Xtra Healthcare

Updated 3 August 2023

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 Care Act 2014.

Inspection team

This inspection was undertaken by 2 inspectors.

Service and service type

This service provides care and support to people living in ‘supported living’ settings, so that they can live 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.

Registered Manager

This provider is required to have a registered manager to oversee the delivery of regulated activities at this location. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Registered managers and providers are legally responsible for how the service is run, for the quality and safety of the care provided and compliance with regulations.

At the time of our inspection there was a registered manager in post.

Notice of inspection

We gave the service 24 hours’ notice of the inspection. This was because we needed to be sure the provider or registered manager would be in the office to support the inspection.

Inspection activity started on 4 July 2023 and ended on 17 July 2023. We visited the office location on 4 July and visited a supported living site on 10 July.

What we did before the inspection

We reviewed information we had received about the service since the last inspection. We sought feedback from the local authority and professionals who work with the service. We used the information the provider sent us in the provider information return. This is information providers are required to send us with key information about their service, what they do well, and improvements they plan to make. This information helps support our inspections. We used all of this information to plan our inspection.

During the inspection-

We spoke with 3 people and observed 1 person who used the service who could not easily communicate with us and 2 people’s relatives to gain an understanding of people’s experience of the service. We spoke with 11 members of staff including 10 care workers, care manager and the nominated individual. The nominated individual is responsible for supervising the management of the service on behalf of the provider. We reviewed a range of records which included 5 care plans, 4 staff recruitment files and a variety of records relating to the management of the service, including policies and procedures and training documents.

Updated 3 August 2023

About the service

Xtra Healthcare is a domiciliary care and supported living service providing care to people in their own homes. At the time of the inspection the service was primarily proving support to people with learning disabilities and autism in supported living. 14 people were being supported at the time of the inspection.

Not everyone who used the service received personal care. CQC only inspects where people receive personal care. This is help with tasks related to personal hygiene and eating. Where they do we also consider any wider social care provided.

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 Safe and Well-led, the service was able to demonstrate how they were meeting the underpinning principles of Right support, right care, right culture.

Right support: People were supported to achieved good outcomes. There were clear communication systems within the service to support this.

Personalised risk assessments gave clear strategies for staff to follow in keeping people safe, whilst enabling people to be as independent as possible. Staff were skilled in recognising signs when people experienced emotional distress and knew how to support people to keep them safe.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.

Right care: The care and support people received was tailored to their individual needs. Staff treated people with dignity and respect and promoted their right to privacy.

Right culture: The culture within the service empowered people who used the service. The staff team promoted inclusive practices which supported people to live a full life. Their rights and aspirations were promoted.

The management team had the specialist skills, knowledge and experience to perform their roles and had a clear understanding of people's needs. Systems and processes were in place to monitor the quality and performance of the service.

There was good communication between, staff, management, people and families. People and staff were listened to and encouraged to give their feedback about the service. The provider was committed to driving improvement and provide the best care and outcomes for people.

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 2 April 2021).

Why we inspected

We received concerns in relation to staff recruitment, staff skills and training and oversite of the service. As a result, we undertook a focused inspection to review the key questions of safe and well-led only.

We reviewed the information we held about the service. No areas of concern were identified in the other key questions. We therefore did not inspect them. Ratings from previous comprehensive inspections for those key questions were used in calculating the overall rating at this inspection.

The overall rating for the service has remained good. This is based on the findings at this inspection.

We found no evidence during this inspection that people were at risk of harm from this concern. Please see the safe and well-led sections of this full report.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Xtra Healthcare 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.