Background to this inspection
Updated
14 December 2017
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.
The inspection was announced and was carried out on the 5 and 10 October 2017 by one inspector.
We gave the service 48 hours’ notice of the inspection because they provide a supported living service, and we needed to be sure that the registered manager would be available.
Prior to the inspection, we checked the information we held about the service and the provider, such as notifications. A notification is information about important events which the provider is required to send us by law. In addition, we asked for feedback from the Local Authority; who has a quality monitoring and commissioning role with the service. No concerns were reported.
Before 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.
During the inspection we used different methods to help us understand the experiences of people using the service, because some people had complex needs which meant they were not able to talk to us directly about their experiences.
We sent out questionnaires to a sample of people using the service, relatives and staff; to gain their feedback about the service provided by Turning Point - Bedford. In total, we received 22 completed questionnaires back – seven from people using the service, two from relatives and 13 from staff.
We visited the registered office and two of the four settings where people live. These were shared by a total of 12 people. We spoke with or observed the support being provided to six of these people. We also contacted the provider and spoke with the registered manager, two supported living managers, one team leader and two support workers.
We then looked at records for seven people, as well as other records relating to the running of the service. These included staff records, medication records, audits and meeting minutes; so that we could corroborate our findings and ensure the care and support being provided to people was appropriate for them.
Updated
14 December 2017
Turning Point - Bedford Supported Living Service provides care and support to people living in four supported living settings, so that they can live in their own homes as independently as possible. People’s care and housing are provided under separate contractual agreements. CQC does not regulate premises used for supported living; therefore this inspection only looked at people’s personal care and support.
At the time of this inspection, there were 16 people using the service who had a range of needs including learning disabilities, autistic spectrum disorders, physical disabilities, mental health and sensory impairments.
A registered manager was 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.
At the last inspection in July 2015, the service was rated Good. During this inspection, which took place on 05 and 10 October 2017, we found the service remained Good.
People were protected from abuse and avoidable harm. Staff had been trained to recognise signs of potential abuse and were confident about reporting any concerns they might have, and risks associated with people’s care were managed positively.
There were sufficient numbers of staff to keep people safe and meet their needs. Staff had been trained to ensure they had the right skills and knowledge to carry out their roles and responsibilities. The provider carried out checks for new staff, to make sure they were suitable to work at the service.
Systems were in place to ensure people received their medicines in a safe way and when they needed them.
The service acted in line with legislation and guidance regarding seeking people’s consent and assessing their capacity to make decisions about the care they received.
People were supported to eat and drink enough, and to maintain a balanced diet. Staff were clear about the importance of monitoring people’s health needs and seeking additional support and advice as required.
Staff had developed positive caring relationships with people using the service. They provided care and support in a personalised and meaningful way. It was clear that people’s involvement was at the heart of the service and staff placed a real emphasis on their inclusion and individual achievements. They treated people with kindness and compassion, and respected their privacy and dignity at all times.
People were supported to have maximum choice and control of their lives and staff supported them to be as independent as possible, in all areas of their lives. They were given opportunities to express their views on the service they received, and to be actively involved in making decisions about their care and support.
A complaints procedure had been developed, to let people know how to raise concerns about the service. People knew how to raise concerns if they needed to do so.
The registered manager provided effective leadership at the service, and promoted a positive culture that was open and transparent. There was a strong emphasis on continually trying to improve the service, and systems were in place to monitor the quality of the service provided, and to drive continuous improvement.
Further information is in the detailed findings below.