Safe Sanctuary Living Ltd

Updated 29 June 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

The inspection was carried out by two inspectors.

Service and service type

This service provides care and support to people living in their own homes so 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

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 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

Before our inspection, we reviewed information we held about the service. This included information received from the local authority and professionals who work with the service. We looked at statutory notifications. A statutory notification is information about important events, which the provider is required to send us by law, such as allegations of abuse and serious injuries.

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.

During the inspection

We spoke with one person who used the service and two relatives about their experience of the care provided.

We spoke with seven members of staff including the registered manager and the nominated individual. The nominated individual is responsible for supervising the management of the service on behalf of the provider.

We reviewed a range of records. This included three people’s care records and two 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 from the provider to validate evidence found. We looked at training data and quality assurance records. We contacted two professionals who regularly visit the service.

Updated 29 June 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

Safe Sanctuary Living Ltd supports people to live in the community. At the time of the inspection

three people were receiving support. The support varied from a few hours to 24 hours a day. People lived in their own home around Nottinghamshire. 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.

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

Right Support

Although the risk assessments were reviewed, they did not always effectively identify all shortfalls noted by our inspectors. Not all risks had been considered in relation to people’s health and social care needs. Medicines management processes did not follow best practice guidance.

The service supported people to have as much choice, control and independence as possible. Staff focused on people’s strengths and promoted what they could do, so people had a fulfilling and meaningful life.

People were asked how they would like to receive support including making reasonable adjustments so that they could access activities in different areas.

Right Care

The service had enough staff to meet people’s needs and keep them safe. The staff received mandatory training; however further training was required to enhance staff’s understanding of autism. Since the inspection, the provider arranged additional training on understanding autism for all staff.

Staff promoted equality and diversity in their support for people. They understood people’s cultural needs, provided culturally appropriate care and respected people’s privacy and dignity.

People received kind and compassionate care.

Staff had training on how to recognise and report abuse and they knew how to report any concerns. The service worked well with other agencies to protect people from poor care and abuse.

Staff and people cooperated to assess risks people might face. Where appropriate, staff encouraged and enabled people to take positive risks, for example using public transport.

Right culture

Not all staff knew and fully understood people’s needs. Some staff were not aware of people’s health issues described in their care plans.

Not all people and those important to them felt fully involved in planning their care. We identified occasions where people’s families could have been communicated with more effectively. Provider was keen to make changes and ensure everyone felt more involved. Following the inspections, the management evaluated the quality of support provided to people, involving the person, their families and other professionals.

The provider faced recruitment challenges due to current pressures in the health and social care sector and, at times it was difficult for the provider to recruit the gender of staff in line with people’s preferences. The service actively tried to recruit permanent staff to ensure consistency of care.

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

Why we inspected

The inspection was prompted in part due to concerns received about the quality of care. A decision was made for us to inspect and examine those risks.

We have found evidence that the provider needs to make improvements. You can see what action we have asked the provider to take at the end of this full report.

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 safe care and treatment and good governance at this inspection.

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 return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.