We carried out a review of the data available to us about Devon Enhanced Recovery Service on 6 July 2023. We have not found evidence that we need to carry out an inspection or reassess our rating at this stage.
This could change at any time if we receive new information. We will continue to monitor data about this service.
If you have concerns about Devon Enhanced Recovery Service, you can give feedback on this service.
Devon Enhanced Recovery Service is a supported living service which provides care and support to people living in two ‘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. At the time of our inspection four people were receiving ‘personal care.’
People’s experience of using this service and what we found
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.
The service provided safe care to people. People felt safe and supported by staff in their homes. Comments included: “I feel safe here and would speak to the staff if I was concerned about anything.” Comprehensive risk assessments were in place. Medicines were safely managed on people’s behalf.
Care files were personalised to reflect people’s personal preferences. People were supported to maintain a balanced diet. Health and social care professionals were regularly involved in people’s care to ensure they received the care and treatment which was right for them.
Staff relationships with people were caring and supportive. Staff treated people with dignity and respect when helping them with daily living tasks. The service ensured people led meaningful and fulfilled lives.
There were safe staff recruitment and selection processes in place. People received effective care and support from staff who were well trained and competent.
Staff spoke positively about communication and how the manager worked well with them and encouraged their professional development.
A number of methods were used to assess the quality and safety of the service people received, and continuous improvements were made in response to the findings.
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 last rating for this service was requires improvement (published 23 November 2018) and there were multiple breaches of regulation. The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection we found improvements had been made and the provider was no longer in breach of regulations.
Why we inspected: This was a planned inspection based on the previous rating.
You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Devon Enhanced Recovery Service on our website at www.cqc.org.uk.
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.
Devon Enhanced Recovery Service provides a supported living service to people with mental health needs so they can live as independently as possible. At the time of the inspection, the service was supporting seven people living in two shared houses. 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.
Not everyone using Devon Enhanced Recovery Service receives a regulated activity; CQC only inspects the service being received by people provided with ‘personal care’ support, that is, help with tasks related to personal hygiene and eating. Where they do, we also take into account any wider social care provided. Two of the seven people using the service were receiving support with their personal care; we therefore only looked at the support these two people received.
The service had a registered manager; however, they were on a period of leave at the time of the inspection. 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. An acting manager had been appointed the week prior to the inspection and they were available on both days we visited.
During the inspection we met with both people receiving personal care support. One person chose to speak with us about their experiences: they said they felt safe and the staff were nice.
The service used a high number of agency staff who were less familiar with people’s support needs and who had limited access to people’s support records. At times only agency staff were available at the shared house where the two people receiving personal care support lived.
Staff were not always provided with the training and support they needed to undertake their job. Recruitment records had not been fully completed for all staff and it was not possible to ascertain their suitably to work at the service.
We reviewed the documentation used by the service to record people’s care needs and any associated risks. We found the records available did not provide staff with a clear description of people’s needs or how they should offer support. This meant that staff did not have all the information they needed to support people in a consistent way that promoted their independence: this was particularly important as the service used a high number of agency staff. Risks to people’s health, safety and well-being had been identified. However, the information to guide staff about how to support people in a way that minimised these risks was insufficiently detailed to ensure people were supported as safely as possible.
Important information about how to support one person with their medicines was not included with the medicine administration records. This placed the person at risk of being given medicines when their GP had instructed staff to withhold this if they drank alcohol.
Both people receiving personal care support had long-standing health conditions, including those relating to eating. The support plans to guide staff about how to support people in line with their best interests and in a way that protected their health were either not detailed or not available.
Throughout our inspection we observed people being supported by staff who were respectful and friendly, and who demonstrated their fondness and interest in people. Staff provided people with one to one opportunities to share their views about how they were being supported. However, a formal process for obtaining feedback from people had not been undertaken for some time.
The person we spoke with said they felt comfortable raising concerns or making complaints. All complaints were recorded in people’s individual records and reviewed by a manager to try to resolve the matter.
The service was managed from one of the shared houses. However, the office staff had encroached into the shared communal space of this home with information posters and a ‘staff only’ toilet in the hallway. In the second shared house, the staff sleeping-in room was being used as an office. The supported housing manager confirmed the provider was seeking other office accommodation outside of people’s homes.
We identified five breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.
You can see what action we told the provider to take at the back of the full version of the report.