Next Step Support Limited

Updated 19 December 2020

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 carried out by one 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. The Expert by Experience made telephone calls to people and relatives to obtain their feedback about their experience.

Service and service type

This service provides care and support to people living in ten ‘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.

The service had a manager registered with the Care Quality Commission. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.

Notice of inspection

This inspection was announced. We gave a short period notice of the inspection as we were mindful of the impact and added pressures of Covid-19 pandemic on the service and needed to be sure that the registered manager would be available to support the inspection. This meant we took account of the exceptional circumstances and requirements arising as a result of the COVID-19 pandemic. We also wanted to make sure that people’s consent to a home visit from an inspector was obtained.

Inspection activity started on 27 November 2020 and ended on 7 December 2020. We visited the office location and one supported living scheme on 27 November 2020. On 30 November 2020 we visited another supported living scheme. On 1 and 2 December 2020 we spoke with people, relatives and staff. Feedback of the inspection process was delivered to the registered manager and the nominated individual on 7 December 2020. The nominated individual is responsible for supervising the management of the service on behalf of the provider.

What we did before the inspection

We reviewed information we had received about the service since the last inspection and formal notifications that the service had sent to the CQC. Notifications are information that registered persons are required to tell us about by law that may affect people’s health and wellbeing. 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 four people about their experience of the care they received. We spoke with the registered manager and two service managers. We reviewed a range of records. This included six people’s care records and five people’s medication records. We looked at six staff files in relation to recruitment and staff supervision. A variety of records relating to the management of the service, including policies and procedures were also reviewed.

After the inspection

We continued to seek clarification from the provider to validate evidence found. We looked at training data and quality assurance records. We spoke with a further eight people using the service and four relatives. We also spoke with an additional nine members of staff including an area manager, two service managers, two deputy managers and four support workers.

Updated 19 December 2020

About the service

Next Step Support Limited is a domiciliary care service providing personal care to people living in their own home within supported living projects. At the time of the inspection the service was supporting 19 people with their mental health needs, alcohol and substance misuse, mild learning disabilities and autism.

Next Step Support Limited support people within ten supported living schemes in and around London, Bedford, Luton and Hertfordshire. The supported living schemes are located within residential areas as part of the local community and vary in size. Each project is a residential house or building within which people have their own flats.

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

People told us that they were happy and well supported. Other people who were unable to communicate due to their disabilities, were observed to be happy, content and well supported.

We saw positive and caring interactions between people and support staff. People were observed to know the support staff well and were comfortable and confident around them.

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 guidance CQC follows to make assessments and judgements about services providing support to people with a learning disability and/or autistic people.

The service was able to demonstrate how they were meeting some of the underpinning principles of Right support, right care, right culture. The model of care and setting maximises people’s choice, control and independence. Care is person-centred and promotes people’s dignity, privacy and human rights. The ethos, values, attitudes and behaviours of leaders and care staff ensure people using services lead confident, inclusive and empowered lives

Support staff understood how to safeguard people from abuse and the actions they would take to report their concerns.

People’s individualised risks associated with their health, care and social needs were comprehensively assessed giving clear guidance to staff on how to minimise the identified risks to keep people safe.

Medicines management and administration was safe. People received their medicines on time and as prescribed.

Support staff recruited were appropriately checked and assessed to ensure their suitability for the role and to ensure they were safe to work with vulnerable adults.

People’s needs were comprehensively assessed prior to any placement and support plan being agreed to confirm the service could effectively meet their needs.

Support staff received appropriate training and support to carry out their role effectively.

People were appropriately supported with their nutrition and hydration which considered any specialist dietary requirements.

People were supported with their health and medical needs where required. We saw records where the service had requested specific involvement from specialist services to address people’s health and care needs.

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.

Support plans were person centred and comprehensive giving clear information about people’s care needs and how they wished to be supported.

Management oversight processes in place enabled the provider to monitor the quality and people’s experiences of the care and support that they received. Where issues were identified action and improvement plans were in place to address these.

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 3 April 2018).

Why we inspected

We received concerns in relation to the care and support people received, staffing and training provision for staff. As a result, we undertook a focused inspection to review the key questions of safe, effective 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. We found no evidence during this inspection that people were at risk of harm from this concern. Please see the safe, effective and well-led sections of this full report.

The overall rating for the service has remained the same. 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 Next Step Support Limited 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.