United Response - 14 Lingwell Approach

Updated 15 November 2018

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider was meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

Before the inspection we had received a completed Provider Information Return (PIR). The PIR asks the provider to give some key information about the service, what the service does well and improvements they plan to make. We reviewed the PIR and other information we held about the service as part of our inspection. This included the notifications we had received from the provider. Notifications are changes, events or incidents the provider is legally obliged to send CQC within required timescales. We contacted commissioners from the local authorities who contracted people's care. We spoke with the local safeguarding teams. We also contacted health and social care professionals who worked with the service. We received no information of concern from these agencies.

This inspection took place on 24 and 25 September 2018 and was unannounced. The inspection was carried out by an adult social care inspector.

Due to people’s health conditions and complex needs they were unable to share their views about the service they received.

During the inspection we spoke with the registered manager, the area manager and two support workers. After the inspection we telephoned two relatives to obtain their views of the care provided. (We observed care and support in communal areas and looked in the kitchen and peoples' bedrooms.) We reviewed a range of records about people's care and how the service was managed. We looked at care plans for two people, the recruitment, training and induction records for three staff, four peoples' medicines records, staffing rosters, staff meeting minutes, maintenance contracts and the quality assurance audits that the registered manager completed.

Updated 15 November 2018

United Response - 14 Lingwell Approach is a 'care home'. People in care homes receive accommodation and personal care under a contractual agreement. CQC regulates both the premises and the care provided and both were looked at during this inspection.

The service is registered to provide accommodation and personal care for up to four people who have learning disabilities and or physical disabilities.

The care service has been developed and designed in line with the values that underpin the Registering the Right Support and other best practice guidance. These values include choice, promotion of independence and inclusion. People with learning disabilities and autism using the service can live as ordinary a life as any citizen.

This inspection took place on 24 and 25 September 2018. The inspection was unannounced on the first day. This meant the staff and provider did not know we would be visiting. The second day was announced.

There was a registered manager. A registered manager is a person who has registered with the CQC to manage the service. Like registered providers, they are 'registered persons'. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

At our last inspection we rated the service as good. At this inspection we found the evidence continued to support the rating of good and there was no evidence or information from our inspection and ongoing monitoring that demonstrated serious risks or concerns. This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection.

We observed people living in the home were safe and relatives told us staff kept people safe. Staff received training on safeguarding adults from abuse and understood their responsibilities in respect of protecting people from the risk of harm.

Risk assessments were carried out, reviewed and updated when people’s needs changed. We found the provider monitored risk effectively and in the least restrictive way. Accidents and incidents were recorded and appropriate action taken to reduce the risk of reoccurrence.

Medicines were managed safely. They were checked regularly and audits carried out to ensure people received their medicines as prescribed. ‘As required’ medicines were managed appropriately with guidance in place for staff to follow.

Safe recruitment processes were in place and had been followed. Pre-employment checks on employees were completed that helped to minimise the risk of unsuitable staff from working with adults at risk. Records confirmed staff received induction training when they were new in post.

Staff received training which helped them to meet people’s needs and staff told us there was enough training to meet people’s needs.

We checked and found the provider was working within the principles of the MCA and all people using the service had a DOLs in place. Best interest decisions also took place and were documented in care plans.

People were supported with their nutritional needs and specific dietary requirements. If requiring support from health care professionals, this was arranged for people and they were supported to attend hospital if needed.

We observed positive interactions between staff and people living in the home. We saw people were encouraged to maintain relations with their family and friends.

Care plans recorded people’s preferences, likes and dislikes to ensure staff met their individualised needs. These were reviewed regularly with people and their relatives. Due to people’s complex needs staff ensured detailed communication plans were in place to support people to consent and make choices about their care.

Staff protected people’s rights for privacy and respected these. People were encouraged to remain as independent as possible and relatives confirmed this.

The provider had not received any complaints since our last inspection. The registered manager understood the importance of how these would be managed in line with their policy.

Staff and people using the service all had positive relationships with the management. They felt supported and said the registered manager was always present in the home.

Surveys were carried out to gather people’s views and to monitor the quality of the service being provided. The provider completed audits to monitor standards and to ensure they were maintained.

The provider was continuously looked at ways to improve care and monthly summaries had been devised to show impact of people’s care and areas for improvement.

They ensured people were involved within the local community and initiatives had been taken to make sure this happened. For example, arranging a local fayre and taking people to hairdressers in the local community.