Background to this inspection
Updated
24 May 2022
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
Two inspectors, and an Expert by Experience carried out the inspection. 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 a ‘supported living’ setting, 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 24 hours’ 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.
What we did before inspection
We reviewed information we had received about the service since registration with CQC. The provider had completed a Provider Information Return (PIR) prior to this inspection. A PIR is information providers send us to give some key information about the service, what the service does well and improvements they plan to make. This information helps support our inspections. We asked the registered manager to send a number of documents relating to the management of the service and people’s care before the site visit. We used all of this information to plan our inspection.
During the inspection
We spoke with, and spent time with, six people who used the service. One person was able to talk with us, five people used different ways of communicating, including using Makaton sign language, pictures, photos, symbols, objects, noises and their body language. We spent time observing the support and communication between people and staff in shared areas of the house and within some people’s flats. The Expert by Experience spoke with five relatives by telephone about their experience of the care provided.
We spoke with seven members of staff including the registered manager and care workers. We reviewed a range of records. This included seven people’s care records and medication records. A variety of records were viewed relating to the management of the service, including staff rotas, training plans, audits and other documents relating to the management of the service.
After the inspection
We continued to seek clarification from the provider to validate evidence found, including for recruitment of staff. We received feedback from one health care professional.
Updated
24 May 2022
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.
About the service
St Botolph’s Road is a supported living service providing personal care and support to seven people at the time of the inspection. The building is purpose built with eight self- contained flats over two floors and includes some communal indoor and outside space. The service can support up to eight people with a learning disability.
People’s experience of using this service and what we found
Right Support
Staff focused on people’s strengths and promoted what they could do, so people had a fulfilling and meaningful everyday life. People and their relatives told us people were leading busy lives. One relative said, “They phone me every week, to tell me what he’s up to.” A health care professional said, “In the 16 years that I worked with the gentleman, I had never seen him laugh and smile so much as he has done in the 2 years he has lived at St Botolphs.”
Staff supported people to make decisions following best practice in decision-making. Staff knew people well and communicated with people in ways that met their needs.
Right Care
People received kind and compassionate care. Staff protected and respected people’s privacy and dignity. They understood and responded to their individual needs. People were relaxed and appeared happy in the company of staff. One person said, “I feel safe here.” Relatives commented on the caring nature of staff. One relative told us, “I think people are very safe and very happy here.” Another said, “The staff care deeply.”
People who had individual ways of communicating, using body language, sounds, Makaton (a form of sign language), pictures and symbols, could interact comfortably with staff and others involved in their care and support because staff had the necessary skills to understand them. Relatives were consistently positive about how staff communicated with people. One relative told us, “He needs people who are familiar with him and he gets that here.”
People’s care, treatment and support plans reflected their range of needs and this promoted their wellbeing and enjoyment of life. Records were detailed and kept up to date to ensure staff had the information they needed, including when people’s needs changed.
Right culture
Staff knew and understood people well and were responsive, supporting their aspirations to live a quality life of their choosing. Staff spoke positively about people’s achievements and we saw how they encouraged them to be as independent as possible.
People’s quality of life was enhanced by the service’s culture of improvement and inclusivity. Staff spoke positively about the management of the service, the open culture and the support they received. One staff member said, “It’s a great place to work, great staff team, very caring.” A relative told us, “Staff seem to stay a long time, there must be a reason for that.”
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
Why we inspected
We undertook this inspection to assess that the service is applying the principles of Right support, right care right culture.
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.