National Care Holdings Limited

National Care Holdings Limited provides care and support to people living in a supported living setting so that they can live as independently as possible. At the time of the inspection, three people were using the service. CQC does not regulate premises for supported living; this inspection looked at people’s care and support.

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

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 and providers must have regard to it.

The service was not able to demonstrate how they were meeting some of the underpinning principles of Right support, right care, right culture.

Right culture:

The provider did not have an effective oversight of the service. The quality assurance system and processes had failed to identify and correct issues, we found at the inspection. However, we found some positive aspects of culture as well. People and their relatives gave us positive feedback about their safety and told us staff treated them well. The service had systems and processes in place to administer and record medicines use. Staff received support through training, supervision and staff meetings to ensure they could meet people’s needs. Staff told us they felt supported and could approach the registered manager at any time for support. The registered manager and staff worked with other external professionals to ensure people were supported to maintain good health. The provider had a system to manage accidents and incidents. There was a management structure at the service and staff were aware of the roles of the management team. The registered manager and staff worked as a team and in partnership with a range of professionals and acted on their advice.

Right support:

People were not supported to have maximum choice and control of their lives and staff did not support them in the least restrictive way possible and in their best interests; the policies and systems in the service did not support this practice. The provider had moved their office to being co-located at the supported living setting. This was not appropriate as it meant the office based staff had to access people’s homes to access the office. We also found some aspects of good support. People’s care plans reflected their current needs. People were protected from the risk of infection. People were treated with dignity; their privacy was respected and they were supported to be as independent in their care as possible.

Right care:

People’s care records were not in line with Accessible Information Standard. However, we found some positive aspects of care. People and their relatives were encouraged to participate in making decisions about their care and support. An assessment of people’s needs had been completed to ensure these could be met by staff. Staff showed an understanding of equality and diversity. Staff respected people’s choices and preferences. People knew how to make a complaint. The registered manager knew what to do if someone required end-of life care.

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 24/10/2019 and this is their first inspection.

Why we inspected

This was a planned inspection.

Enforcement and recommendations

We are mindful of the impact of the COVID-19 pandemic on our regulatory function. This meant we took account of the exceptional circumstances arising as a result of the COVID-19 pandemic when considering what enforcement action was necessary and proportionate to keep people safe as a result of this inspection. We will continue to monitor the service and will take further action if needed.

We have identified breaches in relation to consent and good governance. We made one recommendation about formatting care records in line with the Accessible Information Standard.

Please see the action we have told the provider to take, at the end of this report.

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 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.