Upward Care Limited

Updated 20 December 2019

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 Care Act 2014.

Inspection team

The inspection team consisted of one inspector and one assistant inspector.

Service and service type

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

The service had a manager registered with the Care Quality Commission. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.

Notice of inspection

We gave a short period notice of the inspection. This was because we needed to be sure that the provider or registered manager would be in the office to support the inspection.

Inspection activity started on 26 November 2019 and ended on 27November 2019. We visited the office location on 26 November 2019.

What we did before inspection

We reviewed information we had received about the service since the last inspection. We sought feedback from the local authority who work with the service. We used the information the provider sent us in the provider information return. This is information providers are required to send us with key information about their service, what they do well, and improvements they plan to make. This information helps support our inspections. We used all of this information to plan our inspection.

During the inspection

We spoke with three people who used the service and four relatives about their experience of the care provided. We spoke with eight members of staff including the nominated individual, registered manager and six care workers. The nominated individual is responsible for supervising the management of the service on behalf of the provider. We spoke with one health care professional who regularly visited the service.

We reviewed a range of records. This included five people’s care records and three medication records. We looked at a variety of records relating to the management of the service, including policies and procedures.

After the inspection

We continued to seek clarification from the provider to validate evidence in relation to care plans and risk assessments for two people.

Updated 20 December 2019

About the service

Upward Care Limited is a supported living service providing personal care to people with a learning disability. There were forty-nine people using the service at the time of the inspection.

People using the service lived in a variety of different houses, including shared houses and apartments with up to five people sharing. Staff provided overnight support for people as well as in the day and most properties included a staff sleep in room.

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.

Some aspects of the service have been developed and designed in line with the principles and values that underpin Registering the Right Support and other best practice guidance. This ensures that people who use the service can live as full a life as possible and achieve the best possible outcomes. The principles reflect the need for people with learning disabilities and/or autism to live meaningful lives that include control, choice, and independence. People using the service receive planned and co-ordinated person-centred support that is appropriate and inclusive for them.

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

People received safe care and support. Staff had received training on safeguarding adults and were aware of their responsibilities to protect people from avoidable harm. Medicines were given in a safe way and staff followed infection control procedures. Accidents and incidents were recorded and followed through with appropriate action to minimise the risk of re-occurrence

People’s care and support reflected their individual assessed needs. Staff had the appropriate skills and knowledge to meet people’s needs and received training and ongoing support. People were supported to eat where needed and staff sought healthcare support for people if required. 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.

All the people we spoke with told us they liked where they were living and they were well cared for. The outcomes for people using the service reflected the principles and values of Registering the Right Support by promoting choice and control, independence and inclusion. People's support focused on them having as many opportunities as possible for them to gain new skills and become more independent.

People received care and support that respected their individual preferences and lifestyle choices. Information was presented in accessible formats to support people to be involved in their care and support and make decisions. The provider had a complaints process and people felt confident to raise any concerns. People’s wishes in relation to their end of life care were discussed and plans made with them.

A number of quality audits were in place to assess and monitor the quality and safety of the service. People told us that the manager was approachable and responsive and staff felt supported. People received opportunities to share their views about the service they received. Some systems needed further development to ensure staff were competent when carrying out specific healthcare tasks.

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 was Good (published 20 May 2017).

Why we inspected

This was a planned inspection based on the previous rating.

Follow up

We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.