Explicit Care Solutions Office

Updated 28 September 2022

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

This inspection was carried out by four inspectors. Two inspectors visited the office and two inspectors visited the three supported living services over two days.

Service and service type

This service provides care and support to people living in three ‘supported living’ settings so that they can live as independently as possible. The accommodation is rented and is the occupant’s own home. Each house has an office and two have a sleep-in room for staff use. 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. A registered manager and the provider are legally responsible for how the service is run and for the quality and safety of the care provided. There was a registered manager in place at the time of the inspection.

Notice of inspection

The inspection was unannounced.

Inspection activity started on 4 August 2022 and ended on 16 August 2022. We visited the office location on 4 August and the three supported living houses on 4 August and visited two of the houses again on 11 August. On other days we reviewed records, spoke with professionals and the registered manager in telephone and video calls.

What we did before the inspection

We reviewed information we held about the service including notifications, safeguarding alerts and contacts with the service over the last year. The provider completed a provider information return. This is information we require providers to send us to give some key information about the service, what the service does well and improvements they plan to make. We took this into account when we inspected the service and made the judgements in this report. We used all this information to plan our inspection.

During the inspection

We met 12 people who used the service. We spent time observing staff interacting with people and supporting them. We spoke with 10 people about their experience of the service. Other people were not available or not willing to meet with us. We spoke with seven members of staff, including the registered manager, two senior staff and four support workers. We sought feedback from the local authorities commissioning from the service and professionals who work with the service.

We reviewed a range of records. This included three people’s risk assessments, support plans, care records, medicines records, three staff recruitment files, quality assurance records and staff training records. A variety of records relating to the management of the service, including policies and procedures were reviewed.

Updated 28 September 2022

About the service

Explicit Care Solutions Office is a supported living service providing personal care to people with mental ill health. This service provides care and support to 21 people living in three 'supported living' settings in Haringey and Enfield.

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. 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

Staff compliance with infection prevention and control requirements (specifically mask wearing and screening visitors) was inconsistent.

We found one person whose dignity and privacy were compromised. Other people were satisfied with the support they were receiving from this service. They said staff were kind and helpful.

The service worked well with health and care professionals to meet people's health and care needs. Medicines were managed safely.

Staff supported people to develop their independence. People were able to follow their own chosen lifestyles and daily routines. Staff were trained to meet the needs of the people they were supporting. We observed staff interacting with people. People were comfortable around staff and staff were aware of people’s individual needs and preferences.

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.

Systems were in place to promote continuous improvement. People benefited from a stable staff team who were well supported and worked well as a team.

The provider had a quality assurance system in place to check that the service was running safely and meeting people’s needs.

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 26 October 2018). At this inspection the rating has changed to requires improvement.

Why we inspected

The inspection was prompted in part by concerns reported to us about people’s safety. The information CQC received about an incident indicated concerns about safeguarding people from abuse. This inspection examined those risks. We found that, at the time of the inspection, people were safeguarded from those risks.

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 Caring key question sections of this full report.

The provider has taken some action to mitigate the risks immediately.

Enforcement and recommendations

We have identified a breach of regulation in relation to treating a person with dignity and respect.

We have made two recommendations. One is that to ensure consistent infection prevention and control measures and the other is to provide staff with further training in understanding mental illness. You can see what action we have asked the provider to take at the end of this full 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.