Background to this inspection
Updated
5 May 2018
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.
This was a first comprehensive inspection for this service, following an office move in 2017. The inspection took place on 7, 8 and 15 March 2018. On 7 March we made telephone calls to people that used the service and their relatives. On 8 March we visited the office to review the documents associated with the running of the service. On 15 March we made telephone calls to staff.
We gave the service short notice of our inspection to ensure that people using the service could decide if they wished to receive a telephone call from us and to ensure we had the correct contact details for people and their relatives.
The inspection was completed by one inspector and one 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 and on this occasion their area of expertise was care for people with learning disabilities.
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. The provider returned the PIR and we took this into account when we made judgements in this report.
We reviewed the information we held about the service, including statutory notifications that the provider had sent us. A statutory notification provides information about important events which the provider is required to send us by law. We also contacted health and social care commissioners who place and monitor the care of people living in the home, and Healthwatch England, the national consumer champion in health and social care to identify if they had any information which may support our inspection.
During our inspection, we reviewed the CQC questionnaires 22 people using the service had completed which gave us feedback about the service. We also met two people in their home and spoke with another eight people on the telephone. We spoke with three relatives of people that use the service, three members of care staff, two deputy managers, and the registered manager. We also received feedback from one healthcare professional.
We looked at care plan information relating to six people, and three staff files. We also looked at other information related to the running of and the quality of the service. This included quality assurance audits, training information, handover information, and arrangements for managing complaints.
Updated
5 May 2018
This inspection took place on 8 and 15 March 2018 was announced.
This service provides care and support to people living in 56 different ‘supported living’ settings, so that they can live in their own home 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. At the time of the inspection the service was supporting 72 people with their personal care needs.
The service had a registered manager. 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.
The service demonstrated an excellent commitment to providing outstanding care which was embedded into the practices of the staff, the management team, and the registered manager. The service put people’s views at the forefront of the service and designed the service around their needs. People were given every opportunity to have the best life possible.
People were safe using the service. Staffing requirements were assessed in an innovative and dynamic way following consultations with people that used the service. The rotas reflected the support people required to maintain the choices they had made, and as a result the staffing arrangements were flexible to meet those needs.
The provider took a thorough approach to protect people from harm. Staff were supported to understand safeguarding in a wider context, and staff were confident they would report any matters of concern.
People were actively involved in decisions about their care and support needs. There were formal systems in place to assess people’s capacity for decision making under the Mental Capacity Act 2005. People’s nutritional needs were assessed and regularly monitored. People took as much control over their nutrition as they were able and staff supported people to learn and understand the importance of this.
People were treated with care, compassion, and great kindness. Staff had an empowering and empathetic attitude to support people’s personal development, and each person was supported in a way that was individual to them.
The registered manager recognised the importance and value of good advocacy and went above and beyond expectations to ensure people’s voices were heard and decisions were made that were in each person’s best interests. People’s diversity and individuality was celebrated and people were encouraged and able to share private or vulnerable matters with a consistent staff group that they could form caring relationships with.
Comprehensive assessments were made before people began using the service. People’s care packages were completely person centred and designed around each person’s individual needs, styles, preferences, and values. The format of each person’s care plan was designed by each individual which helped them display to new staff their likes and preferences.
People made great progress whilst they used the service and people were encouraged to discover and achieve their goals. People were able to gain their independence and this was celebrated with staff.
People’s end of life wishes were followed with pride and staff took great comfort when they had supported people to have the end of life they had wished for. Staff made significant efforts to ensure people’s preferences were followed.
People, their relatives, and professionals felt the service was very well run and commented on the positive approach of the management team. Feedback was acted on promptly and the registered manager was keen to look for new ideas which would further help improve people’s lives. Quality assurance systems were in place to ensure the standards of care were maintained and if necessary improved. People were extremely positive about the service they received.