Sapphire Support Services Limited

Updated 16 August 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 undertaken by 2 inspectors and an Expert by Experience. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service.

Service and service type

This service provides care and support to people living in ‘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.

This service is also registered as a domiciliary care agency. It provides personal care to people living in their own houses flats and or specialist housing.

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. A new manager has been in post for 4 months and advised they would be applying to register.

Notice of inspection

This inspection was unannounced.

Inspection activity started on 25 April and ended on 22 May 2023 when formal feedback was provided. We requested and reviewed records remotely during this period. We visited the service on 25 April and 3 May 2023. An expert by experience undertook phone calls to people and their representatives on 26 April 2023.

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 spoke with 8 people and 2 relatives about their experience of the care provided. We also spoke with 8 staff which included care and senior care staff, care co-ordinator, senior administrator, the manager, director, and the nominated individual. The nominated individual is responsible for supervising the management of the service on behalf of the provider.

We reviewed a range of documents and records including the care records for 6 people, a selection of medicine records, 4 staff recruitment files. We also looked at records that related to the management and quality assurance of the service.

Updated 16 August 2023

About the service

Sapphire Support Services Limited is a 'supported living' service that provides care and support to people living in shared communal accommodation. The service supported people with mental health conditions, physical disabilities, dementia and older people. They are also registered to support people with a learning disability and autistic people. At the time of the inspection, the service supported 16 people.

The inspection took place at the providers registered office which is based within a purpose-built site that can accommodate a maximum of 16 people. There is a permanent office for the management and administration teams and waking support staff on site 24 hours a day. People had their own individual bedrooms with a private bathroom and shared communal spaces such as the kitchen, dining room and garden.

The service also supported people in the community living in their own property, but we did not visit them as part of this inspection. 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

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.

At the time of the inspection, the location did not care or support for anyone with a learning disability or an autistic person. However, we assessed the care provision under Right Support, Right Care, Right Culture, as it is registered as a specialist service for this population group.

Right Support

People did not always receive the support they needed to keep them safe from risk of harm or to ensure all their needs were met. Staff were not always recruited safely to ensure they were suitable to work with people. The service did not always support people to have the maximum possible choice, control, and to be independent and have control over their own lives. People were not always supported to achieve their aspirations and goals. Staff supported people with their medicines, but improvements were needed to promote people’s independence.

Right Care:

People were supported by the number of staff they needed but we were not assured all staff had the required skills and knowledge to meet their needs and promote their independence. Staff communicated with people in ways that met their needs. People told us staff respected their privacy and dignity when providing care and support. Where appropriate, staff encouraged and enabled people to take positive risks.

Right Culture:

The provider has continually failed to improve the systems in place to maintain oversight and drive improvements in the service. People’s quality of life was not enhanced by the service’s culture of improvement and inclusivity. People were provided with some opportunities to share their feedback about the service they received. Staff worked with health professionals to monitor people’s healthcare needs.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection and update: The last rating for this service was requires improvement (published 15 November 2022) and there were breaches of regulation. The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection we found the provider remained in breach of regulations. The service remains rated requires improvement. This service has been rated requires improvement for the last 3 consecutive inspections.

Why we inspected

We carried out an announced focused inspection of this service on July 2022. Breaches of legal requirements were found. The provider completed an action plan after the last inspection to show what they would do and by when to improve the safeguarding processes and governance systems in the service.

We undertook this focused inspection to check they had followed their action plan and to confirm they now met legal requirements. This report only covers our findings in relation to the Key Questions Safe and Well-led which contain those requirements.

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 remained as requires improvement. This is based on the findings at this inspection.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Sapphire Support services on our website at www.cqc.org.uk.

Enforcement and Recommendations

At this inspection we have identified breaches in relation to the management of risk, staff training, recruitment of staff and the lack of governance systems to monitor the quality of the service being provided.

Full information about CQC’s regulatory response to the more serious concerns found during inspections is added to reports after any representations and appeals have been concluded.

Follow up

We will meet with the provider following this report being published to discuss how they will make changes to ensure they improve their rating to at least good. 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.