Archived: St Michael's Support & Care

Updated 25 March 2016

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.

The inspection was carried out on 10 and 11 February 2016 and was announced. The inspection was undertaken by a single inspector and one 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.

Before the inspection we reviewed relevant information that we had about the provider including any notifications of safeguarding or incidents affecting people’s safety and wellbeing. We also made contact with the local authority for any information they had that was relevant to the inspection.

We spoke with eight people, the registered manager, two team leaders and five staff members. We also looked at eight care plans, which consisted of people receiving personal care across the five supported living units. We reviewed eight staff files and looked at documents linked to the day to day running of the agency including a range of policies and procedures.

We also looked at other documents held at the supported living services such as medicine records, quality assurance audits and residents and staff meeting minutes.

Updated 25 March 2016

We carried out an inspection of St Michaels Support & Care on 10 and 11 February 2016. This was an announced inspection where we gave the provider 48 hours’ notice because we needed to ensure someone would be available to speak with us.

St Michaels Support & Care provides services to adults with learning disabilities and mental health needs. People who used the service previously lived in hospital, long term residential care or had moved away from their home for the first time. The service supports people in supported living accommodation. At the time of our inspection there were 34 people who received personal care from the service based across five supported living units. During this inspection we visited the office the service operates from and two supported living units. One specialised in provision for people with a learning disability and the other specialised in mental health provision.

We last inspected the service on 7 and 17 April 2014 and found the provider was meeting the required standards at that time.

The service had a registered manager in place. 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.

Most of the risk assessments were recorded and plans were in place to minimise risks. We found risk assessments for two people were not reviewed and updated following a serious safeguarding incident to ensure people were protected at all times.

We did not see evidence that regular and recent fire tests had been carried out at the service to ensure people were safe during an emergency. Staff confirmed recent fire tests had not been carried out but were able to tell us what to do in the event of an emergency. Staff had been trained in fire safety. Checks had been made in gas safety, electrical hardwiring and portable appliance to ensure the premises was safe.

Supervision for the supported living service that provided support to people with learning disabilities was not consistent and regular one to one meetings were not being carried out. Staff had not received annual appraisals. The team leader and registered manager told us this had not been carried out. Supervisions were being carried out in the supported living unit that supported people with mental health needs.

Due to risks to their safety, most people living at the supported living unit that supported people with learning disabilities, were not allowed to go outside without staff or relative accompanying them. Appropriate Deprivation of Liberty safeguards had not been applied for. The registered manager and the team leader told us that people lacked capacity. However, we did not see capacity assessments were carried out to ascertain if people had capacity to make decisions. We were informed that all people living at the service will be assessed in accordance to the Mental Capacity principles.

Spot checks were not routinely documented and there was no information on how often staff had received spot checks. Keeping detailed records of spot checks is important to keep track of the number of checks undertaken and help identify areas of improvements or best practise that could be used in staff supervision and appraisals.

There were appropriate systems in place to monitor the service. Regular audits were undertaken; however, these did not identify the shortfalls we found during the inspection.

Staff and resident meetings were not held regularly at the supported living unit that supported people with learning disabilities. The last staff meeting was held on June 2015 and we did not see evidence of residents meetings being held since May 2015. Staff and resident meetings were regularly carried out in the supported living unit that supported people with mental health needs.

People told us they were happy with the support received from the services. Staff members knew how to report alleged abuse and were able to describe the different types of abuse. Staff knew how to ‘whistleblow’. Whistleblowing is when someone who works for an employer raises a concern about a potential risk of harm to people who use the service.

People were supported by suitably qualified and experienced staff. Recruitment and selection procedures were in place and being followed. Checks had been undertaken to ensure staff were suitable for the role. Staff members were suitably trained to carry out their duties and knew their responsibilities to keep people safe and meet people’s needs.

People were involved in the planning of their care and received a service that was based on their personal needs and wishes. The care plan was then signed by people to ensure they were happy with the care and support listed on the care plan. Care plans were regularly reviewed.

Systems were in place to ensure that medicines were stored, administered and managed safely in both the supported living services we visited.

People had access to healthcare services to ensure their health needs were met. For example people were visited by GP’s, nurses and dentists.

Regular questionnaires were completed by people about the service, which we saw were positive.

There was a formal complaints procedure with response times. People were aware of how to make complaints and staff knew how to respond to complaints in accordance with the service’s complaint policy.

We identified breaches of regulations relating to consent, risk management and staff support. You can see what action we have asked the provider to take at the back of the full version of this report.