Background to this inspection
Updated
30 October 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
The inspection was carried out by an inspector and an Expert-by Experience who carried out telephone interviews. An Expert-by-Experience is a person who has personal experience of using or caring for someone who uses this type of care service.
This service provides care and support to people living in their own home and in six 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 24 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.
Inspection activity started on 29 August and ended on 27 September. We visited the office location and visited two houses on 29 August 2019. Telephone interviews took place between 2 and 27 September 2019.
What we did before the 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. We contacted Healthwatch. Healthwatch is an independent consumer champion that gathers and represents the views of the public about health and social care services in England.
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 five people who used the service about their experience of the care provided. We spoke with six members of staff including the registered manager, quality assurance manager and four support workers.
We reviewed a range of records. This included three people’s care records and two medicines records. We looked at three staff files in relation to recruitment and staff training. A variety of records relating to the management of the service, including policies and procedures were reviewed.
After the inspection
After the site visit we spoke with four people and five relatives of people who used the service and five support workers. We looked at training data and quality assurance records.
Updated
30 October 2019
About the service
Walsingham Support North Cumbria is a supported living service providing personal care to 20 younger and older adults with a learning disability and/or associated conditions in their own homes.
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.
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 were supported in their own homes in smaller groups.
People’s experience of using this service and what we found
Some of the people who used the service had complex needs and they did not express their views verbally about the service. During the time we spent with people we saw they appeared comfortable with staff.
Staff supported people to ensure they received care that helped them develop. Staff received training and support to help them carry out their role.
Some people displayed distressed behaviours. Not all staff had completed training in this area before supporting people. We have made a recommendation about this.
Most people and relatives said they felt safe and were positive about the care provided. We have made a recommendation that staffing capacity is kept under review to ensure people are kept safe and person-centred care is provided.
Staff knew the people they were supporting well. Detailed care plans were in place that documented how people wished to be supported. Staff had developed good relationships with people, were caring in their approach and treated people with respect.
Information was accessible to involve people in decision making about their lives. Most 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 for people.
Some areas of improvement were required to strengthen the governance system. Improvements had been made as a result of recent safeguarding incidents raised due to the management of some behaviours that challenge, but they needed to be actioned in a more timely way.
As a specialist service, moving forward, more robust systems need to be in place to successfully manage such behaviours, including people’s transition to the service, to ensure people enjoy a good quality of life and keep all people safe.
Regular audits and checks were carried out. These however, had not identified the issues we had found at inspection to ensure care and support was provided safely and in a person-centred way.
There were opportunities for people, relatives and staff to give their views about the service. Processes were in place to manage and respond to complaints and concerns.
People were supported to enjoy activities in the community and to go on holiday.
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 and staff were positive about the management of the service and felt valued and respected.
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 28 March 2017).
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.