South Hill

Updated 24 August 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 Health and Social Care Act 2008.

As part of this inspection we looked at the infection control and prevention measures in place. This was conducted so we can understand the preparedness of the service in preventing or managing an infection outbreak, and to identify good practice we can share with other services.

Inspection team

The inspection was carried out by two inspectors and a member of the CQC medicines team.

Service and service type

This service provides care and support to people living in one ‘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 a short period 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.

What we did before inspection

We reviewed information we had received about the service since the last inspection. We sought feedback from the local authority and professionals who work with the service. The provider was not asked to complete 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. We used all this information to plan our inspection.

During the inspection

We spoke with three people who used the service and one relative about their experience of the care provided. All people who used the service were able to communicate with us verbally. We have also received written feedback from three relatives.

We spoke with eight members of staff including the regional director, the registered manager, the deputy manager and care staff.

We reviewed a range of records. This included two people’s care records and six medication records. We looked at two 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.

Updated 24 August 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

Southill Avenue is a supported living service for people with learning disabilities and autistic people. On the day of our inspection the service provided support to nine people. The service has capacity to provide support to 11 people.

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

We found that the management of medicines required some area of improvement. For example, some handwritten medicines administration (MAR) lacked the required information. While we did not find any evidence that this had a negative impact on people, we shared our concern with the registered manager and requested that improvements were necessary to ensure people’s medicines was managed safely. The registered manager has provided us with some information after our inspection visit that they had taken actions to address the concerns stated above.

People who used the service were safe and were protected from harm and abuse. Staff had received appropriate training around safeguarding people from abuse and demonstrated good understanding of their roles and responsibilities. Risk in relation to receiving care and support had been assessed and robust plans to manage such risks were available and reviewed where required. Sufficient staff were deployed to meet people’s needs and appropriate recruitment checks were carried out. Medicines were overall managed safely. However, we discussed with registered manager to improve the system how the service responds to medicines alerts. People were protected from infections and appropriate guidance was followed to minimise the risk of the spread of COVID 19. Accidents and incidents were monitored, and trends and patterns were analysed to reduce the risk of reoccurrence and improvements to care can be made.

Right Support: Model of care and setting maximises people’s choice, control and independence. People were supported to maximise their full potential and care was tailored around this. For example, staff constantly looked for people to have a wider choice of suitable activities to gain more skills, make friends and to ensure they were not socially isolated. People told us that they were in control of their own care and regularly discussed with staff how they wanted to be cared for and what support they needed.

Right Care: Care was person-centred and promoted people’s dignity, privacy and human rights. People who used the service were in the centre of the care and were consulted and asked how they wanted to be supported. The service and the leadership understood and promoted people’s rights and care was provided whilst ensuring people’s dignity was maintained while protecting their privacy. One relative told us, “I am fully involved in my relatives care but the service will always give preference to [name] wishers” and “The service supports [name] to become more independent but this is a slow process and is at [name] own pace.”

Right culture: Ethos, values, attitudes and behaviours of leaders and care staff ensured people using services led confident, inclusive and empowered lives. Feedback about the registered manager and staff was throughout positive and complimentary. People told us that staff ‘genuinely’ cared and showed they were interested in improving people’s lives. The service had a good track record of people gaining more skills and becoming more independent and a number of people had moved into more independent accommodation.

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. The service used positive behaviour support approach, which was opposed to restrictive practices.

The provider had a range of quality assurance processes, including systems necessary to maintain safe environments. The registered manager ensured policies and procedures met current legislation and were up to date. Relatives told us they were asked of their views about the quality of the service.

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

Rating at last inspection and update: The last rating for the service under the previous provider was good, (published on 1 February 2019).

Why we inspected

We undertook this inspection to assess that the service is applying the principles of Right support right care right culture. This was a planned comprehensive inspection.

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 made a recommendation in relation to the safe management of medicines. However, the service provided us with information of how they plan the issues highlighted above.

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.