Albert Road

Updated 7 January 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 two inspectors.

Service and service type

This service provides care and support to people living in 7 ‘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 not a registered manager in post. The provider was planning for one of the supported living services’ manager to apply to be registered.

Notice of inspection

We gave the service 24 hours’ notice of the inspection. This was because the supported living services are small and people are often out. We needed to be sure the managers would be available to support the inspection.

Inspection activity started on 24 November 2022 and ended on 25 November 2022. We visited two of the supported living services on 24 November 2022.

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 (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 met 2 people who used the service but were unable to speak with others who were out during our visit. We spoke with the operations manager as well as managers and deputy managers of both supported living services. We also spoke with 2 behaviour support officers and the head of behaviour support. We viewed the care records of 7 people and reviewed 4 staff files that included recruitment, supervision, appraisal and training records. We also looked at medicines management for all the people living within the two schemes and records relating to the management of the service including service checks and audits.

We obtained feedback from 7 staff members and 2 social care professionals. We looked at a range of documents sent to us such as accidents and incident reports, meeting minutes, training records and care records.

Updated 7 January 2023

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.

About the service

Albert Road provides a supported living service to people living in their own flats or shared accommodation within seven ‘supported living’ schemes. The aim is for people to live in their own home as independently as possible. People’s care and housing are provided under separate contractual agreements. Each supported living scheme had a manager in post, and a registered manager oversaw the seven schemes.

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

Right Support

People were not always supported to have maximum choice and control of their lives and staff did not always support them in the least restrictive way possible and in their best interests; the policies and systems in the service did not always support this practice.

Although the provider worked well with professionals to assess and mitigate risks, and this had been successful with most of the people who used the service, they had been unable to manage and reduce some of the risks to people’s safety and wellbeing.

The provider had made improvements to help ensure people were protected from the risk of abuse. They ensured safeguarding procedures were followed appropriately. Staff followed the procedure for the safe administration and recording of medicines. The service used positive behaviour support principles and worked with behaviour support specialists to support people.

Right Culture

The culture at the service had not always been positive and had not always achieved good outcomes for people who used the service. However, the provider had taken appropriate action to improve this.

Staff appeared responsive to people’s individual needs and knew them well. They supported each person by spending time with them and listening to them. However, in one of the supported living settings, we saw the staff were not always responsive to people’s individual needs. They did not spend time with people, did not support them to engage in activities of their choice and did not consult them about what they wanted to do or eat. In the other supported living setting, people were supported to engage in activities of their choice. They were consulted about what they wanted to do and were listened to.

Staff received the training, support and information they needed to provide effective care. The provider had procedures for recruiting and inducting staff to help ensure only suitable staff were employed.

Right Care

People were supported to attend day centre services where they could gain new skills and become more independent. We saw staff supported people in a person-centred way and respected their privacy, dignity and human rights.

Records indicated people’s needs were met in a personalised way and they, and their representatives, had been involved in planning and reviewing their care. The operations manager told us the staff were kind, caring and respectful and had developed good relationships with people who used the service.

The provider worked closely with other professionals to help make sure people had access to health care services.

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 9 December 2021).

Why we inspected

We received information of concerns in relation to staffing, inappropriate restraint of people, safeguarding allegations and poor management practices. As a result, we undertook a focused inspection to review the key questions of safe and well-led only. 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 changed from good to requires improvement based on the findings of this inspection.

We have found evidence that the provider needs to make improvements. Please see the safe and well sections of this full report.

You can see what action we have asked the provider to take at the end of this full report.

Enforcement and Recommendations

We are mindful of the impact of the COVID-19 pandemic on our regulatory function. This meant we took account of the exceptional circumstances arising as a result of the COVID-19 pandemic when considering what enforcement action was necessary and proportionate to keep people safe as a result of this inspection. We will continue to monitor the service and will take further action if needed.

We have identified a breach in relation to safe care and treatment at this inspection. We have also made a recommendation in relation to good governance.

Please see the action we have told the provider to take at the end of this report.

Follow up

We will request an action plan from the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.