Walsingham Support - Supported Living West Cumbria

Walsingham Support- Supported Living West Cumbria is a domiciliary care service, providing personal care to people who may live with physical disability, mental health needs, learning disabilities or autistic spectrum disorder living in their own homes. The service supported people living across 26 houses in West and North Cumbria. Some people lived in their own houses. Other people lived in shared houses, where they had their own bedrooms and shared facilities such as communal areas, bathrooms and kitchens.

Not everyone who used the service received personal care. The Care Quality Commission (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 the service supported 56 people with personal care.

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

We expect health and social care providers to guarantee people with a learning disability and autistic people respect, equality, dignity, choices and independence and good access to local communities, that most people take for granted. ‘Right support, right care, right culture’ is the guidance CQC follows to make assessments and judgements about services supporting people with a learning disability and autistic people and providers must have regard to it.

Right Support:

Whilst people felt safe with the staff supporting them, we found further work was needed to ensure safeguarding concerns were identified by staff, raised appropriately and shared with relevant organisations. We have made a recommendation about this.

People had busy diaries of fulfilling and meaningful actives. This included working in charities in their local communities, pursuing chosen hobbies and taking part in sporting activities. People eagerly spoke of their achievements and were proud of these.

People were supported to have maximum choice and control of their lives. People were supported by staff in the least restrictive way possible and in their best interests; the policies in the service supported this practice.

Right Care:

Staff were kind and compassionate. Support staff treated people with dignity and respect. People were supported in a person-centred way that reflected their individual choices and enjoyed positive and meaningful interactions with staff.

Right Culture:

The provider did not always have effective systems and processes in place to support the delivery of high-quality care. Issues with the provider’s IT systems meant full, accurate and up to date information about people’s care needs was not always recorded in one place. This put people at risk of harm.

People were supported by skilled staff whose values, attitudes and behaviours empowered people to achieve their goals. Staff encouraged teamwork between people and a sense of empowerment to take individual and collective decisions in relation to their home surroundings.

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 29 May 2019).

Why we inspected

This inspection was prompted by a review of the information we held about this service.

We carried out an unannounced focused inspection on 21 June 2023. We inspected the Safe and Well-led key questions. For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating.

The overall rating for the service is requires improvement, based on the findings at this inspection.

We have found evidence that the provider needs to make improvements. Please see the Safe and Well-led key section of this full report.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Walsingham Support- Supported Living Services West Cumbria on our website at www.cqc.org.uk.

Enforcement and Recommendations

We have identified a breach in relation to good governance at this the service. Please see the action we have told the provider to take at the end of this report.

We have made a recommendation about safeguarding and CQC notifications.

Follow up

We will request an action plan from the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.

Walsingham Support, Domiciliary Care West Cumbria provides care and support to people living with a learning disability or autism, 16 people live alone in their own properties and eight people live in houses with one other person. There are two services with accommodation for five people, four flats where the care is provided on a shared basis and a block of flats for seven people where staff support all the tenants.

Not everyone using Walsingham Support, Domiciliary Care West Cumbria receives a regulated activity; CQC only inspects the service being received by people provided with ‘personal care’; help with tasks related to personal hygiene and eating. Where they do we also take into account any wider social care provided.

The care service has been developed and designed in line with the values that underpin the Registering the Right Support and other best practice guidance. These values include choice, promotion of independence and inclusion. People with learning disabilities and autism using the service can live as ordinary a life as any citizen.

People’s experience of using this service

People told us they felt safe. Staff had received suitable training about protecting vulnerable adults.

Good arrangements were in place to ensure new members of staff had been suitably vetted and they were the right kind of people to work with vulnerable adults. Accidents, incidents, complaints and concerns were responded to appropriately.

People told us they had good support from staff. The registered manager kept staffing rosters under review as people's needs changed. The service had some vacancies but were actively recruiting to these posts.

People told us staff understood their needs. Staff were appropriately inducted, trained and developed to give the best support possible. We met team members who understood people's needs and who had suitable training and experience in their roles.

People were happy with the arrangements for medicines support. Medicines were suitably managed with people having reviews of their medicines on a regular basis.

People saw their GP and health specialists whenever necessary. Staff took the advice of nurses and consultants. The staff team had good working relationships with local GP surgeries and with the learning disability health and social care teams.

Staff carried out assessments of need and reviewed the delivery of care for effectiveness. They worked with health and social care professionals to ensure assessment and review of support needed was suitable and up to date.

People told us they were supported to budget, shop and cook healthy meals. Some people had specialist support to maintain a healthy weight and staff were reviewing nutritional planning.

The service base was now located near the centre of Workington and the office had space for meetings, training and activities.

The staff team were aware of their responsibilities under the Mental Capacity Act 2005. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice.

People told us the staff were caring. We also observed kind and patient support being provided. Staff supported people in a respectful way. They made sure confidentiality, privacy and dignity were maintained.

Risk assessments and care plans provided detailed guidance for staff in the home. People in the service, their social workers and relatives, where appropriate, had influenced the content. The registered manager had ensured the plans reflected the person-centred care that was being delivered.

Staff could access specialists if people needed communication tools like Makaton or braille.

People told us they enjoyed the activities, interests and hobbies on offer.

The service had a quality monitoring system and people were asked their views in a number of different ways. Quality assurance had been used to draw up a new action plan for the service.

We had saw that the registered manager could deal with concerns or complaints appropriately. There had been two complaints in this service, which had been dealt with by the provider.

Records were stored securely. The team of deputy managers were reviewing and updating records relating to care delivery.

At the last inspection the service was rated Good (published 1/12/2017).

Why we inspected:

This inspection was part of our scheduled plan of visiting services to check the safety and quality of care people received.

Follow up

We will continue to monitor intelligence we receive about the service until we return to visit as per our re-inspection programme. If any concerning information is received we may inspect sooner.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk