Archived: Swan House

Updated 20 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 checked 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 comprehensive inspection took place on 19 and 21 December 2017 and was unannounced.

The inspection was carried out by one inspector and an expert-by-experience. An expert-by-experience is a person who has personal experience of using or caring for someone who uses this type of care service.

Prior to the inspection the provider completed a Provider Information Return (PIR). This is a form that asks the provider to give some key information about the service, what the service does well and improvements they plan to make. We reviewed the information sent to us in the PIR and notifications we had received from the provider. Notifications are for certain changes, events and incidents affecting the service or the people who use it that providers are required to notify us about.

During the inspection, we observed support being delivered to people to help us understand people’s experiences of using the service. We also looked at records, including four people’s care plans, four staff records, medicine administration records and records relating to the management of the service. We spoke with four people who used the service and three relatives of other people, the registered manager, the site manager, two team leaders and two support workers, one of whom was a regular agency worker. We also spoke with two social care professionals by telephone to obtain their feedback about the service.

Updated 20 January 2018

The inspection took place on 19 and 21 December 2017 and was unannounced. At the last inspection, on 21 and 23 December 2015, the service was rated Good. At this inspection we found the service remained Good.

This service provides care and support to people living in a ‘supported living’ setting, 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 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.”

Swan House is a supported living service managed by The London Borough of Hillingdon. Swan House is split across two levels with people with mental health needs living independently upstairs and up to nine people with complex behaviour and learning disability living downstairs.

Each person had their own tenancy and lived in a large self-contained flat. The service only provided personal care to people living downstairs. At the time of our inspection, eight people were receiving care and support and a new person was due to move in shortly.

There was a registered manager in post at the service at the time of our inspection. 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 registered manager and site manager were passionate about accessing community resources in order to improve the quality of life of people who used the service.

People's care plans were very comprehensive and detailed people’s identified individual needs. They were personalised to reflect people’s wishes and what was important to them.

Where appropriate, people’s end of life wishes were discussed and recorded.

Care plans and risk assessments were reviewed and updated whenever people's needs changed. People and relatives told us they were involved in the planning and reviewing of their care and support and felt valued.

A wide range of activities were arranged that met people’s individual interests and people were consulted about what they wanted to do.

There were systems and processes in place to protect people from the risk of harm. There were enough staff on duty to meet people's needs and there were contingency plans in the event of staff absence. Employment checks were in place to obtain information about new staff before they were allowed to support people.

The risks to people's safety and wellbeing were assessed and regularly reviewed. People were supported to manage their own safety and remain as independent as they could be. The provider had processes in place for the recording and investigation of incidents and accidents.

People were given the support they needed with medicines and there were regular audits by the management team.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice.

Staff had undertaken training in the Mental Capacity Act 2005 (MCA) and were aware of their responsibilities in relation to the Deprivation of Liberty Safeguards (DoLS). They ensured people were given choices and the opportunity to make decisions.

The provider ensured people's nutritional needs were met. People were involved in the planning of their meals and where possible, shopped for ingredients and cooked their own food with the support of staff.

People were supported by staff who were sufficiently trained, supervised and appraised. The service liaised with other services to share ideas and good practice.

People’s healthcare needs were met and staff supported them to attend medical appointments.

People lived in a comfortable environment which was clean and free of hazards. They were assisted to personalise their flats and the communal areas as they wished.

Staff were caring and treated people with dignity, compassion and respect. Support plans were clear and comprehensive. They recorded people's individual needs, detailed what was important to them, how they made decisions and how they wanted their care to be provided.

Throughout the inspection, we observed staff supporting people in a way that took into account their diversity, values and human rights. People were supported to make decisions about their activities, both at their home and in the community.

Information about how to make a complaint was available to people and their families, and they felt confident that any complaint would be addressed by the management.

There was a clear management structure at the service, and people and staff told us that the management team were supportive and approachable. There was a transparent and open culture within the service and people and staff were supported to raise concerns and make suggestions about where improvements could be made.

The provider had effective systems in place to monitor the quality of the service and where issues were identified, these were addressed promptly.