Archived: West Midlands

Updated 18 May 2023

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 Health and Social Care Act 2008.

Inspection team

The inspection team consisted of 1 inspector.

Service and service type

This service is a domiciliary care agency and supported living service. It provides personal care to people living in their own houses and flats.

Registered Manager

This provider is required to have a registered manager to oversee the delivery of regulated activities at this location. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Registered managers and providers are legally responsible for how the service is run, for the quality and safety of the care provided and compliance with regulations.

At the time of our inspection there was a registered manager in post.

Notice of inspection

We gave the service 24 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.

Inspection activity started on 30 March 2023 and ended on 13 April 2023. We visited the location’s office on 30 March 2023.

What we did before the inspection

We reviewed information we had received about the service since the last inspection. We sought feedback from the local authority who commission the service. We used the information the provider sent us in the provider information return (PIR). This is information providers are required to send us annually with key information about their service, what they do well, and improvements they plan to make. We used all this information to plan our inspection.

During the inspection

We spoke with the person supported by the provider. We also spoke with the registered manager, the newly appointed manager and 3 care staff. We also spoke with 1 professional who worked with the service.

We looked at 1 person’s care records and medicines administration records (MARs). We also viewed 3 staff files and documentation related to the governance of the service.

The provider sent us further documentation we had requested following the site visit including additional risk assessments and recruitment documentation.

Updated 18 May 2023

About the service

West Midlands is a domiciliary care service and supported living service providing personal care to people living with a physical disability and a learning disability. At the time of our inspection, there was 1 person receiving support as part of a supported living 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

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:

Actions had not always been taken to address the concerns raised at the last inspection. Protocols to guide staff when to administer ‘when required’ medicines were not in place. Recruitment documentation had been reviewed but action had not yet been taken to address gaps in recruitment files. For example, induction records were not always complete or checked by the registered manager to ensure staff had the training they needed to gain the skills and knowledge to be competent. Systems in place to check the quality of the service had not yet been embedded so the provider could not be assured whether they were effective in checking the quality of the service. The provider had developed audit tools to check the quality of the service, but they were not yet being used. Staff supervisions had been arranged but staff had not yet received supervision to check they had the skills to meet people’s needs effectively.

Staff supported the person to have choice and control over their life. Staff supported the person to be independent. The person was supported by staff to pursue their interests and engage in activities of their choice. Staff supported the person to play an active role in maintaining their own health and wellbeing.

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.

Right Care:

The person was supported by staff who treated them with kindness and compassion. Staff respected the person’s privacy and dignity. Staff understood how to keep the person safe and protect them from abuse. The person was supported by staff who were appropriately skilled to meet the person’s needs and keep them safe. The person was supported to take positive risks and risk assessments were in place to manage this risk.

Right Culture:

The person told us they thought the world of the staff. The person felt valued by staff who supported them. The person was supported by staff who were keen to learn and improve their knowledge around the person’s needs. Staff understood the person well and knew how to meet their needs. The person was involved in the planning of their care. The registered manager promoted a culture at the service that improved the person’s quality of life.

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 17 February 2023).

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 but the provider remained in breach of regulations.

Why we inspected

This inspection was carried out to follow up on action we told the provider to take at the last inspection.

Enforcement

We have identified breaches in relation to the governance of the service at this inspection.

Please see the action we have told the provider to take at the end of this report.

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.