Person Centred Care Homes

Updated 21 February 2019

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 was a comprehensive inspection which took place on 4 and 17 January 2019. It was conducted by one adult social care inspector. We gave the service 48 hours' notice of the inspection visit because of its small size and to ensure members of the management team would be available to assist the process. The second day of visiting took place to meet the registered manager, who was on leave on the first day.

The provider completed a Provider Information Return (PIR) in advance of the inspection. 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.

Before the inspection, we checked for any notifications made to us by the provider and the information we held on our database about the service and provider. Statutory notifications are pieces of information about important events which took place at the service, such as safeguarding incidents, which the provider is required to send to us by law.

Site visit activity took place on both inspection days, including visits to the supported living scheme. There were eight people receiving a personal care service in their flats at the supported living scheme. Their complex needs meant we could not easily obtain their views. We spoke with four people’s relatives, two community professionals, four support workers, a senior support worker, a deputy manager, the operations director, the registered manager and the provider. We also observed support being provided to people in communal areas of the scheme.

We looked at care and medicines records of four people using the service, the personnel files of four staff, and management records such as the staff training matrix and staffing rosters. In-between and following our visits, the management team sent us some further information relating to our findings.

Updated 21 February 2019

This announced inspection took place on 4 and 17 January 2019.

Person Centred Care Homes Supported Living is a supported living service. It provides care and support to adults with learning disabilities and autism living in their own flats within a purpose-built ‘supported living’ scheme, so that they can live in their own homes as independently as possible. People’s care and housing are provided under separate contractual agreements. The Care Quality Commission (CQC) does not regulate premises used for supported living, and so this announced inspection looked at people’s personal care and support.

CQC only inspects the service being received by people provided with ‘personal care’, meaning help with tasks related to personal hygiene and eating. Where they do we also take into account any wider social care provided. There were eight people using the service in this respect.

The care service has been developed and designed in line with the values that underpin the Registering the Right Support and other best practice guidance. These values include choice, promotion of independence and inclusion. People with learning disabilities and autism using the service can live as ordinary a life as any citizen.

At our last inspection in May 2016 we rated the service good. At this inspection we found the evidence continued to support the rating of good. However, we found people’s medicine administration records were not always accurately maintained. Where people had medicines prescribed only-as-needed, we found there was often no associated guidance for staff on when the medicine was to be offered. These factors put people at risk of not receiving their medicines as prescribed and therefore of receiving an unsafe service. The management team provided a prompt action plan addressing these matters. We have therefore made a recommendation around safe medicines support.

People using the service had complex needs which meant we could not easily obtain their views. However, there was much evidence available which demonstrated that the service had supported them to move into the scheme successfully and was providing them with individualised care that was meeting their needs. People’s relatives praised the service. “It’s a very good service,” was a typical comment. There was also positive feedback from involved community professionals, one describing the service as excellent. We found the service worked in partnership with community professionals and people’s relatives.

People’s needs and choices had been comprehensively assessed, so that care and support could be delivered in line with standards to achieve effective outcomes. There was a significant focus on how people communicated, their interests and routines, and exploration of any behaviours that challenged services. The information was acquired through meeting the person and any representatives such as relatives, social workers and other care providers. This helped to set up a tailor-made service for each person moving into the scheme.

We found people received personalised care and support that was responsive to their needs and routines. The service empowered people and their relatives to express their views and make decisions about their care and support. Concerns and suggestions were listened to and acted on.

Staff received training and support to meet people's individual needs. The registered manager worked closely with staff as part of this process. We found staff were aware of people's specific needs and preferences, and how to respond appropriately.

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.

The service ensured people's privacy and dignity was respected and promoted. There were positive relationships between people and members of staff. People’s autonomy and independence was valued. The service supported people to maintain relationships that mattered to them and to follow their interests.

The service provided support for people to maintain good health and to eat a diet which reflected their nutritional needs and cultural backgrounds. The service protected people through infection control procedures.

There were enough staff working at the service to keep people safe and meet their needs. Records showed the service operated safe staff recruitment practices.

Risks were identified and minimised in respect of each person’s care and support. Where incidents occurred, they were reviewed to see what could be learnt about how to holistically work with that person to achieve better outcomes for them.

The registered manager was well informed about the service and had a hands-on approach to it. The service promoted a positive and inclusive culture that aimed to achieve good outcomes for people.