Archived: Voyage (DCA) Scotia House

This service provides care and support to people living in ‘supported living’ so that they can live as independently as possible. This comprised of 11 independent flats contained within one building with communal lounges and management offices based at the location. 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.

At the time of our inspection 11 people were receiving support from Voyage (DCA) Scotia House.

There was a registered manager in post who was present during 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.

We carried out an unannounced comprehensive inspection of this service on 9 June 2016 and breaches of legal requirements were found and we rated the service as Requires Improvement overall. After the inspection, the provider wrote to us to say what they would do to meet the legal requirements in relation to Regulation 12, safe care and treatment and Regulation 17, good governance.

We undertook a focused inspection in October 2016 to check that they had followed their plan and to confirm that they now met legal requirements. At that inspection we focused on the key questions, is the service safe? And is the service well-led? At that inspection we found that they were meeting the legal requirements but improvements were still required in these two key areas.

At that time these topic areas were included under the key questions of safe, responsive and well-led. We reviewed and refined our assessment framework and published the new assessment framework commencing from 1 November 2017. Under the new framework these topic areas are included under the key questions of safe, effective, responsive and well-led. Therefore, for this inspection, we have inspected these key questions and also the previous key question to make sure all areas are inspected to validate the ratings.

At this inspection we found that improvements had been made and we rated the service Good.

People were safe as staff had been trained and understood how to support people in a way that protected them from danger, harm and abuse. People were supported by enough staff to safely assist them. People received help with their medicines from staff who were trained to safely support them. When errors occurred the provider had systems in place to investigate and take action to minimise the risks to people.

The provider followed infection prevention and control guidance. The provider undertook regular checks on equipment that people used to ensure it was safe and well maintained. The provider completed pre-employment checks on staff before they started work to ensure they were safe to work with people. The provider had systems in place to address any unsafe staff practice.

People received care from staff members that had the skills and knowledge to support them and to meet their needs. New staff members received an induction to their role and were equipped with the skills they needed to work with people. Staff attended training that was relevant to those they supported and any additional training needed to meet people’s requirements was provided.

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 received support and guidance from a management team who they found approachable, knowledgeable and supportive. People, relatives and staff felt able to express their views and felt their opinions mattered.

People had positive relationships with staff members who knew their individual likes and dislikes and who assisted them in a way which was personal to them. Where possible people were involved in decisions about their care and had information they needed in a way they understood.

People had their privacy and dignity respected and information personal to them was treated confidentially. People had access to healthcare when needed and staff responded to any changes in needs promptly and consistently. People were supported to eat and drink sufficient amounts to maintain good health.

The provider had regular contact with those they supported to gain feedback in the service they provided and to make changes where necessary. People and relatives felt confident they were listened to and their views were valued. The provider had effective quality monitoring systems in place to identify and drive improvements to the service they provided.

Voyage (DCA) Scotia House are registered to provide personal care. People are supported with their personal care needs to enable them to live in their own homes and promote their independence. Personal care was provided in a supported living setting, which meant accommodation was provided under a separate private tenancy agreement to people who used the service and the office was based within the same building where people had their own independent flats. People who used the service also had access to two communal lounges. At the time of the inspection the service supported 11 people in their own homes.

There was a registered manager at the service. 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.

Some improvements had been made to the systems in place to assess and monitor the quality of the service. However, some systems to mitigate risks to people had not been fully implemented at the time of the inspection.

Further improvements were needed to ensure that people’s care records contained an accurate account of their needs.

People’s risks were not always planned and managed in a way to protect people from the risk of inappropriate and inconsistent care.

Improvements had been made to the management of medicines, which ensured people received their medicines as prescribed.

Staff and the registered manager understood their responsibilities to protect people from abuse and were able to explain the actions they would take if abuse was suspected.

We found there were enough staff available and staffing was managed in a way that ensured people received their care when they needed it.

The provider had safe recruitment procedures and we found that the required checks had been carried out, which ensured that staff were suitable and of good character to provide care to people who used the service.

The provider had implemented an improvement plan to make changes to the way people received their care. The registered manager was working through the actions and the provider was involved in the checking and monitoring of these actions.

Voyage (DCA) Scotia House are registered to provide personal care. People are supported with their personal care needs to enable them to live in their own homes and promote their independence. Personal care was provided in a supported living setting, which meant accommodation was provided under a separate private tenancy agreement to people who used the service. The office was based within the same building where people had their own independent flats. People who used the service also had access to two communal lounges. At the time of the inspection the service supported 11 people in their own homes.

There was a registered manager who shared their time across two of the provider’s services. 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.

We found the systems in place to assess and monitor the quality of the service were not effective. Some of the concerns we raised at the inspection had been identified by the provider, but there had not been swift and appropriate action taken to mitigate the risks for people who used the service.

People’s risks had not been assessed or monitored effectively to keep people safe. People were at risk of harm because records we viewed did not always match the support that staff told us people needed to keep them safe.

Medicines were not managed safely to protect people from the risk of harm. We could not be assured that people were receiving their medicines as prescribed.

Improvements were needed to ensure that people’s health and wellbeing was monitored and managed effectively and people were referred to other health professionals where their needs had changed.

We saw staff treated people in a caring way and showed dignity and respect when they provided support. However, some improvements were needed to ensure that staff understood how other factors had an effect on people’s care.

Improvements were needed to ensure that people’s care was reviewed and changes in people’s needs were reflected in their care records.

Staff had received training and an induction before they provided care and staff told us that they felt supported to carry out their role effectively.

The provider was acting within the requirements of the Mental Capacity Act 2005. Where people were unable to consent to their care assessments had been carried out to ensure people were supported to make decisions in their best interests.

People were supported to eat and drink sufficient amounts and people were supported to maintain a healthy diet.

We found that people’s preferences in care had been considered and staff had a good understanding of people’s preferences which enabled their care to be provided in a way that met their individual needs.

Staff gave people choices in how they wanted their care provided. Staff understood people’s individual communication methods when making choices about how they wanted their care providing.

Staff and the registered manager understood their responsibilities to protect people from abuse and were able to explain the actions they would take if abuse was suspected.

We found there were sufficient staff available and staffing was managed in a way that ensured people received their care when they needed it.

The provider had safe recruitment procedures and we found that the required checks had been carried out, which ensured that staff were suitable and of good character to provide care to people who used the service.

The provider had a system in place to handle and respond to complaints that had been made by people who used the service or their relatives.

We identified breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see what action we told the provider to take at the back of the full version of the report.