Guardian Supported Living Ltd Also known as St Georges Community Hub

Guardian Supported Living Ltd is a supported living service providing personal care to people with learning disabilities, autistic spectrum disorders, physical disabilities, mental health difficulties and sensory impairments. At the time of the inspection one person was receiving 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 people don’t receive personal care we also consider any wider social care provided.

The service has been developed and designed in line with the principles and values that underpin Registering the Right Support and other best practice guidance. The principles reflect the need for people with learning disabilities and/or autism to live meaningful lives.

People’s experience of using this service and what we found

The provider had failed to ensure risk assessments were put in place following allegations of abuse and the providers audit systems had not identified the risk assessment was missing. Care plan reviews did not identify where information was conflicting. Staff’s health conditions were not discussed as part of the recruitment process. The previous CQC inspection ratings were not displayed in line with legal requirements.

There was one person living at the service on the day of the inspection who received personal care. Because of this and the fact we want to protect this person’s rights to a private life, the report will provide an overview rather than specific examples.

The person felt safe and staff had good knowledge of safeguarding processes. There were enough staff to support the person safely. The person received their medicines as prescribed.

The person was supported to have maximum choice and control of their life 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.

The person was treated with kindness and compassion. They were encouraged to express their views and make decisions. Their privacy and dignity was maintained.

The person was involved in decisions about their care. Their communication needs were met. They were supported to follow interests, build and develop social skills and take part in activities.

The service applied the principles and values of Registering the Right Support and other best practice guidance. These ensure the person using the service can live as full a life as possible and achieve the best possible outcomes that include control, choice and independence.

The outcomes for the person using the service reflected the principles and values of Registering the Right Support by promoting choice and control, independence and inclusion. The person’s support focused on them having as many opportunities as possible for them to gain new skills and become more independent.

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 requires improvement (published 4 January 2019)

Why we inspected

This was a planned inspection based on the previous rating.

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.

We gave the provider 24 hours’ notice of our intention to undertake the inspection so that there would be someone available to assist us with the inspection process.

At our last inspection carried out on 02 May 2018 we judged this service as ‘good’ in the key questions of safe, responsive, caring and effective and ‘requires improvement’ in the well led key question and rated the service as ‘good’ overall.

Prior to our last inspection we received concerning information about how the registered manager who is also the provider had dealt with a situation at the service. Since our last inspection we received some further information regarding the same incident. This focused inspection was planned so that we could follow up on these concerns and see what lessons had been learnt by the provider. This report only covers our findings in relation to the two key questions of safe and well led. You can read the report from our last comprehensive inspection, by selecting the 'all reports' link for Guardian Supported Living on our website at www.cqc.org.uk

Guardian Supported Living provides care and support to people living in a supported living setting, so that they can 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. Guardian Supported living consists of 21 individual apartments’ in a converted listed building. There were 15 people living there when we inspected.

There was a registered manager in post at the time of 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.

The service was not always safe because staff were not always aware of some of the risks associated with people's support needs and records concerning risks to people's safety and well-being needed to be improved so the risks to people and how they would be managed were clear.

Staff had an understanding of abuse and what to look for but where unclear about who concerns would be raised with outside of the service. When an incident occurred there needed to be greater clarity about who this information had been shared with.

People received support to take their medicines as prescribed but some improvements were required to the storage and recording of medicine administration within the service.

The provider’s quality monitoring systems were not always effective at identifying where improvements were needed.

People spoke positively about the care staff. We saw people were relaxed around the staff and registered manager. There was a friendly and calm atmosphere within the service.

A registered manager was in place at Guardian Supported Living. 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.’

This service provides care and support to people living in a supported living setting, so that they can 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. Guardian Supported living consists of 21 individual apartment’s in a converted listed building. There were 15 people living there and two people were in receipt of the regulated activity of personal care.

Staff would benefit from some additional training to enhance their skills and knowledge and this was being addressed by the registered manager. Systems for the effective oversight of the service and to ensure lessons were learnt and enhanced future practice needed to be embedded.

People were supported by sufficient numbers of staff to meet their needs. People were protected from the risk of abuse because staff understood their responsibilities and knew how to raise concerns if needed. People were supported to have their prescribed medication safely.

Staff were able to tell us of the needs of the people they provided care for and their role and responsibility in keeping people safe.

People were pleased with the consistency of the staff that provided their care and reported staff to be caring. People were treated with dignity and respect and received their care with consent. People were also encouraged to be independent and staff involved people in making choices and decisions about their day to day needs. They were supported to access healthcare appointments.

People knew how to make a complaint if they were unhappy and felt that any complaints or issues raised would be dealt with. The management team were compliant with the Duty of Candour regulation and were receptive to the feedback we provided at the time of our inspection.

People told us they liked where they lived. Staff, relatives and professionals spoke positively about the management of the service. The management team ensured regular checks were completed to monitor the quality of the care and support people received.