Archived: NAS Community Services (Hertfordshire)

Updated 25 August 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.

Inspection team

One inspector carried out the inspection.

Service and service type

This service provides care and support to people living in 4 ‘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.

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 not a registered manager in post. A new manager had been in post since January and had submitted an application to register. We are currently assessing this application.

Notice of inspection

We gave 24 hours’ notice of the inspection because some of the people using it could not consent to a home visit from an inspector. This meant we had to arrange for a ‘best interests’ decision about this.

What we did before the inspection

We reviewed information we had received about the service since the last inspection. 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 used all this information to plan our inspection.

During the inspection

We reviewed a range of records related to 3 people's care and support. We looked at the medicine records for 1 person and 2 staff files in relation to recruitment and training. We reviewed records related to the management of the service, which included training records, safeguarding incidents, complaints, quality assurance records and a range of policies and procedures.

We spoke with the manager, team leader and 1 senior worker. We visited 1 person in their home and their support worker. After the inspection we contacted 4 professionals, and we received feedback from 1. We spoke with 3 relatives.

Updated 25 August 2023

About the service

NAS Community Services (Hertfordshire) is a supported living service providing personal care to 4 people. The service supports people with learning disabilities and autistic people.

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

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.

Right Support:

People were not supported to have maximum choice and control of their lives and staff did not support them in the least restrictive way possible and in their best interests; the policies and systems in the service did not support this practice. People did not always receive personalised care, but staff were aware of people's likes, dislikes, and preferences. It was evident that staff support was making a positive impact on people’s lives. The provider’s systems for monitoring the service were still being embedded into the service. We made a recommendation to the provider about this.

Right Care

A new manager had recently started, and they were working to review all risk plans to ensure the information was correct and to provide staff with sufficient information for staff to care for people in a safe way. There were inconsistencies in how staff were recording accidents and incidents which meant they were not always following up on actions correctly. People’s needs were assessed before care started. People were supported to eat well. People were supported to access healthcare services.

Right Culture

Staff members knew the people they supported well. Staff understood people’s individual needs. People’s independence, privacy and dignity were supported and promoted by staff.

We recommend the provider review training to ensure staff have the necessary skills to support people to develop more meaningful relationships.

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 under the previous provider was good (published 12 November 2017).

Why we inspected

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

Enforcement and Recommendations

We made 2 recommendations to the provider to embed their monitoring to ensure care is consistent and to provide staff training.

Follow up

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