Background to this inspection
Updated
1 October 2019
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
The inspection was carried out by one inspector.
Service and service type
Mediline Supported Living has offices based in Liverpool. The service provided support to people living in across Liverpool, Wirral, Lancashire and Sefton.
The service provides care and support to people living their own homes, 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
We gave the service 48 hours’ notice of the inspection. This was because we needed to be sure that the provider or registered manager would be in the office to support the inspection. Also, we needed to be sure people provided consent for us to visit their homes or speak to them on the telephone.
What we did before the inspection
We reviewed information we had received about the service. 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 five people who used the service about their experience of the care provided and three relatives. We spoke with the registered manager, two service managers, one support coordinator, and four support staff. We also spoke with one health and social care professional.
We undertook two home visits, so we could observe the delivery of care and talk to people in their own homes. We also looked at the support documentation kept in people’s homes.
We reviewed a range of records. This included eight people’s care records and medication records. We looked at four 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 reviewed.
After the inspection
We continued to seek clarification from the provider to validate evidence found. We requested information to be sent by email and called three other people by telephone.
Updated
1 October 2019
About the service
Mediline Supported Living is a supported living service offering care and support to people living in their own homes. The service supports adults, most of whom live with a learning disability, autism and acquired brain injury . Not everyone who used the service received personal care. The Care Quality Commission (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. 65 people were being supported with personal care at the time of our inspection.
The Secretary of State has asked CQC to conduct a thematic review and to make recommendations about the use of restrictive interventions in settings that provide care for people with or who might have mental health problems, learning disabilities and/or autism. Thematic reviews look in-depth at specific issues concerning quality of care across the health and social care sectors. They expand our understanding of both good and poor practice and of the potential drivers of improvement.
As part of thematic review, we carried out a survey with the registered manager at this inspection. This considered whether the service used any restrictive intervention practices (restraint, seclusion and segregation) when supporting people.
The service used positive behaviour support principles to support people in the least restrictive way. No restrictive intervention practices were used.
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
This is the first rated inspection since the service underwent a change of legal entity.
The culture of the service ensured the provision of support was bespoke and truly person centred. Management and staff embraced the organisational values as their own and were committed to the provision of care and support. People were supported and empowered by staff to control their own lives and live a life which was meaningful to them. The registered manager led the teams with creativity and collaboration, built on seamless relationships and good practice.
People were treated with the utmost respect dignity, empathy, and compassion. They were empowered to make choices to live a life of their choosing. Staff had gone to great lengths to ensure peoples preferences and voices were heard, and the support given was as individual as the person receiving it.
People had a say in who they wanted to support them. Where possible, they took an active part in staff recruitment processes. Some staff had undergone additional training to meet the specific needs of the people they supported. Staff completed a thorough induction and undertook regular training to meet the requirements of their role.
People were actively encouraged to make decisions about how their support was provided and staff were respectful and understanding of people’s rights and choices. Care and support requirements were recorded in a truly person-centred way.
Risk assessments were detailed, reflected people’s individual needs, preferences, daily routines, and were regularly reviewed to ensure the most up-to-date information was available for staff to follow. There was a creative and comprehensive approach to risk taking and encouraging people to take risks to help them get the most of their support. People's individual communication needs were recorded and understood, and information was provided in a format most appropriate for them, which meant they could feel involved and included in their support.
People were supported and encouraged to maintain contact with friends and relatives and be a part of their local community. People participated in activities and occupations of their choice. Staff encouraged people to lead healthy and active lifestyles and supported people in trying new things.
People and their relatives were very complimentary regarding the caring nature, kindness and support of the staff team. Staff were thoughtful and truly felt proud of the people they were supporting.
People's support focused on them having as many opportunities as possible for them to gain new skills and become more independent.
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.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection
This service was registered with us on 03/07/2018 and this is the first inspection.
The last rating for this service was good (published 24 October 2018). Since this rating was awarded the provider has altered its legal entity. We have used the previous rating of good to inform our planning and decisions about the rating at this inspection.
Why we inspected
This was a planned inspection.
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.