Background to this inspection
Updated
6 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 Care Act 2014.
Inspection team
The inspection was carried out by one inspector, and two ‘Experts by Experience’. 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 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 specialist ‘extra care’ housing. Extra care housing is purpose-built or adapted single household accommodation in a shared site or building. The accommodation is bought or rented and is the occupant’s own home.
This service also provides care and support to people living in one residential ‘supported living’ setting; people are supported to 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.
Registered Manager
This service is required to have a registered manager. A registered manager is a person who has registered with CQC 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 there was not a registered manager in post.
An interim manager had been appointed, they had submitted all the relevant registration documentation to CQC and received confirmation of their registration status following the inspection.
Notice of inspection
We gave 24 hours’ notice of the inspection. This was because we needed to be sure the provider or manager would be in the office to support the inspection.
Inspection activity started on 17 March 2022 and ended on 23 March 2022. We visited the office location on 17 March 2022.
What we did before the inspection
We reviewed information we received about the service. We sought feedback from the local authority and professionals who work with the service. The provider was 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 the information to plan our inspection.
During the inspection
We spoke with eight people over the phone who used the service and three relatives who were involved in their loved one’s care packages. We also spoke with one person who requested to speak with us face to face. We spoke with the manager, operations manager and five members of staff.
We reviewed a range of records. This included five people’s care records, multiple medication records, four staff personnel files in relation to recruitment and staff supervision and a variety of records relating to the management of the service, including policies and procedures.
After the inspection
We continued to seek clarification from the provider to validate evidence found. We looked at training data and quality assurance records and liaised with one external professional who works in partnership with the service.
Updated
6 May 2022
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 The Care Quality Commission (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.
About the service
A Next Stage ‘A Way Forward’ - Warrington is a domiciliary care agency, supported living service and offers ‘extra care’ housing provision to younger and older adults. The service provides personal care to people living with addiction issues, physical disabilities, sensory impairments, mental health support needs and learning disabilities and/or autistic spectrum disorders. Personal care was provided either in the community (across the borough of Warrington), in one residential shared property or across two adapted buildings, each offering single occupancy accommodation.
At the time of the inspection 39 people were receiving personal care across the different services. Not everyone who used the service received personal care. CQC only inspects where people receive personal care. ‘Personal Care’ 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
Right support
The model of care and settings help to maximise choice, control and independence. People are empowered to remain independent and are involved in the provision of care they receive.
Right Care
People's dignity, privacy and human rights were respected and supported. People received personalised care that was tailored around their likes, wishes and preferences.
Right Culture
The ethos, values and attitudes of leaders and care staff helped to ensure people were encouraged to live confident, inclusive and empowered lives.
Quality assurance and governance measures were in the process of being improved by the manager. We were not always assured that current quality performance or risk management measures were always monitoring or managing quality and safety of care.
Risk assessment and review processes needed to be strengthened. We identified that additional oversight and assurance measures need to be implemented as a way of ensuring that all areas of risk were appropriately recorded and monitored. We have made a recommendation regarding this.
Covid-19 had impacted staffing levels; the provider acknowledged that increased staffing levels were required. The manager and local authority were actively discussing staffing levels and deployment of staff. Recruitment was on-going; measures and procedures to recruit staff safely were in place.
Infection prevention and control (IPC) arrangements were in place. Staff were provided with the relevant personal protective equipment (PPE) and were engaged in routine weekly COVID-19 testing regimes.
Safe medication administration procedures were in place. Staff received the necessary medication administration training, regularly had their competency levels checked and a greater level of compliance oversight had been introduced.
Safeguarding reporting and investigation procedures were in place. Staff knew how to escalate their concerns, knew who to contact and expressed the importance of keeping people safe.
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.
Care records contained person-centred information, positive relationships developed and people expressed that staff provided care and support that was centred around them and their wishes.
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
This service was registered with us on 21 January 2021 and this is the first inspection at this registered location. The last rating for the service (at the previous registered location) was ‘good’ (published 18 May 2018).
Why we inspected
This inspection was prompted by a review of the information we held about this service.
Follow up
We will continue to monitor information we receive about the service, which will help inform when we next inspect.