Archived: Walsingham Support - Lister House

Updated 23 April 2016

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 took place on 1st and 2nd February 2016 and was unannounced. This was the first inspection of this location.

The inspection team consisted of the lead adult social care inspector and a specialist advisor. The specialist advisor was an experience and well qualified occupational therapist who taught the subject at degree level.

Prior to the inspection we sent out questionnaires to people who used the service and to relatives and visiting professionals. We had a good response from these. We also received a provider information return. This document gave us full information about the service and was well written and gave suitable details of all aspects of the service. We also asked the local authority and local health care practitioners about the service during one of our regular meetings with health and social care professionals.

When we visited the service we met with thirteen of the fourteen service users in Lister House. On this occasion we did not contact the three other people who received care in the local area. We met with two relatives who were visiting during our inspection. We read all of the care plans for the service users. We looked at six care files in depth and spoke to these people about the content of the plans. These included assessments of support needed and the specialist advisor looked at moving and handling assessments and management plans. We observed care delivery with two people who found it difficult to discuss their care needs.

We spoke with the registered manager, the locality manager and to staff. We also had contact with the operations manager after the visits. We saw six staff files, including the files for two recently appointed members of the team. The specialist advisor looked at the training and competence records for staff in relation to moving and handling. We did this to ensure that these met the often complex needs of people living with a physical disability.

We were given copies of the last four weeks' rosters. We reviewed copies of the record of training received and a training plan for 2016.

We were sent quality monitoring reports completed by external officers of Walsingham and we saw a wide range of quality audits for the service. We checked on medicines managed on behalf of people. We also saw risk assessments for the service which included food and fire safety records. We discussed the management of money for two people who needed extra support with this.

Updated 23 April 2016

This was the first inspection of this location. The visit was unannounced and started on Monday 1st of February with a second visit the next day where we met all the tenants and the inspector attended a tenants meeting.

Lister House is a block of flats where people have their own tenancies. The flats were purpose built for people living with disability. Walsingham Support Limited provide care and support from this location to fourteen people who live in these tenancies and to three people who live elsewhere in the local area. The organisation has office space in the building. The staff based at Lister House provide personal care but also support people to access the community, deal with their daily living needs and give people support in a variety of other areas. People who live in Lister Court also access support from other providers. Walsingham provide similar support across England and also run residential care homes.

The service has a registered manager who is responsible for this service and other services in Cumbria which provide domiciliary care, care in supported living settings and in three housing with care locations. 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. The day to day operation is delegated to a locality manager.

People in the tenancies told us they felt safe in their own homes. They had opportunities to talk to senior managers in the organisation. Staff we spoke with had a good understanding of balancing risks and supporting people to be as independent as possible. Staff had received training in safeguarding and were confident about how they would manage any concerns. Walsingham had a confidential whistleblowing line which staff could access easily.

Individual risk assessments were in place where appropriate. General risk assessments were also available and these covered risks to staff and environmental risks while operating the project.

We saw rosters for this location and these showed that there were enough staff to give people the support they had purchased. Staff were recruited appropriately and the organisation had disciplinary and grievance procedures in place.

Staff had been trained to support people who needed assistance with medicines. Self administration was encouraged. Suitable records were in place.

Staff had received training in infection control measures and had access to equipment and chemicals when necessary.

We looked at the records of training and at staff supervision and development records. Staff in the team had received good levels of training and support. Staff said that they felt their training helped them to support people appropriately. Staff displayed good levels of skills and knowledge.

Staff understood their responsibilities under mental health and mental capacity legislation. No one in the service had any constraints on their liberty. Restraint was not used in the service. Most of the people who lived at Lister House were assertive and they told us that they directed their own support and that consent was not an issue.

We had evidence to show that people were supported to shop and cook for themselves. Staff gave support and helped people to have a balanced diet.

Most of the people who Walsingham supported dealt with their own health care arrangements. One or two people needed staff support and we saw that this was done in a timely way. We had evidence to show that people were well supported if they needed to have hospital admissions.

The flats people lived in were specially designed but we saw that the staff had supported people to redecorate, buy furniture and access specialist equipment and adaptations.

We met staff who treated people with dignity and respect. Staff and service users had developed supportive relationships. Staff worked with people in an equitable way and understood people's rights to diversity and independence. We attended a tenants' meeting and we saw that people were proactive in decision making with the Walsingham staff and with the housing association who managed the property.

Each person had an assessment of support needs which included strengths and risks. Person centred plans were in place and people told us that they directed the care planning. Many of the tenants held their own support budgets and made decisions about how they would use this funding. Care plans were of a high standard. They gave staff guidance, looked at ways to support independence and included personal aims and goals.

People who lived at Lister House enjoyed some shared activities but every person also followed their own hobbies, entertainments and interests. Some people were in involved in voluntary work, education and community action groups. People went out to shop and to socialise. We judged that the Walsingham staff supported people to have a meaningful life.

There were suitable arrangements in place to deal with complaints. There had been no complaints received about care and support.

We had evidence to show that people had been encouraged to use their direct payments to build their own support packages. Walsingham had worked with service users and with social workers to support people who wanted to use their funding in a creative way.

The service was well led. This location was managed by an experienced and suitably trained registered manager. The locality manager was responsible for the day to day support people received. She was also suitably trained and experienced. Together they had developed an open culture that followed the vision and values of Walsingham.

There was a comprehensive quality monitoring system in place and the organisation responded to any issues that this identified. Good forward planning was in place and much of this was directed by people who used the service.

We judged that records management needed to be reviewed and we made a recommendation about how records were managed.