Background to this inspection
Updated
21 August 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
The inspection was carried out by three inspectors. Two inspectors conducted the site visits and a third inspector assisted with collation and review of information received from the service
Service and service type
This service provides care and support to people living in two supported living settings, so that they can live as independently as possible. People's care and housing needs 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 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.
Notice of inspection
We gave three working days’ notice of the inspection. This was to ensure all the risks around Covid-19 could be explored and to ensure that people and the management team would be home to speak with us.
What we did before the inspection
We reviewed information we had received about the service since the last inspection. We sought feedback from the local authority and professionals who work with the service. The provider had not been asked to complete the required Provider Information Return. This is information providers are required to send us with key information about the service, what it does well and improvements they plan to make. We reviewed notifications and safeguarding concerns we had received from the service. Services are required to send these through to CQC as part of their requirements of registration. We asked for information to be sent to us in advance of the inspection so that we could review this prior to visiting the site with the aim to reduce what we needed to ask for on the inspection days. We used all this information to plan our inspection.
During the inspection
We spoke with three people who used the service about their experience of the care provided. We spoke with ten members of staff including the registered manager, director, supported living managers and support workers. We reviewed a range of records, this included three people’s care records. A variety of records relating to the management of the service, policies and procedures, incidents and accidents and infection control were reviewed.
After the inspection
We continued to seek additional information from the registered manager with regards to additional supporting evidence. This included care records, staff competency checks and environmental risk assessments. We spoke with two relatives by phone to obtain feedback of their experiences with the service.
Updated
21 August 2020
About the service
Supporting Independence provides personal care and support to people with learning disabilities, autism and mental health needs living in 'Supported Living' accommodation. 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.
Staff provided support to 13 people across two locations. There were three people who were receiving the regulated activity of personal care, this was across both settings, Ivy Cottage in Findon and Mortimer House in Littlehampton. The service also supported two people with outreach support in their own homes, they did not receive the regulated activity of personal care so have not been included within this report.
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 told us they were happy living at Ivy Cottage and Mortimer House. All the people we spoke with during the inspection said they were treated well by staff who were kind and caring and supported them to be independent to achieve their goals.
People told us they felt safe with regards to their daily living and also with the Covid-19 pandemic. People told us that staff had supported them to understand the risks around Covid-19 and how they can make sure they stay safe when out, now that some restrictions have been lifted by the government.
Overall risk had been managed appropriately for people and risk assessments in place around each person’s identified needs. We did find a concern with the assessment process for one person who moved into the service during the Covid-19 pandemic. We found that communication had slipped between the provider and external services to ensure the placement was fully risk assessed and appropriate for the person. The registered manager was open and honest about this process and stated lessons had been learnt from it to ensure future placements are fully assessed prior to commencing. We did not find any concern with the other pre assessments for people prior to living at the services.
People were supported to have maximum choice and control over 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.
People were observed to have positive and supportive interactions with staff. The atmosphere at both Ivy Cottage and Mortimer house was happy with people smiling and laughing with staff. People seemed to have developed good positive relationships with staff and people did not appear to be cautious or uneasy in the presence of staff including managers.
People could access healthcare professional involvement when needed. Where people had accidents and incidents staff responded to these and the registered manager and management team reviewed all incidents to identify any triggers or causes to help reduce reoccurrence. Staff told us they felt they received good feedback in relation to incidents and could discuss how to assess and monitor risk.
Staff said they were happy working for the provider. Staff did indicate there had been some confusion with regards to the management changes across the service, but this had improved recently, and staff gave glowing feedback for the new managers who had been recruited to join the team.
The registered manager had made improvements towards developing a positive culture within the service. Staff reported a change in atmosphere since these had been implemented which included recruiting new staff and making the management structure clearer to staff. The registered manager was open and honest about where things had gone wrong. They acknowledged there had been a period of unsettlement during Covid-19 and new staff and management changes but felt things had improved, which was supported by the staff we spoke to during the inspection.
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 was Good (report published 16 July 2019).
Why we inspected
We undertook a focused inspection due to concerns we received relating to incidents of alleged abuse, restrictive practice, staffing culture and management oversight at the service. This report only covers findings in relation to care which people received, safe care and treatment, safeguarding people from abuse, and management of the service. Ratings from previous comprehensive inspections for those key questions were used in calculating the overall rating at this inspection.
The overall rating for the service has not changed following this focused inspection and remains Good.
We found no evidence during this inspection that people were at risk of harm from these concerns. Please see the Safe and Well-Led sections of this full report.
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.