Background to this inspection
Updated
5 August 2021
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.
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. One inspector reviewed evidence remotely whilst the other visited the office, and the service where concerns had been raised.
Service and service type
This service provides care and support to people living in 20 ‘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 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 48 hours’ notice of the inspection. This was because we needed to be sure that the provider or registered manager would be in the office to support the inspection. We also needed to gain consent from people to visit them at their house.
What we did before the inspection
The provider was not asked to complete a provider information return prior to this inspection. This is information we require providers to send us to give some key information about the service, what the service does well and improvements they plan to make. We took this into account when we inspected the service and made the judgements in this report. We used all of this information to plan our inspection.
During the inspection-
We spoke with one person who used the service and one relative about their experience of the care provided. We observed interactions between staff and people following a trip in the local community. We spoke with six members of staff including the area operations manager, the registered manager, a service manager, team leader and two support workers.
We reviewed a range of records. These included five people’s care records and multiple medication records. We looked at three staff files in relation to recruitment and staff supervision. A variety of records relating to the management of the service, including quality assurance audits, newsletters and policies and procedures were reviewed.
After the inspection –
We continued to seek clarification from the provider to validate evidence found. We looked at stakeholder survey feedback.
Updated
5 August 2021
About the service
ECL Office provides personal care and support to adults living in ‘supported living’ settings, so that they can live as independently as possible. The service is run from an office in Maidstone. This supported living service meets the needs of people with learning disabilities, autism and people with more complex health needs such as epilepsy. At the time of this inspection there were 15 people receiving personal care.
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.
People’s experience of using this service and what we found
People had been supported to live the life they had chosen, and had been supported to be an active member of the community. People appeared comfortable and relaxed in the presence of staff; observation showed people smiling and giving eye contact.
Staff had been trained and were clear on the action to take if they suspected abuse. Potential safeguarding concerns had been reported to the local authority, audits detailing any actions that required completing were monitored by the senior management team.
Risks had been mitigated and staff understood each person’s specifics risks. Staff understood how to support people at times of heightened anxiety where they may display behaviour that challenged themselves or others. Checks took place to promote health and safety within each service.
People received their commissioned hours of support. Support hours were planned around people’s activities at times they had specified. Staff were recruited safely and, were given the opportunity to make any suggestions or to raise any concerns they had about their role.
Medicines were managed safety and people received their medicines as prescribed. Staff had been trained and followed detailed protocols for each person and their specific needs. Staff had been trained in infection control and understood the importance of reducing the risk of infection.
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.
Feedback and views were sought and acted on from people, staff and relatives. There was an open, inclusive, person centred culture within the organisation where staff felt valued in their role. Staff worked in partnership with people, relatives and external health care professionals to ensure a consistent approach to meeting people’s needs.
Systems were in place to monitor the quality of the service people received. A range of checks and audits were completed to ensure people received a high-quality service. Manager’s held debriefing sessions with staff following an incident to identify any potential actions to reduce the risk of reoccurrence.
We expect health and social care providers to guarantee autistic people and people with a learning disability the choices, dignity, independence and good access to local communities that most people take for granted. Right Support, right care, right culture is the statutory guidance which supports CQC to make assessments and judgements about services providing support to people with a learning disability and/or autistic people.
This service was able to demonstrate how they were meeting the underpinning principles of Right support, right care, right culture. The service supported people to reach their potential whilst maximising independence. People's houses were treated as their home with staff supporting people to live the life they have chosen. People were at the centre of all decisions and involved in their care and support.
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 20 November 2019).
Why we inspected
We received concerns in relation to one particular supported living service in relation to safeguarding incidents, staffing levels and person-centred care. As a result, we undertook a focused inspection to review the key questions of safe and well-led only.
We reviewed the information we held about the service. No areas of concern were identified in the other key questions. We therefore did not inspect them. Ratings from previous comprehensive inspections for those key questions were used in calculating the overall rating at this inspection.
The overall rating for the service has remained Good. This is based on the findings at this inspection. We found no evidence during this inspection that people were at risk of harm from this concern. Please see the safe and well-led sections of this full report.
You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for ECL Office on our website at www.cqc.org.uk.
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.