Step Up Support

Updated 31 July 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. This inspection was planned to check whether the provider was meeting the legal requirements and regulations associated with the Act, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

Inspection team:

The inspection was carried out by one inspector and an assistant inspector.

Service and service type:

Step Up Support is a 'care home'. People in care homes receive accommodation and nursing or personal care. The Care Quality Commission (CQC) regulates both the premises and the care provided, and both were looked at during this inspection.

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:

This inspection was announced. The registered provider was given short notice of our inspection. We did this because the service is small and we needed to ensure the registered manager would be available.

What we did:

Before this inspection we reviewed the information we held about the service, which included correspondence we had received, and any notifications submitted to us by the service. Statutory notifications are information the registered provider is legally required to send us about significant events that happen within the service. For example, where a person who uses the service has a serious injury. 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 contacted social care commissioners who help arrange and monitor the care of people using the service. We also contacted Healthwatch Sheffield. Healthwatch is an independent consumer champion that gathers and represents the views of the public about health and social care services in England. We used all of this information to plan our inspection.

We were not able to speak with some people using the service because we were unable to communicate verbally with them in a meaningful way. We reviewed the comments people and their relatives had made in the quality questionnaires surveys. We also contacted four people’s relatives by telephone to obtain their views about the service.

During the inspection we spoke with the registered manager and a senior care worker. We also spoke with two care staff by telephone. We looked at three people's care records. We checked a sample of medication administration records and three staff files, which included recruitment checks, supervisions and appraisals. We also looked at other records relating to the management of the service, such as quality assurance documents.

We looked around the building to check the service was safe and clean.

Updated 31 July 2019

About the service:

Step Up Support service provides short breaks for adults with learning disabilities. The service is based in a four bedroomed house. The house can accommodate three individuals for overnight stays. Staff provide night time support on a sleep-in basis for people staying at the service. At the time of the inspection there were 16 people using the service.

The service has 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:

Relatives spoken with did not express any concerns about the safety of their family member. Relatives made very positive comments about support that had been provided to their family member. Comments included, “Yes, it’s good” and “Absolutely fantastic. Very caring and sensitive to [family member] needs. They [staff] put themselves out for you.”

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.

Safeguarding procedures were robust and staff understood how to safeguard people.

Individual risk assessments were completed for people so that identifiable risks were managed effectively.

Systems were in place to make sure the manager and staff learned from events such as incidents, concerns and investigations.

Relatives spoken with didn’t express any concerns about the staffing levels at the service. The staff team planned and discussed the diary bookings and rota to ensure there were enough staff deployed to keep people safe and meet their needs.

There were robust recruitment procedures in place, so people were cared for by suitably qualified staff who been assessed as safe to work with people.

Medicines were managed safely at the service. The service had a robust system in place for receiving and returning people’s medication when they came for a short break.

People were supported by staff who knew them well. People’s care plans were person centred.

There was clear leadership in place, the registered manager supported people who came to stay at the service, so they got to know who she was. All the relatives spoken with made very positive comments about the staff team and the registered manager.

The service was clean and had a very welcoming homely atmosphere.

Staff had undertaken training which was regularly updated to ensure they had the skills and knowledge to support people effectively. Staff had received specialised training to meet the needs of people using the service. Staff told us they felt supported.

We saw that people’s care plans contained information about the type of decisions people were able to make and how best to support people to make these decisions.

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.

We saw people were offered a wide choice of food and their individual preferences were considered.

People were treated with dignity and respect. People could choose how they wished to spend their time when they came to stay at the service. People were supported to attend activities within the community.

People were supported to maintain their independence and some people engaged in activities of daily living such as, food shopping and cooking a meal.

Relatives spoken with felt confident they could raise any concerns with staff and the registered manager.

The registered manager had a good oversight of the service and were experienced in their role. Staff spoken with made very positive comments about the staff team and the registered manager.

There were planned and regular checks completed at the service to check the quality and safety of the service provided.

Rating at last inspection:

At our last inspection the service’s overall rating was good. The key question “Safe” was rated as requires improvement (report published 30 January 2017). At this inspection we found the service had made improvements to the assessment of people’s risks and achieved a rating of good for this key question.

Why we inspected:

This inspection was part of our scheduled plan of visiting services to check the safety and quality of care people received.

Follow up:

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

For more details, please see the full report which is on the CQC website at www.cqc.org.uk.