Background to this inspection
Updated
5 February 2020
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 two inspectors and an Expert by Experience. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service.
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.
Notice of inspection
We gave the service 48 hours’ notice of the inspection. This was because it is a small service and we needed to be sure that the provider or registered manager would be in the office to support the inspection.
What we did before the inspection
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 two relatives about their experience of the care provided. We spoke with five members of staff including the registered manager, service manager and three support workers.
We reviewed a range of records. This included four people’s care records and medication records. We looked at four staff files in relation to recruitment and staff supervision. A variety of records relating to the management of the service, including policies and procedures were reviewed.
After the inspection
We continued to seek clarification from the provider to validate evidence found. We looked at training data and quality assurance records.
Updated
5 February 2020
About the service
Advance Housing and Support is a supported living service that provides personal care support to adults with learning disabilities. People using the service lived in their own flats. The provider had three sites where people received support across East London and Kent. At the time of the inspection 33 people were using the service.
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
People were supported by staff who knew how to identify and report abuse. People’s risk of harm was reduced as people had appropriate risk assessments.
People told us they felt safe with staff and there were enough staff to meet their needs.
Staff were recruited to the service safely and the provider ensured there were enough staff to meet people’s needs if there was to be a shortage.
People’s medicine was managed safely and staff were trained to manage medicine correctly.
The risk of infection was minimised as staff were provided with personal protective equipment to reduce the risk of cross infection.
People and their relatives thought staff were good at their jobs and had the necessary skills and experience. Staff received regular training, support and supervision to help them monitor their progress and performance in their role.
People received an initial assessment of needs before they received care to ensure their needs could be met. People’s health was monitored regularly and appointments with healthcare professionals made on their behalf as needed.
People and their relatives liked the staff who provided support and found them to be very kind and caring. Staff were non-discriminatory and treated people as individuals. People's sexuality was not documented in their care plan.
We have made a recommendation about recording people’s sexuality.
People’s dignity and privacy was respected, and their independence encouraged.
Care was personalised and regularly reviewed. People’s communication needs were met and people knew how to make a complaint. Staff showed empathy when discussing people's end of life wishes.
People and their relatives liked the registered manager and found them approachable. There were regular quality monitoring systems in place and people were encouraged to provide feedback on the service .
The service applied 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.
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.
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 7 July 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.