare two people’s medicines and take them to the two people together. They did not follow good practice or the providers medicines policy. However, at another two services that we visited, staff were following correct procedures and other people and relatives we spoke with did not indicate any concerns with medicines. We have made a recommendation in connection with the safe administration of medicines.

People who used the service and those supporting them knew who to report any concerns to if they felt they or others had been the victim of abuse. Staff had received training in safeguarding and knew about whistleblowing procedures.

Emergency procedures were in place should the staff need to activate them to keep people safe, for example, in the event of a fire or poor weather conditions.

Risks to people's health and safety were managed and detailed plans were in place to enable staff to support people safely. Accidents and incidents were investigated and monitored for any trends forming.

We found one supported living accommodation that we visited in need of redecoration and some refurbishment work. We have asked the provider to support people to address the outstanding work.

There were enough staff with the right skills training and experience to meet people's needs, and although holidays and sickness interfered with staffing rotas, this was managed well with attention given to minimise the impact to people through inconsistency of the same staff as much as possible. Staff felt supported and suitable training and development opportunities were in place.

People told us they felt confident that should concerns be raised these would be dealt with appropriately. People told us they could contact the management team or staff at the service if they needed to discuss anything. People had the opportunity to talk about their opinions of the service during reviews and through meetings or surveys they completed.

Care Quality Commission (CQC) is required by law to monitor the operations of the Mental Capacity Act 2005 (MCA), and to report on what we find. MCA is a law that protects and supports people who do not have the ability to make their own decisions and to ensure decisions are made in their ‘best interests’. We found the provider was complying with their legal requirements.

People were supported to be able to eat and drink suitable amounts to meet their needs. People received a range of treatment when needed from health care professionals which helped to promote their health and well-being, including GPs, dentists and specialist consultants.

People were treated with kindness and respected by staff. Staff had a good relationship and rapport with the people they cared for and supported them to be as independent as possible. People were encouraged and supported to undertake daily tasks and attend to their own personal hygiene needs where possible.

Care and support records were regularly updated to ensure that people’s needs were continually being met and a range of activities and social interactions were available for people to participate in.

Complaint processes were in place for people and their relatives to access if they were dissatisfied with any aspect of the service provision. Any complaints received were prioritised and dealt with quickly and appropriately.

The provider and registered manager ensured people received the quality of care and services they would expect. There were processes in place to monitor the quality of the service people received and experienced. This was through regular communication via meetings, surveys and a programme of continuous checks and audits.

The registered manager had not sent the Commission notifications as they are legally obliged to.

We have made two recommendations for the provider to follow.

Relatives of the people who used the service said they were very happy with the care provided. One person said, 'The staff are very kind and professional, they are very good staff, and very patient.' Another relative told us, 'The staff are very good indeed. My relative receives care from a small team of staff and there is very little change. My relative does not like change so this situation is very good.'

Staff were trained on how to safeguard people from abuse and harm when they were first employed and this was part of the on-going training programme.

The people who used the service appeared comfortable in the company of staff. They described the staff as 'lovely' and 'really good'. One person said, 'The staff are great, you can have a laugh with them.' Another person told us, 'The staff are always nice.'

Relatives of the people who used the service had no concerns to raise about their relative's safety and welfare.

Quality assurance systems had been developed to regularly assess and monitor the quality of the service provided. The systems were focused on the needs of the people who used the service. These quality assurance systems ensured the people who used the service benefited from safe quality care and treatment that was based on effective management.

One of the relatives we spoke with said the service was flexible and took account of their changing circumstances which they said was very useful.