We carried out a review of the data available to us about Gideon Supported Housing Limited on 6 July 2023. We have not found evidence that we need to carry out an inspection or reassess our rating at this stage.
This could change at any time if we receive new information. We will continue to monitor data about this service.
If you have concerns about Gideon Supported Housing Limited, you can give feedback on this service.
At our last inspection in September 2017 the overall rating of the service was requires improvement. Well-led was rated inadequate due to the number of concerns we found. We found four breaches of regulations of the Health and Social Care Act 2008 (Regulated Activities) 2014. These related to management of medicines, person centred care planning, consent to care provided and good governance. You can read the report from our last comprehensive inspection, by selecting the 'all reports' link for ‘Gideon Supported Living Home’ on our website at www.cqc.org.uk. The provider sent us an action plan on how they would meet these regulations. At this inspection we found the provider had made the required improvement and now complied with our regulations. We have rated the service overall as Good. However, the rating for well-led is requires improvement. This is because of the previous rating in this area. We needed to be sure they consistently improved and well managed before we can change the rating of well-led to Good.
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.
Risks were assessed and management plans developed to reduce potential harm to people. People’s medicines were managed in a safe way. There were sufficient numbers of staff to support people. Staff knew actions to take if they suspected abuse. The registered manager understood their responsibilities to protect people from abuse. Recruitment practices were thorough. Incidents and accidents were recorded and reviewed. Staff followed infection control procedures.
Staff and the registered manager understood their roles and responsibilities under the Mental Capacity Act (MCA) 2005. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service support this practice. People consented to their care before they were delivered.
People’s care needs were assessed, planned and delivered in a way that met their individual needs. Care plans were detailed and provided guidance to staff. They were up to date and reflected people’s present needs and circumstances. People and their relatives were involved in planning their care and support. People received the supported they needed to meet their nutritional needs. Staff supported people to access healthcare services they needed to maintain good health. The service liaised with other services to ensure people received coordinated care. Staff were supported well through regular training, supervision and appraisal. Staff told us they felt supported in their roles.
Staff supported people with their emotional needs and treated people with dignity and respect. People were comfortable with staff and there was positive interaction between them. Confidential matters were discussed in private and records kept secured. People were supported to participate in the community and to do activities they enjoy. People were supported to maintain relationships which mattered to them. Staff understood the importance of promoting equality and diversity.
Relatives told us they knew how to complain if they were unhappy with the service. There was a complaints procedure in place and the registered manager addressed concerns in line with this procedure.
The registered manager complied with the requirements of their CQC registration. They sent us notifications and displayed their inspection rating as required. Regular checks and audits were conducted to assess and monitor the quality of service. The registered manager took actions to improve the service. Relatives told us that their feedbacks were acted on to improve the service. Staff felt supported and motivated to work at the service. Staff knew who to speak to if they needed advice and direction. The service worked in partnership with other organisations to improve the service.
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.
The first inspection of the service was in 6 June 2016 where we were unable to formally rate the service because there was just one person using the service at that time. However, at that inspection we identified two breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. These related to unsafe recruitment practices and insufficient training and support for staff. We also found that the way people’s medicines were managed needed some improvement. The provider sent us an action plan on how they would make the required improvements. You can read the report from our last comprehensive inspection, by selecting the 'all reports' link for ‘Gideon Supported Housing Limited’ on our website at www.cqc.org.uk.
At this inspection we found the provider had made the required improvements in their recruitment processes to ensure staff were suitable for the roles they had applied for. Staff were also given regular support and supervision, and had completed training required to perform their jobs effectively. However, we also found a number of breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.
Risk assessments were in place but were not comprehensive and did not always identify potential harm to people. Risk management plans did not provide sufficient guidance to staff to enable them maintain people’s health and safety.
People’s medicines were not handled and managed in a safe way. Medicines Administration Records (MARs) had not always been completed to confirm people had received their medicines as prescribed. We found high levels of medicines stock at the service which could not be explained.
Appropriate consent had not always been obtained relating to people’s care and support arrangements. Mental capacity assessments had not taken place where people lacked capacity to consent to their care arrangements. Decisions had not always appropriately been made in people’s best interests. In line with the Mental Capacity Act 2005 (MCA).
Care was not always planned and delivered in a way that met people’s individual needs. The service did not always take the needs of people into account to ensure they were met. Care plans were not detailed and provided insufficient guidance to staff on how people should be supported. They were also not up to date or reflective of people’s present needs and circumstances.
The registered manager and service manager had not ensured effective quality monitoring systems were place to monitor and assess the quality and safety of the service provided because the issues we found at this inspection had not been identified by the internal quality assurance processes.
There were a sufficient number of staff available to meet people’s needs safely. The service manager and registered manager were hands-on and were available to support staff in their delivery of care, as needed. Staff knew the signs to look for and action to take if they suspected people had been abused.
People had access to the healthcare services they required to maintain their health. People were supported to meet their nutritional and dietary needs.
Staff knew the people they supported and what made them anxious or distressed. Staff treated people with dignity and respected their privacy. People were comfortable with staff and we observed their interactions to be positive. People’s confidential matters were only discussed in private and records relating to people’s care were kept securely.
Relatives told us they knew how to complain if they were unhappy with the service. There was a complaint procedure in place. People were supported to participate in activities they enjoyed and to socialise.
There was clear and visible leadership in the service. Staff knew who to speak to if they needed advice and direction.
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.
Staff understood how to safeguard people they supported and relatives told us they believed that their loved ones were kept safe. However, the provider had not always taken appropriate steps to ensure that staff were safely recruited and this required improvement. Medicines required some improvement so that they were managed safely. Appropriate risk assessments were in place to mitigate risk to people using the service. There was a whistle-blowing procedure available. There were enough staff to meet people’s care and support needs.
Staff completed an induction when they started work, however improvements were needed to ensure that staff were up to date with the provider’s mandatory training. The team manager and staff understood the Mental Capacity Act 2005 (MCA) and the Deprivation of Liberty Safeguards (DoLS) and acted according to this legislation. People were supported to access food and drink so that their dietary needs were met. People were supported to access healthcare professionals as and when required.
People were treated with dignity and respect, and their privacy was taken into account. Peoples care plans provided guidance for staff on how to support people to meet their needs. Staff were aware of the complaints procedure and said they were confident that complaints would be dealt with appropriately.
Quality monitoring checks and audits were conducted regularly to monitor the quality of the service, however they did not identify issues we found at inspection. Staff said they enjoyed working at the service and they received good support from the management team.