Turning Point - Cumbria Learning Disabilities Supported Living

Updated 9 February 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 Health and Social Care Act 2008.

Inspection team

The inspection was carried out by an 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.

Service and service type

This service provides care and support to people living in 5 ‘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

This inspection was unannounced.

What we did before inspection

We reviewed information we had received about the service since the last inspection. We sought feedback from the local authority, care professionals and Healthwatch. Healthwatch is an independent consumer champion that gathers and represents the views of the public about health and social care services in England. 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. We used all this information to plan our inspection.

During the inspection

We spoke with 8 people who use the service. We spoke with 11 relatives and contacted 7 more by email. We spoke with 8 staff including the registered manager, service managers, team leaders and support staff.

We reviewed a range of records. This included 6 people’s care records and medicine records. We looked at 3 staff files in relation to recruitment. We also viewed a variety of records relating to the management of the service, including audits, policies and procedures.

Updated 9 February 2023

About the service

Turning Point Cumbria Learning Disabilities Supported Living Service provides personal care to people. At the time of the inspection the service was supporting 30 people with personal care.

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 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.

Right Support:

Records did not always demonstrate care was provided in the right way, including medicines records and consent records. Risk assessments were not always completed to assess known risks to people. People said they were encouraged to be as independent as possible. There had been improvements to the essential training of regular staff, but it was not clear if agency staff were sufficiently trained.

People were supported to have maximum choice and control of their lives and staff assisted them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice but there were not always records in place to demonstrate this.

Right Care:

The service made sure there were enough regular and agency staff to support people and keep them safe. Regular staff knew people well and knew the most effective ways to communicate with people. Care was provided in a person-centred way although records did not always reflect outcomes for people. People said staff treated them with care and kindness and supported them to take part in their individually preferred activities and to follow their own lifestyles.

Right Culture:

The culture at the service was positive. People, relatives and staff said there had been improvements to the stability of the management of the service. Staff were complimentary about the values they share with their colleagues and the supportive team culture this created. The provider needed to improve record-keeping across a number of areas and to review quality assurance systems to support this going forward.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection and update

The last rating for this service was requires improvement (published 27 August 2021) and there was a breach of regulation. The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection we found some improvements had been made and the provider was no longer in breach of regulations but further improvements were needed to records.

This service has been rated requires improvement for the last three consecutive inspections.

Why we inspected

We carried out an unannounced inspection of this service on 25 June 2021. A breach of legal requirements was found. The provider completed an action plan after the last inspection to show what they would do and by when to improve staff training and skills.

We undertook this focused inspection to check they had followed their action plan and to confirm they now met legal requirements. This report only covers our findings in relation to the key questions Safe and Well-led which contain those requirements. For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating. The overall rating for the service has remained requires improvement. This is based on the findings at this inspection.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Turning Point Cumbria Learning Disabilities Supported Living Service on our website at www.cqc.org.uk.

Recommendations

We have made a recommendation about medicines records, consent and best interest records and ensuring identified actions are completed.

Follow up

We will continue to monitor information we receive about the service, which will help inform when we next inspect.