We carried out a review of the data available to us about Chesham Supported Living on 6 July 2023. We have not found evidence that we need to carry out an inspection or reassess our rating at this stage.
This could change at any time if we receive new information. We will continue to monitor data about this service.
If you have concerns about Chesham Supported Living, you can give feedback on this service.
Chesham Supported Living is a ‘supported living’ service that provides personal care to people in group settings. The service supports adults with learning disabilities and autism, people with dementia, and those with physical disabilities or sensory impairments. At the time of the inspection, 21 people received ‘personal care’.
There was one building where the service provided ‘supported living’, which was divided into two houses. People using the service lived in either one of the 14 self-contained flats or the seven bedsits. People who lived in the bedsits had staff always available to support their complex needs. People who lived in the flats were more independent and had care workers to support them only when required. Both houses had communal facilities available, and each person had their own bedroom.
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. This ensures that people who use the service can live as full a life as possible and achieve the best possible outcomes. The principles reflect the need for people with learning disabilities and/or autism to live meaningful lives that include control, choice, and independence. People using the service receive planned and co-ordinated person-centred support that is appropriate and inclusive for them.
People’s experience of using this service and what we found
People’s care was safe, and they were protected from harm. Care records showed risks were appropriately assessed and controlled. There were enough staff to ensure people’s safe support. People were able to manage their medicines independently or receive support from staff.
Staff received a large amount of training to equip them with the knowledge and skills to provide the right support. People’s needs, and preferences were recorded, and staff ensured that people’s support was tailored to their individual needs. Staff worked with other agencies and healthcare professionals to ensure people led a healthy lifestyle.
People received care from dedicated and kind staff. We observed that people enjoyed time with the care workers, and that the registered manager was patient and caring when people dropped in to her office throughout the day. Relatives explained an inclusive culture, where people were included in the support planning and any changes.
People’s care was personalised. They led active social lives and were encouraged to build relationships with others in the local community. Staff provided support to people when they needed it, and this fostered their independence. We made a recommendation about end of life care planning.
The service was well-led. The registered manager and deputy manager were well respected by people, relatives and staff. Care workers told us the managers were supportive, visible within the day-to-day support setting and ensured people received high quality care. Checks were regularly conducted to ensure a safe, effective and well-led service.
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.
The service applied the principles and values of Registering the Right Support and other best practice guidance. These ensure that people who use 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 people using the service reflected the principles and values of Registering the Right Support by promoting choice and control, independence and inclusion. People'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 good (published 12 April 2017).
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 previously inspected the service on 11 and 13 February 2015. The service was meeting the requirements of the regulations at that time and was rated good. The service remained good at this inspection.
Why the service is rated good:
We received positive feedback about the service. A relative told us “It ticked all the list of things we wanted as a family and more.” They added “It feels like we’ve landed in paradise.” They said there were “Lots of smiles and giggles now” from their family member; “They weren’t doing that before.” Another relative said “It’s wonderful, they really care, like a family.” A person who used the service told us “This is the best place I’ve ever been. They try and make us happy and ask you what you want to do.” Another person said they were very happy at the service and added “We do have a laugh.”
People were protected from the risk of harm. The service used robust recruitment procedures to make sure people were supported by staff with the right skills and attributes. Staff understood their responsibilities to safeguard people from abuse. People’s medicines were handled safely.
There were enough staff to meet people’s needs. This included one to one support to help people access the community and try different things.
People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice.
We found there were sufficient staff to meet people’s needs. They were recruited using robust procedures and staff received appropriate support through induction, supervision and training.
Care plans had been written, to document people’s needs and their preferences for how they wished to be supported. The service listened to people’s views, such as when recruiting staff. People were supported to take part in a wide range of social activities. Staff supported people to attend healthcare appointments to keep healthy and well.
People knew how to raise any concerns and were relaxed when speaking with staff and the registered manager.
The service was managed well. There were good monitoring systems to assess standards of care. Records were well kept.
Further information is in the detailed findings below.
Chesham Supported Living provides support for up to 21 adults with learning disabilities. Fourteen people have their own flats. Seven people live in Hawthorn House, which is a shared house. Twenty people were using the service at the time of our visit. The service had a registered manager in post. 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 inspection took place on 11 and 13 February 2015. It was an announced visit to the service. We previously inspected the service on 16 July 2013. The service was meeting the requirements of the regulations at that time.
We received positive feedback about the service. Comments from people who used the service included “I feel safe”, “I love having my own front door,” “I’ve plenty of choice,” and “You’ve got independence here and there are staff to help you with the things you can’t do.” A social care professional said it was a “Great service, people living there are really empowered to live their lives.” A healthcare professional told us they were happy with the level of care and that the service was caring and well-led. A relative told us “We have found the staff to be caring and compassionate at all times…they include us as partners in any important decisions to be made. We are tremendously grateful for all that they do and the manner in which they do it.”
Staff had undertaken training to provide them with the skills and knowledge to recognise and respond to safeguarding concerns. There were procedures for them to follow in the event of any concerns and these were used appropriately.
People were supported to be as independent as possible and any risks had been assessed to reduce the likelihood of harm. People took part in social activities. Several people had personal assistants who regularly supported them to access the community.
People received their medicines safely. Regular audits were undertaken of medicines practice to check staff followed correct procedures.
Staff were recruited using robust procedures to make sure people were supported by workers with the right skills and attributes. Staff received support through a structured induction, supervision, team meetings and annual appraisals. People told us there were enough staff to support them and they all had a keyworker. This is a member of staff assigned to them who helped to co-ordinate their care, liaise with family members and ensure care plans were accurate and up to date.
Each person had a care plan which outlined their needs and preferences. People were supported with their healthcare needs and a record was kept of the outcome of medical appointments and any treatment that was required.
The service had received several compliments over the past year. There were no complaints during the same period.
The service was managed well. The provider regularly checked quality of care at the service through visits and audits. The registered manager had kept their training up to date and was undertaking an adult social care qualification to enhance their skills and knowledge. Records were well maintained at the service and kept secure.
We returned to the service on 16 July 2013 to check whether improvements had been made. We looked at four people's support plans. We noted improvements had been made to these to ensure people's needs could be met. Risk assessments had also improved, to help ensure people could safely be as independent as possible.
We were satisfied the provider had taken sufficient action to become compliant with this standard.
People we spoke with were pleased with the support they received. One person told us, ''I'm very happy here. It's like Butlin's.'' People told us staff were available to support them when they needed assistance. They said they had a key worker to help ensure continuity of their care.
We found there was good regard for people's privacy and dignity. Staff were respectful towards people and supported them in accessing the community and being independent.
Support plans were in place to identity people's care needs. In two of the three support plans we read, some further work was needed to ensure people's needs could be met. We found there were insufficient risk assessments to reduce the likelihood of injury or harm to people.
There were appropriate measures to safeguard people from abuse. Staff undertook safeguarding training and there were procedures to follow in the event of any suspicions or allegations of abuse. The manager referred any concerns to the local authority, in line with multi agency guidance.
We found there were robust recruitment practices. New staff received a structured induction to equip them with the skills and knowledge to meet people's needs. There were systems to supervise and appraise staff. Staff had access to good training opportunities.