We inspected this service so we could consider our five questions; Is the service caring? Is the service responsive? Is the service safe? Is the service effective? Is the service well led? One inspector carried out this inspection.There were eight people using the service at the time of our inspection. Below is a summary of what we found. The summary is based on speaking with three people who used the service and, a relative and three members of staff supporting them. We also spoke with the manager of the service and two health / social care professionals.
If you want to see the evidence supporting our summary please read the full report.
Is the service safe?
People and a relative confirmed that they believed that the service was safe. Their comments included: "I love it and the carers (staff) are nice," and "The staff are nice, I work in the office with X (name of staff member). Yes I am safe."
However, we had concerns about the safety of one person who used the supported living service. The initial assessment for one person had outlined potential safety issues which has not been adequately risk assessed and shared with the funding authority to alert them to risks with the level of staff support that had been agreed. The provider ensured that this risk was addressed at the time of our visit and we contacted the local safeguarding authority.
There were appropriate arrangements in place to ensure that medication was administered safely and that the spread of any infections could be controlled.
New staff were recruited appropriately and checks on applicants' previous employment and their safety to work with vulnerable people were undertaken.
We found that records were not always kept of the outcome of people's visits with health professionals, details of who provided the support and when were not kept and incidents were not consistently recorded. This meant the service did not have records to manage the service.
CQC monitors the operation of Deprivation of Liberty Safeguards. There had been no applications to deprive any people of their liberty at the time of our inspection.
We have asked the provider to tell us what they are going to do to meet the requirements of the law in relation to planning and delivery of safe care and staffing.
Is the service effective?
People's healthcare and support needs had been assessed before people received the service and care plans were usually in place. Reviews were undertaken on a routine basis however, these did not always take into incidents that had occurred between reviews. This meant that reviews of people's care were not always effective.
People, relatives and health / social care professionals told us that people received the support they needed. Their comments included: "They helped me get a bus pass, sort out my pension and get stronger tablets from my doctor," and "They communicate well with us and people get good support from the staff."
There were effective arrangements in place to ensure that staff had equipment to help prevent the spread of infection. Staff and people we spoke with confirmed that this equipment was available and used. Staff were aware of the policies and procedures about infection control.
Care staff told us and records showed they had staff meetings to discuss practice issues and any concerns about the care of people who used the service.
Is the service caring?
We observed interactions between the manager, staff and people who used the service and saw good interactions between them. Staff were observed to patient and kind with people and able to redirect people when necessary. People confirmed that staff were kind their comments included: "I love it (here)," "My relative has made friends and is happy to stay" and " Yes the staff are good."
We noted in care plans that there were details of what was important to people in their daily lives such as certain activities, having their hair dyed, contact with relatives and specific type of food or food preferences. People were encouraged to maintain these choices of lifestyle.
Is the service responsive?
A relative told us that they could contact the service when needed either day or night and they would get a response. If they had concerns they told us that they could contact the manager and they would put it right. We saw that there were tenants meetings and some surveys that were completed with people. These concentrated mainly on activities. People were attending activities if they wished to.
Is the service well-led?
The service was led by a manager who had the qualifications, skills and experience to provide a good, well led service.
There were no records of any complaints made to the home. We saw copies of compliments made by two relatives and a social care professional about the support to four people who used the service. Systems were in place to monitor people's views of the service.
We found that the risks to people had been identified but the system to review the quality of the service was not effective and had not led to action being taken when identified risks had not been acted on. The system for audit and monitoring of the service had failed to identify that the records were not consistently completed and maintained.
We have asked the provider to tell us what they are going to do to meet the requirements of the law in relation management of risks to people.