We carried out a review of the data available to us about Lady Margaret Road 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 Lady Margaret Road, you can give feedback on this service.
Scotts Road provides a supported living service to people with a learning disability and/or mental health needs living a shared accommodation within three ‘supported living’ schemes. The aim is for people to live in their own home as independently as possible. People’s care and housing are provided under separate contractual agreements.
People’s experience of using this service and what we found
We expect health and social care providers to guarantee autistic people and people with a learning disability the choices, dignity, independence and good access to local communities that most people take for granted. Right Support, right care, right culture is the statutory guidance which supports CQC to make assessments and judgements about services providing support to people with a learning disability and/or autistic people.
This service was able to demonstrate how they were meeting the underpinning principles of Right support, right care, right culture.
Right support:
• The service used positive behaviour support principles to support people in the least restrictive way. No restrictive intervention practices were used.
Right care:
• People's support focused on them having as many opportunities as possible for them to gain new skills and become more independent. The staff supported people in a person-centred way and respected their privacy, dignity and human rights.
Right culture:
• Staff were responsive to people’s individual needs and knew them well. They supported each person by spending time with them and listening to them. They ensured that each person felt included and valued as an individual. People were engaged in meaningful activities of their choice. They were consulted about what they wanted to do and were listened to.
Following the last inspection, the provider had mitigated risks to people’s safety by making improvement to the environment. All three supported living schemes were clean, tidy and hazard-free. There were robust systems in place for the prevention and control of infection and the staff followed these.
People who used the service and their relatives were happy with the service they received. Their needs were met in a personalised way and they had been involved in planning and reviewing their care. People said the staff were kind, caring and respectful and they had developed good relationships with them.
People's needs were assessed before they started using the service and care plans were developed from initial assessments. People and those important to them were involved in reviewing care plans. Risks to their safety and wellbeing were appropriately assessed and mitigated. There were systems for monitoring the quality of the service, gathering feedback from others and making continuous improvements.
The provider worked closely with other professionals to make sure people had access to health care services. People received their medicines safely and as prescribed. People’s nutritional needs were assessed and met.
Staff were happy and felt well supported. They enjoyed their work and spoke positively about the people they cared for. They received the training, support and information they needed to provide effective care. The provider had robust procedures for recruiting and inducting staff to help ensure only suitable staff were employed.
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 requires improvement (published 5 July 2019) and there were breaches of regulations 12 safe care and treatment and 17 good governance. The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection we found improvements had been made and the provider was no longer in breach of regulations.
Why we inspected
The inspection was prompted in part by notification of a specific incident. Following which a person using the service died, and an anonymous complaint in relation to how the incident was managed. A decision was made for us to inspect and examine those risks. We found no evidence during this inspection that people were at risk of harm from this concern.
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.
Scotts Road provides a supported living service to people with a learning disability and/or mental health needs living in shared accommodation within three ‘supported living’ schemes. The aim is for people to live in their own home as independently as possible. People’s care and housing are provided under separate contractual agreements.
Not everyone using the service received a 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. At the time of our inspection, 18 people were receiving personal care.
The registered manager and the compliance manager oversaw the three schemes, supported by a team of senior staff.
The principles and values of Registering the Right Support and other best practice guidance ensure people with a learning disability and or autism who use a service can live as full a life as possible and achieve the best outcomes that include control, choice and independence. At this inspection the provider had ensured they were applied.
The outcomes for people using the service reflected the principles and values of Registering the Right Support by promoting choice and control, independence and inclusion. People's support focused on them having as many opportunities as possible for them to gain new skills and become more independent.
People’s experience of using this service:
The provider had a procedure regarding infection control and the staff had specific training in this area. However, one of the supported living schemes was not clean and there was a risk of infection and cross contamination.
The risks to people's safety and wellbeing were assessed and regularly reviewed. However, on the day of our inspection, we identified some areas which could pose a health and safety risk to people who used the service.
The provider had systems in place to monitor the quality of the service and where issues were identified, these were usually addressed promptly. However, although they had identified the need to improve the cleanliness of one of the schemes during their audits, staff had not addressed this, and action had not been taken to make the necessary improvements.
The provider had effective arrangements to protect people against the risks associated with the management of medicines. People were receiving their medicines safely and as prescribed.
There were enough staff on duty to meet people's needs and there were contingency plans in the event of staff absence. Employment checks were in place to obtain information about new staff before they could support people.
