Background to this inspection
Updated
19 May 2022
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
An Inspector and an Expert by Experience carried out the inspection. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service.
Service and service type
This service provides care and support to people in two houses, living in a supported living setting, 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.
This service is required to have a registered manager. A registered manager is a person who has registered with the Care Quality Commission to manage the service. 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.
At the time of our inspection the registered manager had recently transferred to another service and was in the process of deregistering as manager for this service. They were present at the inspection as well as a manager who had returned to manage the service and applied to register with the Commission.
Notice of inspection
We gave the service 24 hours’ notice of the inspection. This was because the service is small and people are often out and we wanted to be sure there would be people at home to speak with us.
What we did before inspection
We reviewed information we held about the service which included notifications of events and incidents at the service. We asked the local authority for their views about the service.
The provider was not asked to complete a Provider Information Return (PIR) prior to this inspection. A PIR is information providers send us to give some key information about the service, what the service does well and improvements they plan to make.
This information helps support our inspections. We used all of this information to plan our inspection.
During the inspection
We spoke with two people who used the service in person and one person using the service by phone. We spent time observing people interacting with staff in the communal areas. We also spoke with three relatives after the inspection about their experience of the support provided.
We spoke with two members of staff, an agency worker, the new manager and the registered manager on the site visit. We contacted two staff members by phone following the site visit to seek their views about the service.
We reviewed a range of records. This included three people’s care records and three medication records. We looked at three staff records and a variety of records relating to the management of the service, including meeting minutes and audits.
After the inspection
We continued to seek clarification from the provider to validate evidence found. We looked at training data and quality assurance records.
Updated
19 May 2022
About the service
Century Way provides personal care to people with a learning disability in a supported living setting. People using the service lived in one of two houses with shared communal facilities. 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. At the time of our visit, the service supported four people with personal care needs.
People’s experience of using this service and what we found
We found the provider’s oversight of fire risk was not effective and there were not enough staff to support people to safely evacuate at night. Some staff were not familiar with the fire evacuation equipment. These issues had not been identified through the provider’s quality monitoring processes, but, were addressed promptly following the inspection.
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.
The service was able to demonstrate how they were meeting the underpinning principles of Right support, right care, right culture.
Right support:
The model of care and setting maximised people's choice, control and independence. Staff supported people to make decisions following best practice in decision-making. Staff supported people to achieve their aspirations and goals.
People could take part in activities and pursue interests that were tailored to them. The service gave people opportunities to try new activities or seek employment in a way that enhanced and enriched their lives.
Staff knew people well and communicated with people in ways that met their needs. Staff enabled people to access specialist health and social care support in the community.
People had a choice about their living environment and were able to personalise their rooms.
Right Care
Staff understood how to protect people from poor care and abuse. Staff had training on how to recognise and report abuse and they knew how to apply it.
Risks to people’s health, emotional state or behaviours were identified and staff worked with people to reduce possible risks.
Medicines were safely managed. Staff followed good infection prevention practice.
People received kind and compassionate personalised care. Staff protected and respected people’s privacy, dignity and human rights. They understood and responded to their individual needs.
Staff received appropriate training to support people and to empower them to be as independent as possible.
Right Culture
The provider had systems to seek feedback from people about the service and the support they received. Staff spoke of working to increase people’s independence and empowering them to make active decisions. However, records of some meetings did not always evidence how people were involved and empowered to make decisions or give feedback. Staff notices or equipment intruded into some areas of people’s homes.
Staff knew and understood people well and engaged with them. They were responsive, to their needs and wishes, and supported them to live a life of their choosing.
People knew how to complain if they were unhappy with the service.
The provider evaluated the quality of support provided to people, involving the person, their families and other professionals as appropriate. An action plan had been developed to address some areas for improvement.
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 the service under the previous provider was Good published on 7 November 2019.
Why we inspected
We undertook this inspection to assess that the service is applying the principles of Right support right care right culture and provide a rating for the service.
Enforcement
We are mindful of the impact of the COVID-19 pandemic on our regulatory function. This meant we took account of the exceptional circumstances arising as a result of the COVID-19 pandemic when considering what enforcement action was necessary and proportionate to keep people safe as a result of this inspection. We will continue to monitor the service and will take further action if needed.
We have identified breaches in relation to fire risk and staffing levels. Please see the action have asked 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 return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.