Nugent Community Choices

Updated 9 September 2023

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 Health and Social Care Act 2008.

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 an inspector and an Expert by Experience, who completed telephone calls with relatives to gather their views. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service. A medicines inspector was also available remotely to support the inspection.

Service and service type

Nugent Community Choices is a domiciliary care and supported living service. It provides personal care and support to people living in 9 ‘supported living’ settings, 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

This provider is required to have a registered manager to oversee the delivery of regulated activities at this location. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Registered managers and providers are legally responsible for how the service is run, for the quality and safety of the care provided and compliance with regulations. At the time of our inspection there was a registered manager in post.

Notice of inspection

We gave the service a short period of notice of our intention to inspect. This was because we did not know if all people living at the service could consent to a visit from an inspector, and to ensure the registered manager was available, as they worked across a number of different settings and locations.

Inspection activity started on 11 July 2023 and ended on 28 July 2023, at which point we had received and reviewed all emailed evidence we requested prior to and following our inspection visits. We visited the office location and 1 property on 13 July and 2 further properties on 18 and 19 July 2023.

What we did before inspection

We reviewed information we had received about the service since they had registered with the CQC. 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. We sought feedback from professionals who work with or commissioned the service. We used all of this information to plan our inspection.

During the inspection

We spoke with 2 people who used the service and 4 relatives about their experience of the care provided. To communicate verbally with people effectively we tailored our communication to suit people's preferences, including observing people's body language and facial gestures.

We spoke with 5 members of staff in person, including the registered manager, community lead and support workers. We also captured the views of 7 staff members via emailed questionnaires.

We reviewed a range of records. This included 5 people’s care records and multiple medication records. We looked at recruitment records for 6 staff, along with training and supervision records for all staff members. A variety of records relating to the management of the service, including policies, procedures, audits and monitoring systems were reviewed.

Updated 9 September 2023

About the service

Nugent Community Choices is part of Nugent Care, a charitable organisation who provide care and education to vulnerable children, young people and adults through their schools, care homes and community based services. Nugent Community Services provides care and support to people living in 'supported living' settings located in Wigan, Liverpool and Sefton so that they can live as independently as possible. The service can currently support up to 29 people across 9 properties. 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. At the time of the inspection, 8 people were in receipt of personal care and were included in the inspection.

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

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

Right Support

Although people received their medicines as prescribed, record keeping and oversight of medicines management required improvement. The service and its staff supported people to have the maximum possible choice, control and independence. People had control over their own lives. Staff supported people to make decisions following best practice in decision-making. Staff focused on people’s strengths and promoted what they could do, so people had a fulfilling and meaningful everyday life. People were supported to pursue their interests and achieve their goals. Staff supported people to take part in activities in their local area and to pursue voluntary employment in areas of interest. Staff supported people with their health and wellbeing, including attending medical appointments.

Right Care

People received kind and compassionate care from staff who knew them well and how they wished to be supported. Staff understood how to protect people from poor care and abuse. Staff received training in how to identify abuse and report safeguarding concerns and worked with other agencies and professionals to ensure and maintain people’s safety. The service deployed enough staff to provide planned care and keep people safe. The provider had faced some recruitment challenges, with agency staff currently being used to cover any shortfalls. Staff understood people’s cultural needs and promoted equality and diversity in their support for people. People could communicate with staff and understand information given to them because staff supported them consistently and understood their individual communication needs.

Right Culture

Systems and processes to assess the quality and safety of the support provided, had not always identified shortfalls. Training records showed some staff had yet to complete all sessions the provider deemed mandatory and role essential. However, staff reported enough training was provided to ensure they could meet the needs of the people they supported. Staff ensured risks of a closed culture were minimised to ensure people received support based on transparency, respect and inclusivity. Staff knew and understood people well and were responsive, supporting their aspirations to live a quality life of their choosing. Staff evaluated the quality of support provided to people, involving the person, their families and other professionals through reviews, surveys and ongoing discussion.

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

Rating at last inspection

This service was registered with us on 7 April 2022 and this is the first inspection.

Why we inspected

This inspection was prompted by a review of the information we held about this service and to provide a rating.

Enforcement and Recommendations

We have identified breaches in relation to the management of medicines and audit and governance processes at this inspection. We have also made a recommendation about staff training.

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 continue to monitor information we receive about the service, which will help inform when we next inspect.