Background to this inspection
Updated
9 November 2016
We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.
This inspection took place on 29 September 2016 and was carried out by one inspector. The location provides a supported living service to people with a learning disability living in the community. The provider was given 48 hours’ notice of inspection to ensure the service’s manager was available to meet us and to make arrangements for us to visit people in their homes.
Before the inspection we reviewed the information we held about the service. The service was last inspected on 19 August 2014. At that time the service was meeting the essential standards of safety and quality and no concerns were identified. We looked at previous inspection reports, statutory notifications (issues providers are legally required to notify us about), other enquiries received from or about the service and the Provider’s Information Return (PIR). This is a form that asks the provider to give some key information about the service, what the service does well and the improvements they plan to make.
During the inspection we visited people who used the service and their support staff in Bridgwater and Burnham and the service’s administrative office in Taunton. We met with 10 people who used the service and spoke with six members of support staff, a member of the office staff, two practice team leaders/deputy managers, and the registered manager.
We reviewed four care plans and other records relevant to the running of the service, including: staff training records, medication records, complaints and incident files.
We also reviewed the responses received from people’s family members to the service’s most recent quality feedback questionnaire. The families of 13 people who used the service responded and the majority rated the service as very good or outstanding in most areas.
Updated
9 November 2016
This inspection took place on 29 September 2016 and was carried out by one inspector. The provider was given 48 hours’ notice of inspection to ensure the registered manager was available to meet us and also to make arrangements for us to visit people in their homes.
The service is registered with the Care Quality Commission (CQC) for the provision of personal care for people with a learning disability living in the community. This includes assistance or prompting with washing, toileting, dressing, eating and drinking. We call this type of service a ‘supported living’ service. At the time of the inspection the service supported 25 people living in single occupancy flats or shared occupancy houses in Bridgwater, Burnham and Bath; and two people living with their parents in Trowbridge and Taunton. Personal care was provided to 24 of these people.
The service also provided other forms of social care support that are not included within CQC’s registration requirements for a supported living service. For example, in addition to personal care, the service also assisted people with their housekeeping, shopping, attending appointments and other independent living skills. Systems were also in place to ensure people received their medicines safely. Most of the people were able to take their own prescribed medicines although some needed assistance or prompting.
The service provided people’s personal care and support under a separate contractual arrangement to people’s housing provision. People’s accommodation was provided by separate private landlords, usually on a rental or lease arrangement. This meant people could choose to use an alternative support service if they wished. The service was happy to support people with reporting any faults or maintenance requirements to their respective landlords or housing association.
People who used the service had varying degrees of learning disabilities and other support needs. The amount of support provided was based on people’s assessed needs and varied from 24 hour a day support for people with very complex needs; to just a few hours each week for people who were relatively independent.
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.
The registered manager told us the provider was a Christian based charity but they supported people of all faiths and of no faith. Although the service promoted a Christian ethos, staff respected people’s individual beliefs and preferences. Some people engaged actively with the local church, while others who had no particular interest in spiritual matters, were free to follow their own interests and were under no obligation to participate in spiritual activities. Similarly, the service employed staff with both Christian and non-Christian beliefs. The registered manager said their service philosophy was about “What the people we support, and the whole team, wants the service to be like. We want people to be involved, enthusiastic and to be part of any changes or developments. I want everyone to feel part of the team, to be comfortable and happy”.
People, relatives and staff all said the registered manager and deputy managers were very accessible and approachable. They said they could raise issues or concerns with any of the managers and they always received helpful responses. Support staff told us everyone in the organisation, from the top down, focused on the well-being of the people they supported.
People and their relatives said the staff were very good at meeting people’s personal care and support needs. One person said “I get on well with all of the staff and we are all good friends”. Another person said “The staff help me and I get on so well with everyone”. A relative said “[Person’s name] has been supported very well and he always appears to be happy”. The families of 13 people who used the service responded to the service’s most recent quality feedback questionnaire. The great majority of relatives rated the service as either very good or outstanding in most areas, including staff being courteous, helpful and friendly.
People had a say in which members of staff supported them and staff members of the same gender were available to assist people with personal care, if this was their preference. For example, a female who used the service said “I only have ladies to help me with my showers”. People’s views were also sought when prospective new staff were being interviewed.
The number of hours of staffing support was agreed with the relevant funding authority to meet each person’s individual needs. Staff told us they felt the staffing levels were appropriate to meet the needs and preferences of the people they supported. People told us the staff always assisted them, when needed, but encouraged them to be as independent as possible. This helped to boost people’s confidence and self-esteem and enabled them to become more self-reliant and independent over time.
Most of the staff employed by the service had worked with the people they supported for a number of years and knew people’s needs and preferences well. Staff also received regular training and supervision to ensure they knew how to deliver effective support. People’s care plans were comprehensive and provided guidance to staff on how to meet people’s needs. However, we have made a recommendation about improving the format of the care plans.
The registered manager told us they worked collaboratively with all of the local health and social care professionals. They also had links with the local community through voluntary work placements, people’s social and leisure interests, and activities organised by the local church.
The provider had an effective quality monitoring system to ensure standards of service were maintained and improved.