Walsingham Support - Hertfordshire Supported Living

Updated 20 September 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 carried out by 2 inspectors.

Service and service type

This service provides care and support to people living in 4 ‘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.

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 a registered manager in post.

Notice of inspection

We gave the service 48 hours’ notice of the inspection. This was because it is a small service and we needed to be sure that the provider or registered manager would be in the office to support the inspection.

Inspection activity started on 7 August 2023 and ended on 25 August 2023. We visited the location’s office on 9 August 2023 and 2 of the supported living flats on 15 and 16 August 2023.

What we did before the inspection

We reviewed information we had received about the service since the last inspection. We sought feedback from 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 information gathered as part of monitoring activity that took place on 15 May 2023 to help plan the inspection and inform our judgements. We used all this information to plan our inspection.

During the inspection

During the inspection we spoke with the registered manager, 2 service managers and the nominated individual. The nominated individual is responsible for supervising the management of the service on behalf of the provider. We spoke to or received feedback from 5 staff, 4 people and 1 relative. 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. We did this by reading their care and communication plans and speaking to staff or relatives and the person themselves. In this report, we used this communication tool with 2 people to tell us their experience. We reviewed 6 people’s care records, 2 staff records and documents relating to the management of the service including policies and audits.

Updated 20 September 2023

About the service

Walsingham Support – Home Counties Outreach Services is a supported living service providing personal care to people in shared housing in the community. At the time of our inspection there were 14 people using the service.

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. At the time of our inspection, 13 people were supported with personal care.

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.

Right Support:

People were not always supported to have maximum choice and control of their lives and staff did not always 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.

Staff did not always encourage people to do what they could for themselves.

Staff enabled people to access health and social care support in the community.

Right Care:

People’s risk assessments had not always been updated to ensure they reflected their current needs.

Staff understood how to protect people from poor care and abuse. The service had enough staff to meet people’s needs and keep them safe. Staff supported people to take part in activities.

Right Culture:

The service had been without a registered manager for a period and during this time the provider had not maintained oversight of the service. A manager had registered recently and identified issues with the service but at the time of our inspection these had not yet been resolved.

Staff were not all up to date with their training, and competency assessments were not always completed.

Staff knew and understood people well.

People and those close to them were involved in planning their care.

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

Rating at last inspection

The last rating for this service was good (26 April 2019)

Why we inspected

This inspection was prompted by a review of the information we held about this service.

Enforcement and recommendations

We have identified breaches in relation to risk assessments and incidents, staff training and governance. We have made a recommendation relating to mental capacity assessments.

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

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.