Choice Supported Living - West Midlands

Updated 30 November 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 was carried out by one inspector.

Service and service type

This service provides care and support to people living in three ‘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. Another manager had recently been recruited and we were told they would likely apply to become registered manager in the future.

Notice of inspection

We gave a short period notice of the inspection because some of the people using it could not consent to a home visit from an inspector. This meant that we had to arrange for a ‘best interests’ decision about this. We also needed to be sure the registered manager would be in the office to support the inspection.

Inspection activity started on 18 September 2019 and ended on 20 September 2019. We visited the office location on 19 September 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 and professionals 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 looked at any information available from Healthwatch. 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.

During the inspection

We spoke with one person who used the service and four relatives about their experience of the care provided. We spoke with three members of staff in addition to the new manager, the registered manager and the deputy manager and a professional involved in one person’s care.

We reviewed a range of records. This included three people’s care records and multiple medication records. We looked at two staff files in relation to recruitment and a variety of records related to the quality and safety of the audits.

After the inspection

We continued to seek clarification from the provider to validate evidence found and continued with phone calls as part of our inspection.

Updated 30 November 2019

About the service

Choice Supported Living - West Midlands is a supported living service providing the regulated activity of personal care to five people at the time of the inspection.

There were three supported living settings; one setting was shared by three people and two people lived alone. People were supported by staff during the day and night. 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.

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

One person told us they felt safe and we saw other people were at ease around one another and staff. Staff understood how to reduce people’s risks and to provide safe care. Systems ensured concerns related to people’s safety and potential abuse were appropriately escalated. Relatives and staff told us people received safe support with their medicines however we have made a recommendation about medicines management because systems were not robust. Relatives told us people’s homes were kept clean and a home we visited reflected this. Recruitment checks were carried out safely.

People’s needs had been assessed and were known to staff including how to safely prepare people’s meals. Staff felt they had the support and training needed for their roles. People had been supported to have their homes adapted to meet their needs and to access healthcare support when needed. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.

We saw, and relatives told us, people were well supported and treated by staff. The service had taken extra steps to support people when they might be distressed, for example during hospital stays. People were supported to have their views heard and to be involved in decisions about their care. People’s privacy and dignity was promoted.

The service reflected the principles and values of Registering the Right Support and other best practice guidance. These ensure that people who use the service can live as full a life as possible and achieve the best possible outcomes that include control, choice and independence.

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.

Care was planned to meet people’s needs and preferences and to promote good outcomes. This included encouragement to get involved in activities and social events. People’s communication needs were understood and met. Complaints had been appropriately responded to.

Relatives and staff described an open, inclusive service centred around meeting people’s needs. We found some inconsistencies in staff knowledge and how records and audits were completed. This did not always promote the quality and safety of the service as far as possible. The provider notified us of events and incidents as required although we had to prompt one recent incident which had not yet been shared with us. The registered manager understood their responsibilities to the CQC and took action in response to our inspection findings to help continuously improve the service.

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 November 2016).

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.