Archived: St Christopher's Trust

Updated 30 August 2019

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

This inspection was completed by one inspector.

Service and service type

This service is a domiciliary care agency. It provides care and support to people living in their own houses and in various ‘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.

The service had a manager registered with CQC. This means the manager and the provider are both 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 48 hours’ notice of the inspection as we needed to be sure staff would be available during the office visit and we wanted to arrange visits to people in their own homes.

Inspection activity started and ended on 2 August 2019. We visited the office location to see the registered manager and office staff; and to review care records and policies and procedures. We also visited people in their homes to obtain their feedback about the service.

What we did before the inspection

We reviewed information we had received about the service since the last inspection. We sought feedback from commissioners of the service. We used the information the provider sent us in the provider information return. This is information providers are required to send us with key information about their service, what they do well, and improvements they plan to make. This information helps support our inspections. We used all of this information to plan our inspection.

During the inspection

We spoke with three people who used the service about their experience of the care provided. We spoke with seven members of staff including the registered manager.

We reviewed a range of records. This included three people’s care records and two staff files in relation to recruitment and induction. We checked a variety of records relating to the management of the service, including policies and procedures.

After the inspection

We spoke with three relatives over the telephone to obtain their feedback about the service. We also sought some additional documents from the registered manager. They were provided in a timely manner and were used to inform our judgements.

Updated 30 August 2019

About the service

St Christopher’s Trust is a domiciliary care service which provides personal care to people with a range of support needs. Some people using the service had learning disabilities and/or autism. People lived in ‘supported living’ settings, so they could live as independently as possible. At the time of this inspection, the service was providing personal care to 25 people.

Not everyone who used the service received the regulated activity of personal care. The Care Quality Commission (CQC) only inspects services where people receive personal care. This is help with tasks related to personal hygiene and eating. Where they do receive personal care, we also consider any wider social care provided.

The service has been developed and designed in line with the principles and values that underpin Registering the Right Support and other best practice guidance. This ensures that people who use the service can live as full a life as possible and achieve the best possible outcomes. The principles reflect the need for people with learning disabilities and/or autism to live meaningful lives that include control, choice and independence. People using the service receive planned and co-ordinated person-centred support that is appropriate and inclusive for them.

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

People felt safe. Risks to people were assessed and minimised and people were protected from abuse. There were enough staff available to provide personalised care to people. People received their medicines, as prescribed, from staff who were trained to provide this support safely. People were protected from the spread of infection.

People were supported by staff who were competent and skilled. Staff asked people for their consent before providing them with any care. 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.

People told us staff were kind and caring. People said they felt well-treated by staff and we observed people were continually involved in decisions about their care. Staff supported people to maintain their independence. People’s privacy was respected.

The service applied the principles and values of Registering the Right Support and other best practice guidance. These ensure that people who use the service can live as full a life as possible and achieve the best possible outcomes that include control, choice and independence.

The outcomes for people using the service reflected the principles and values of Registering the Right Support by promoting choice and control, independence and inclusion. People's support focused on them having as many opportunities as possible for them to gain new skills and become more independent.

People were told how they could complain about the service, if they had any concerns. People were supported to maintain relationships with their family and friends and take part in activities that were meaningful to them. People were supported by staff who could communicate effectively with them. People had access to a range of communication tools, to help them make decisions about their care.

People, their relatives and staff all told us they thought the service was well-run. Everyone told us the registered manager was supportive and operated an 'open-door' policy. The registered manager and staff were keen to deliver a high-quality, person-centred service. The registered manager completed a range of checks on the safety and quality of the service on an ongoing basis, to ensure any necessary improvements were identified and implemented.

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 (published 19 December 2016).

Why we inspected

This was a planned inspection based on the previous rating.

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.

Thematic review

The Secretary of State has asked CQC to conduct a thematic review and to make recommendations about the use of restrictive interventions in settings that provide care for people with or who might have mental health problems, learning disabilities and/or autism.

Thematic reviews look in-depth at specific issues concerning quality of care across the health and social care sectors. They expand our understanding of both good and poor practice and of the potential drivers of improvement.

As part of thematic review, we carried out a survey with the registered manager at this inspection. This considered whether the service used any restrictive intervention practices (restraint, seclusion and segregation) when supporting people.

The service used positive behaviour support principles to support people in the least restrictive way. No restrictive intervention practices were used.