TNCT Supported Living

Updated 5 June 2021

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.

As part of this inspection we looked at the infection control and prevention measures in place. This was conducted so we can understand the preparedness of the service in preventing or managing an infection outbreak, and to identify good practice we can share with other services.

Inspection team

The inspection was completed by one inspector

Service and service type

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

This service also 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 two managers 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.

Inspection activity started on 19 April 2021 and ended on 4 May 2021. We visited the office location on 19 April 2021.

What we did before the inspection

We reviewed information we had received about the service since they registered with CQC. We sought feedback from the local authority and professionals who work with the service.

The provider was not asked to complete a provider information return prior to this inspection. This is information we require providers to send us to give some key information about the service, what the service does well and improvements they plan to make. We took this into account when we inspected the service and made the judgements in this report.

We used all of this information to plan our inspection.

During the inspection-

We visited the registered office to review records and speak with the two registered managers. We looked at five care plans and risk assessments, three recruitment records and staff training files. We also looked at a range of other documents such as policies and procedures, complaints, staff supervisions, quality audits and staff training.

We visited two people who lived in one of the supported living services. We spoke in detail to one of these people. We spoke with two staff during this visit.

We spoke with four staff via video call and we also spoke to two further staff via phone calls and had feedback via email from one further staff member. We spoke by phone to four people who received domiciliary care in their own homes and to two relatives.

After the inspection –

We sought feedback from two healthcare professionals.

Updated 5 June 2021

About the service

TNCT Supported living service provides care and support to people in their own homes. There are two arms to this service. One part provides 24-hour care and support to people in their own tenancies. This service has been set up for people with learning disabilities and autism. The other part of the service provides care in people’s own homes. Packages of care vary and are tailored to meet individual’s needs. This domiciliary arm of the service provides care and support for people of all needs, including frail elderly, physical disabilities and covers Bideford and the surrounding area. Each of these services have a separate registered manager and separate staff team.

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 and their relatives were extremely positive about the care and support provided by this service. Comments included “Very happy with service, staff very helpful and kind, really top notch.”

People who received shared hours and 24-hour care said their staff team knew them well and helped them in ways which supported their independence. For example, one person said “Staff help me with getting drinks and meals. I don’t like housework, but staff help me with this.”

Care and support were planned to ensure people’s needs and wishes were taken into account. Risks were assessed and carefully monitored to ensure individuals and staffs safety.

People were supported to take their medicines when required. Staff received training and support to ensure the medicine records were accurate and up to date.

Staff were knowledgeable about people’s needs wishes and preferred routines. Staff said they had been given a comprehensive induction, ongoing training and support which enabled them to do their job safely and effectively.

People’s healthcare, nutritional and mobility needs were fully considered and where needed monitored. Staff ensured people were supported to maintain a healthy balanced diet and to attend any healthcare appointments when needed.

Systems were in place to ensure quality monitoring was embedded and this included seeking the views of people, staff and other professionals.

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.

We expect health and social care providers to guarantee autistic people and people with a learning disability the choices, dignity, independence and good access to local communities that most people take for granted. Right Support, right care, right culture is the statutory guidance which supports CQC to make assessments and judgements about services providing support to people with a learning disability and/or autistic people.

This service was able to demonstrate how they were meeting the underpinning principles of Right support, right care, right culture.

Right support:

• Model of care and setting maximises people’s choice, control and independence.

People had individual tenancies in their own home or small home with a few others. Care and support had been developed around individual assessed needs. Staff worked in a way which promoted people’s independence. For example, one person said “Sometimes I do things with (name of person sharing their tenancy), but sometimes I do my own thing. Staff help me to choose what I would like to do and then we do it. I love shopping and I am hoping to go back to college.”

Right care:

• Care is person-centred and promotes people’s dignity, privacy and human rights

People said their privacy and dignity was always respected. For example, staff always knocked on their door. Staff did not just enter the person’s home. Plans were person centred and ensured the individual was fully involved in the development and review of their plan as far as possible. Training and support for staff ensured human rights was at the heart of the delivery of care and support.

Right culture:

• Ethos, values, attitudes and behaviours of leaders and care staff ensure people using services lead confident, inclusive and empowered lives

The ethos of the supported living service was to develop support packages which suited individuals and helped them live the best life possible in an area they wished to live. They organisation have taken time to develop their plans, ethos and staff teams so that they can ensure they are fulfilling what people actually want and need. They were working with housing providers to develop the service further but at a pace which ensured as new projects came on line they had the right staff with effective training and leadership. To this end they have employed two registered managers and used a consultant to help develop the service over the last year. Although this service had been registered for over a year, they have taken a planned slow approach to make sure they had the right support in place.

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

This service was registered with us on 14 April 2020 and this is the first inspection.

Why we inspected

This was a planned inspection as we had not inspected or rated them before.

We looked at infection prevention and control measures under the Safe key question. We look at this in all inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.

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.