Care plans and risk assessments were reviewed and updated whenever people's needs changed. People and relatives told us they were involved in the planning and reviewing of their care and support and felt valued.
People were supported to manage their own safety and remain as independent as they could be.
The provider had processes in place for the recording and investigation of incidents and accidents and lessons were learnt when things went wrong.
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 supported this practice.
Staff had undertaken training in the Mental Capacity Act 2005 (MCA) and were aware of their responsibilities in relation to the Act. The provider had liaised with the local authority when people required Court of Protection decisions about being deprived of their liberty in the receipt of care and treatment. At the time of our inspection, nobody was being deprived of their liberty unlawfully.
People’s health and nutritional needs were recorded and met. Where possible, people using the service were supported to shop for ingredients and cooked their own food. Staff supported people to attend medical appointments where support was required.
People were supported by staff who were sufficiently trained, supervised and appraised.
A range of activities were arranged that met people’s individual interests and people were consulted about what they wanted to do. Most people were able to access the community and were supported to undertake work and education.
Staff were caring and treated people with dignity, compassion and respect. Support plans were clear and comprehensive and included people's individual needs, detailed what was important to them, how they made decisions and how they wanted their care to be provided.
People told us, and we saw staff supported them in a way that considered their diversity, values and human rights. People confirmed they were supported and encouraged to be involved in the running of the service and felt valued.
Information about how to make a complaint was available to people and their families, and they felt confident that any complaint would be addressed by the management. We saw evidence that complaints were addressed appropriately.
People, relatives and staff told us that the registered manager and compliance manager were supportive, approachable and hands on. Staff were supported to raise concerns and make suggestions about where improvements could be made.
Rating at last inspection:
At the first inspection of the service on 16 November 2018 (Published 5 December 2016), the service was rated good in all key questions and overall. During this inspection we found breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 relating to safe care and treatment and good governance. You can see what action we have asked the provider to take within our table of actions.
Why we inspected:
This was a planned inspection based on the previous rating.
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 any concerning information is received, we may inspect sooner.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Scott’s Road is part of Infinity Services, and is a seven bedded unit, designed over two floors. Scott’s Road provides supported living for seven adults with a learning disability and/or mental health needs. The management team is based at the service. The provider is also registered to provide supported living for five adults with mental health needs who live at a nearby location (Shrubbery Road). Each person living at both locations had a tenancy agreement with a landlord to rent their individual bedrooms and share the common areas of the house such as the kitchen, bathrooms, lounge and dining areas. Most of the bedrooms at Shrubbery Road were ensuite so people did not need to share bathrooms with other tenants.
The service is required to have a registered manager and there was a registered manager in post at the time of our inspection. 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. They were supported by a compliance manager, a team leader and a team of support workers led by a senior support worker.
People told us they felt safe and we saw that there were systems and processes in place to protect people from the risk of harm whilst giving them the chance to take positive risks. There were enough staff on duty to meet people’s needs and there were contingency plans in the event of staff absence to ensure people’s safety.
Staff had received training in safeguarding adults and this was updated regularly. There was a safeguarding policy and procedure in place. There had not been any safeguarding issues at the service since they had registered.
Effective systems were in place to ensure the safe management of people’s prescribed medicines and staff had received training in the administration of medicines.
The provider had systems in place to monitor the quality of the service and ensured that areas for improvements were identified and addressed.
Staff had undertaken training in the Mental Capacity Act (MCA) 2005 and were aware of its principles. We were told and saw that people were given choices and the opportunities to make decisions, and records were signed by people to indicate that consent was obtained.
People’s nutritional needs were being met. Staff supported people to shop for their food and cook their own meals if they wished to.
Staff received effective training, supervision and appraisal. The registered manager sought guidance and support from other healthcare professionals and kept themselves informed of important developments within the social care sector in order to cascade information to staff, thus ensuring that the staff team was well informed and trained to deliver effective support to people.
Staff were caring and treated people with dignity and respect and in a way that took account of their diversity, values and human rights. Care plans were in place and people had their needs assessed. Care records contained detailed information and reflected the needs and wishes of the individual so staff had the information they required to meet people’s needs.
People, relatives, staff and stakeholders told us the registered manager, management team and staff were supportive and professional. The management team said they encouraged an open and transparent culture within the service. The service supported people to raise concerns and used feedback to make improvements where needed.
There were regular meetings for staff, managers and people using the service which encouraged openness and the sharing of information.