Background to this inspection
Updated
21 February 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.
The inspection took place on the 16 January 2018 and was announced. The provider was given 48 hours’ notice because the location provides a supported living service. We wanted to be sure that someone would be in to speak with us.
The inspection team consisted of one inspector and an expert by experience. An expert-by-experience is a person who has personal experience of using or caring for someone who uses this type of care service.
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 looked at information we held about the service. This included notifications. Notifications are changes, events or incidents that the service must inform us about. We used all this information to decide which areas to focus on during our inspection.
During our inspection we spoke with two people and three relatives over the telephone, two care staff, a team leader, assistant co-ordinator, community leader and the registered manager. We observed the manager and staff working in the office dealing with issues and speaking with people and staff over the telephone and in the office.
We reviewed a range of records about people’s care and how the service was managed. These included the care records for four people, medicine administration record (MAR) sheets, three staff training, support and employment records, quality assurance audits, incident reports and records relating to the management of the service.
Updated
21 February 2018
The inspection took place on the 16 January 2018 and was announced. The provider was given 48 hours’ notice because the location provides a supported living service. We wanted to be sure that someone would be in to speak with us.
This service provides care and support to people living in a supported living setting, 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.
L'Arche Bognor Regis is registered to provide personal care to people living with a learning disability and other complex needs, including autism. At the time of our inspection, the service was supporting five people. The provider offers care and support to people who require help with day-to-day routines including personal care, meal preparation, housework, accessing the community and companionship.
The service had a registered manager. 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 service was last inspected on the 6 September 2016, where we found the provider was in breach of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. This was because we identified the provider did not always assess the risks to the health and safety of people receiving care and did not do all that is reasonable to mitigate such risks. There was no robust system and processes to assess, monitor and mitigate risks or, monitor and improve the quality and safety. The service received an overall rating of 'Requires Improvement', and after our inspection the provider wrote to us to say what they would do to meet the legal requirements in relation to these breaches.
Staff had a firm understanding of how to keep people safe and there were appropriate arrangements in place to manage risks. People were protected from the risk of abuse because staff understood how to identify and report it.
Quality assurance audits completed by the registered manager and provider were embedded to ensure a good level of quality was maintained. We saw audit activity for areas such as accidents and incidents, care planning and training.
People were supported to receive their medicines safely. The provider had arrangements in place for the safe administration of medicines. People were supported to get their medicine safely when they needed it. People were supported to maintain good health and had access to health care services.
Staff considered peoples capacity using the Mental Capacity Act 2005 (MCA) as guidance. People’s capacity to make decisions had been assessed. 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.
People were supported at mealtimes to access food and drink of their choice. Some people’s food preparation at mealtimes was supported by staff or themselves, staff ensured meals were accessible to people.
People’s individual needs were assessed and care plans were developed to identify what care and support they required. People were consulted about their care to ensure wishes and preferences were met. Staff worked with other healthcare professionals to obtain specialist advice about people’s care and treatment when required.
People and relatives felt staff were kind and caring. Staff spoke warmly about the people they supported and provided care for. Staff were able to detail people's needs and how they gave assurance when providing care.
Staff felt supported by management to undertake their roles. Staff were given training updates, supervision and development opportunities. Staff spoke positively about training and supervisions they received from the management and provider and commented on how they found they could ask questions freely.