Midlands Supported Living

Updated 28 December 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 was planned to check 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 the 1, 2 and 8 November 2018 and was announced. We gave the service 48 hours' notice of the inspection as care is provided in the community and we needed to ensure that staff were available to support the inspection. We visited the office location on the 1 November and completed the office visit and visited one person in their supported living accommodation on 2 November. We completed the inspection with a telephone call to a person using the service and their relative on the 8 November.

The inspection was undertaken by one inspector.

Before the inspection, the provider completed a Provider Information Return (PIR). This is a form that asks the provider to give some key information about the service, what the service does well and improvements they plan to make. We received the completed document prior to our visit and reviewed the content to help focus our planning and determine what areas we needed to look at during our inspection.

We reviewed the information we held about the service, including information sent to us by other agencies, such as Healthwatch; an independent consumer champion for people who use health and social care services. We also contacted commissioners and asked them for their views about the service. Commissioners are people who work to find appropriate care and support services for people.

Some people using the service had complex needs which impacted on their ability to provide feedback on their experiences. We spoke with one person who used the service with the support of their relative. We also visited one person in their supported living accommodation. We spoke with five members of staff, including the registered manager, two team leaders, a support worker and maintenance staff. We looked at records relating to the personal care and support of two people using the service and two people’s medicines records. We also looked at three staff recruitment records and other information related to the management oversight and governance of the service. This included quality assurance audits, staff training and supervision information, staffing rotas and the arrangements for managing complaints.

Updated 28 December 2018

This announced inspection took place on 1, 2 and 8 November 2018.

The service provides care and support to people living in ‘supported living’ settings, 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. Some people using the service lived in a ‘house in multi-occupation’ that could be shared by four people. Houses in multiple occupation are properties where at least three people in more than one household share toilet, bathroom or kitchen facilities. Another person lived alone in a house in a residential area with staff support.

At the time of our inspection, there were two people in receipt of personal care support. The service provides support to adults with autism, learning disabilities and mental health needs.

Not everyone using Midlands Supported Living receives regulated activity; CQC only inspects the service being received by people provided with 'personal care'; help with tasks related to personal hygiene and eating. Where they do, we also take into account any wider social care provided.

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.

At the last comprehensive inspection on 15 and 19 September 2017, we found the service to be rated ‘Requires Improvement’ and the provider was in breach of two regulations of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. We asked the provider to take action to make improvements in relation to the governance of the service and the administration of medicines. The provider submitted an action plan detailing the improvements that they would make to comply with the regulations; they stated that they would be compliant by 15 December 2017.

Staff demonstrated their understanding of MCA and the need to ensure that people's care and support was provided in the least restrictive way. However, the provider had not ensured that recorded MCA assessments and best interest decisions were carried out with people. Where people had other professionals involved in their support, for example to provide medical care, assessments were in place.

There were safe systems in place for the administration of medicines and people received their medicines as prescribed. Regular audits ensured that medicines were stored and administered appropriately and any errors would be identified promptly.

Quality monitoring systems and processes were in place and audits were taking place within the service to identify where improvements could be made.

People were supported in a safe way. Staff had an understanding of abuse and the safeguarding procedures that should be followed to report abuse. All the staff we spoke with were confident that any concerns they raised would be followed up appropriately by senior staff. People had risk assessments in place to cover any risks that were present within their lives, but also enabled them to be as independent as possible.

Staff supported people in a way which prevented the spread of infection. Staff used the appropriate personal protective equipment to perform their roles safely.

Staff recruitment procedures ensured that appropriate pre-employment checks were carried out to ensure only suitable staff worked at the service. Staffing levels were suitable to meet people's needs, and the staffing rotas showed that staffing was consistent.

Staff attended induction training where they completed mandatory training courses and were able to shadow more experienced staff. Staff were well supported by the registered manager and senior team and had regular one to one supervisions.

Where needed staff supported people to have access to suitable food and drink. Staff supported people to health appointments when necessary. Health professionals were involved with people's care as and when required.

People were involved in their own care planning as much as they could be, and were able to contribute to the way in which they were supported. People were in control of their care and listened to by staff.

Staff treated people with kindness, dignity and respect and spent time getting to know them and their specific needs and wishes.

The service had a complaints procedure in place. This ensured people and their relatives were able to provide feedback about their care and to help the service make improvements where required.

The service worked in partnership with other agencies to ensure quality of care across all levels. Communication was open and honest, and any improvements that were needed were acted upon. There were arrangements in place for the service to make sure that action was taken and lessons learned when things went wrong so that the quality of care across the service was improved.