Gingerbread Office

Updated 27 October 2021

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

This inspection was carried out two inspectors. One of the inspectors used a symbol-based communication tool to gather the views of people using the service.

Service and service type

This service provides care and support to people living in a number of ‘supported living’ setting[s], 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 a short period notice of the inspection. This was because the service is small and people are often out and we wanted to be sure there would be people at home to speak with us.

Inspection activity started on 01 October 2021 and ended on 08 October 2021. We visited the office location on the first day of the inspection.

What we did before the inspection

We reviewed information we had received about the service since registration. We sought feedback from the local authority and Healthwatch. Healthwatch is an independent consumer champion that gathers and represents the views of the public about health and social care services in England. 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 are improving how we hear people’s experience and views on services, when they have limited verbal communication. We have trained some CQC team members to use a symbol-based communication tool. We checked that this was a suitable communication method and that people were happy to use it with us. During the inspection we used this communication tool with four people to tell us their experience. We also spoke with another person who used the service, who used their own pictures to express their views, and two relatives. We spoke with six members of staff including the registered manager, office staff and four support staff.

We reviewed a range of records. This included two people’s care plans and multiple 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 to validate evidence found. We looked at training data, quality assurance records, information in relation to medicines management, mental capacity and the management of risks to people.

Updated 27 October 2021

About the service

Gingerbread Office, known to people as Kasbah is a supported living service. The service provides support to people with learning disabilities, autism, sensory needs and physical disabilities. At the time of the inspection five people with autism needs received a regulated activity. 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.

The service was provided to people who lived their own homes. People lived in shared houses. People who received the regulated activity, personal care, lived in two shared houses which were based on the same site as the office building. There was a driveway and garden space shared between the houses and a small animal petting farm on site.

People’s experience of using this service and what we found

People accessing the service used pictorial communication tools to tell us they were happy with the support they received. Relatives were also positive in their feedback. One relative said, “They help [my relative] with their self-esteem. It’s the best thing for [my relative] and the family.” Another said, “I feel relieved that [my relative is] in a safe and warm environment.”

There were areas we identified concerns. These were addressed during or immediately after the inspection. However, the system of auditing in place had not identified these prior and needed to be improved. The registered manager was not networking with others to learn and share best practice which would be of benefit.

People were supported to be safe. Risks to people were managed with mitigations in place. People received support with their medicines. However, prior to the inspection medicine records needed to be improved and staff competency to support people with their medicines had not been assessed. This was addressed at the time of the inspection. Staff wore appropriate personal protective equipment (PPE) and people were protected from the risk of infection.

Staff recruited directly were recruited safely, although some records were not in place prior to the inspection where staff had been employed via an agency. Staff told us they were well supported and had the skills and training the needed to support people. There were enough staff to support people.

People’s needs were assessed, and people received support individualised to their needs. People were encouraged to maintain their health and were supported to access healthcare services where this support was needed. When things went wrong staff responded appropriately and took action to reduce the risk of incidents occurring again.

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. People made decisions and choices about their lives, what activities they were involved with and how they spent their time.

We expect health and social care providers to guarantee autistic people and people with a learning disability the choices, dignity, independence and good access to local communities that most people take for granted. Right Support, right care, right culture is the statutory guidance which supports CQC to make assessments and judgements about services providing support to people with a learning disability and/or autistic people.

The service was able to demonstrate how they were meeting the underpinning principles of Right support, right care, right culture.

Right support:

•The model of care and setting maximises people’s choice, control and independence. People made choices about their care and support. People were encouraged and supported increase their independence. People were supported to access their communities in participate in activities of their choice such as taking part in sports and going on holidays.

Right care:

• Care was person-centred and promoted people’s dignity, privacy and human rights. Staff knew people well and understood their needs, likes and dislikes. People’s support was individual to their needs and wishes. People were supported by staff who were kind and caring and listened to them and their relatives.

Right culture:

•The ethos, values, attitudes and behaviours of leaders and care staff ensure people using services lead confident, inclusive and empowered lives. There was a positive culture at the service. Staff and the registered manager were passionate about their roles and about providing good support to people. This had a positive impact on the support they provided to people.

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 28/06/2019 and this is the first inspection.

Why we inspected

This was a planned inspection based on the date of registration.

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.