12 April 2021
During an inspection looking at part of the service
Support for Living Domiciliary Care Agency provides personal care and support to people living in supported living accommodation in North West London. The service is part of Certitude, a London based, not for profit, social care provider for people with learning disabilities, autism, mental health needs or multiple needs.
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.
At the time of our inspection, 125 people were receiving support with personal care across 25 different supported living houses.
People’s experience of using this service and what we found
In some of the schemes we found improvements were needed to safety, infection control and medicines management. We discussed this with the provider, and they addressed these issues and developed an action plan to make improvements.
People experienced personalised care which met their needs and reflected their preferences. The provider was committed to reducing restrictive practices and staff understood this and worked with individual people to enable them to take risks and develop their independence. People's care was planned to meet their individual needs, with staff working alongside healthcare professionals to make sure people received the right support.
The staff were well trained, supported and knowledgeable. They demonstrated a good understanding of the people they were caring for and were able to use a variety of communication methods to allow people to make choices and have control over their lives. The staff were able to access the training and support they needed and felt valued.
The provider had effective systems for addressing concerns and making improvements to the service. They undertook quality checks and responded appropriately when things went wrong. People using the service, their families and staff felt managers were approachable, open, and listened to them.
There were local and provider level strategies to promote human rights and improve the quality of people's experiences. For example, the provider had improved the way they supported staff and people using the service with protected characteristics to feel included, safe and respected.
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 expect health and social care providers to guarantee autistic people and people with a learning disability the choices, dignity, independence and good access to local communities that most people take for granted. Right Support, right care, right culture is the statutory guidance which supports CQC to make assessments and judgements about services providing support to people with a learning disability and/or autistic people.
This service was able to demonstrate how they were meeting the underpinning principles of Right support, right care, right culture.
Right support: People were supported to live within settings that met their individual needs. There was a robust assessment process which included involving people, their families and other stakeholders to make sure care was personalised and maximised people's choice while meeting their needs. People were supported to learn independent living skills and take risks to enhance their quality of life.
Right care: Care was provided in a person-centred way which promoted people's dignity and rights. Their lifestyle choices, religion, sexuality, culture and disabilities were respected and they were given the right care and support to live their lives to the full.
Right culture: There was a positive culture where staff were committed to caring for people. They knew people well and wanted to support them in a personalised way. They felt a sense of pride in people's achievements and happiness. The leadership created positives values and behaviours which were embedded and echoed throughout the service and in the day to day support of people being cared for.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk.
Rating at last inspection (and update)
The rating at the last inspection was outstanding (Published 5 April 2018). Whilst we found the service still had some outstanding qualities, we judged that these were not enough to rate the service outstanding in any key questions or overall. We also identified improvements were needed to ensure the safety of people using the service at all times. The provider addressed these concerns when we discussed them with the registered manager and nominated individual.
Why we inspected
The inspection was prompted in part by information about a number of incidents where people had been harmed. We carried out an inspection to assess whether standards of safety and quality were being met. Whilst we identified potential risk of harm in some areas, we were satisfied people were receiving a good service and the provider had responded appropriately to these concerns.
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.