Allerton C&S SW

Updated 22 February 2022

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 Health and Social Care Act 2008.

Inspection team

The inspection was carried out by two inspectors.

Service and service type

This service is a domiciliary care agency. It provides personal care to people in supported living houses.

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

This inspection was unannounced.

Inspection activity started on 18th January 2022 and ended on 27th January 2022. We visited the location’s office on 25th January 2022.

What we did before the inspection

We reviewed information we had received about the service since the last inspection. We sought feedback from professionals who work with the service. We used the information the provider sent us in the provider information return (PIR). This is information providers are required to send us annually with key information about their service, what they do well, and improvements they plan to make.

This information helps support our inspections. We used it to plan our inspection.

During the inspection

We spoke with nine people who were supported by Allerton C&S SW, but only five of them received personal care from the service. People who were unable to talk with us used different ways of communicating including voice output communication aids, objects, signs and body language.

We are improving how we hear people’s experience and views on services, when they have limited verbal communication. We have trained some CQC team members to use a symbol-based communication tool. We checked that this was a suitable communication method and that people were happy to use it with us. We did this by reading their care and communication plans and speaking to staff or relatives and the person themselves. In this report, we used this communication tool with two people to tell us their experience.

We received feedback from five people’s relatives and nine members of staff, including the registered manager, acting assistant manager, quality lead and nominated individual. The nominated individual is responsible for supervising the management of the service on behalf of the provider.

We received feedback from seven professionals or other stakeholders who worked with the service. Their comments have been incorporated into this report.

We looked at four people’s care records and reviewed medicines records and additional information on the electronic records system. We reviewed a range of records relating to the management of the service such as incident records, audits, policies and training data.

After the inspection

We continued to have contact with the registered manager and nominated individual. They sent documents and information after the inspection. We had further contact with other professionals regarding the initial concerns which had been shared with us.

Updated 22 February 2022

We expect health and social care providers to guarantee people with a learning disability and autistic people respect, equality, dignity, choices and independence and good access to local communities that most people take for granted. ‘Right support, right care, right culture’ is the guidance CQC follows to make assessments and judgements about services supporting people with a learning disability and autistic people and providers must have regard to it.

About the service

Allerton C&S SW is a domiciliary care service which provides support to 20 people in supported living settings. The people receiving support may have a learning disability, autism, mental health needs, physical disability or sensory impairment.

A supported living service is one where people live in their own home and receive care and support to enable people to 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.

Not everyone who used the service received personal care. This is help with tasks related to personal hygiene and eating. Where they do we also consider any wider social care provided. At the time of the inspection 16 people were receiving personal care. We visited three houses, but people were only receiving personal care at two of these premises.

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.

Based on our review of the safe, effective and well led key questions, the service was able to demonstrate how they were meeting the underpinning principles of right support, right care, right culture.

Right Support

• People had not always had a consistent team of staff working with them recently because of staff turnover. This was now improving, and permanent staff were being recruited.

• Staff supported people with their medicines safely and to achieve the best health outcomes. Sometimes staff needed to make sure people’s creams were used and recorded consistently.

• Staff focused on people’s strengths and promoted what they could do, so people had a fulfilling and meaningful everyday life.

• People were protected from infection or illness, such as covid 19, by the guidance and safe practice of staff.

• Staff supported people to play an active role in maintaining their own health and wellbeing. Staff enabled people to access specialist health and social care support in the community.

• Staff supported people to have the maximum possible choice and control and make their own decisions where possible. Policies and records supported this practice.

Right care

• People received kind and compassionate care. Staff protected and respected people’s privacy and dignity. They understood and responded to their individual needs.

• Staff understood how to protect people from poor care and abuse. Staff had training on how to recognise and report abuse and they knew how to apply it.

• People could communicate with staff and understand information given to them because staff supported them consistently and understood their individual communication needs. Staff had the skills to understand people who had individual ways of communicating.

• When possible, staff and people worked together when considering the risks people might face. Some risk assessments needed review to ensure they were detailed enough or up to date.

Right culture

• People led inclusive and empowered lives because of the ethos, attitudes and skills of the management and staff. Staff received additional training to safely support people with specific or complex needs.

• Managers ensured staff were competent and held the appropriate values to work for Allerton C&S SW. Actions were taken to address concerns and improve standards where necessary.

• Staff knew and understood people well and were responsive, supporting their aspirations to live a quality life of their choosing.

• Staff turnover had been high, but people now had consistent teams and key staff who knew them well.

• Staff evaluated the quality of support provided to people, involving the person, their families and other professionals as appropriate. Some written reviews and assessments needed updating.

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 good (published 14th April 2021).

Why we inspected

We received concerns in relation to safeguarding and risk management at one of the supported living homes. As a result, we undertook a focused inspection to review the key questions of safe, effective and well led only.

We found the supported living home concerned did not provide personal care to the people who live there. This means it is not regulated by CQC. Therefore, the concerns relating to that home are being managed by other stakeholders and are not included in this report.

We found no evidence during this inspection that people were at risk of harm at the services which are regulated by CQC.

For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Allerton C&S SW on our website at www.cqc.org.uk.

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.