Background to this inspection
Updated
31 January 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 is 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.
This inspection activity started on 12 October 2017 and ended on 13 November 2017 and was unannounced. The inspection process included visiting people within their supported living complex, speaking on the telephone to relatives of people who used the service and staff members in order to obtain their views.
The provider had not been asked on this occasion, to complete a Provider Information Return [PIR] 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 also reviewed other information we held about the service including statutory notifications. Statutory notifications include information about important events which the provider is required to send us.
During the inspection we spoke with six people who used the service, two relatives, three staff members and the provider. We looked at four people’s care records and five staff files. We reviewed other documents including audits and records relating to the management of the service. Prior to our inspection we also sought the views of the local authority’s contract monitoring officers.
Updated
31 January 2018
This inspection took place over several dates. On the 12 October 2017 we visited the site office. On the 31 October 2017 we visited people in their own homes and on13 November 2017 we telephoned relatives and staff members in order to obtain their feedback about the service.
At the time of this inspection 16 people were being supported to live independently. Seven people were being supported at a location in Stevenage and nine people were being supported at a location in Hemel Hempstead. The people being supported by the service had complex needs including learning disabilities and Autism.
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.” Registering the Right Support CQC policy.
This service provides care and support to people living in two supported living settings, so that they can live in their own home 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 registered manager in post. A registered manager is a person who has registered with the Care Quality Commission 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.
When we previously inspected the service on 23 March 2016 we found that the care and support people received was not always safe. People`s consent and principles of the Mental Capacity Act 2005 were not always followed by staff and the provider’s governance systems were not always effective to identify and improve shortfalls. Following the inspection the registered manager submitted an action plan which detailed how they were going to implement and sustain the necessary improvement.
At this inspection we found that the provider and the registered manager had made the necessary improvements to ensure people received care and support in a safe, effective and personalised way.
People told us they felt safe with the support they received from the staff. Staff had been trained and appropriately supported to carry out their roles effectively. They knew how to safeguard people from avoidable harm and about the potential risks and signs of abuse. Risks to people's health, well-being or safety were assessed and regularly reviewed to take account of people's changing needs and circumstances. There were enough staff available to meet people’s needs and safe recruitment practices were followed to help make sure that staff were suitable for the roles they performed. We found that staff followed best practice guidance when supporting people to take their medicines.
Staff took appropriate actions to protect people from the risk of infection by using appropriate hand washing techniques when supporting people with the preparation of their meals. The registered manager and the provider demonstrated an open culture of learning from complaints and previous shortfalls identified.
People told us they were asked for their permission before staff assisted them with support. We saw that people had signed their own care records or where it was appropriate people`s relatives were involved in their care .Staff followed the principles of MCA to help ensure the support people received was in their best interest.
People and their relatives told us that the staff providing support to people were kind and compassionate. Staff respected people’s dignity and encouraged them to remain as independent as possible. People received support from consistent and reliable staff members. People had regular opportunities to feedback about the service and to participate in reviews of their support needs.
People were supported and encouraged to pursue their hobbies and interests, and to be actively involved in the community and participate in a range of activities which they enjoyed.
People and their relatives felt that the registered manager was approachable with any concerns. All the people we spoke with told us that they felt that Glenholme Living Solutions was well managed. The registered manager demonstrated a good knowledge of the staff they employed and people who used the service. Staff told us that the senior staff team were approachable, supportive and that they could talk to them at any time.
There was a programme of checks undertaken routinely to help ensure that the service provided for people was safe.