Sandwell Community Caring Trust

Updated 12 March 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 two inspectors, a specialist advisor (who was a qualified nurse), an assistant 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 provides care and support to people living in 66 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 a manager 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 24 hours’ notice of the inspection. This meant we could be sure the registered manager would be in the office to support the inspection and we had access to the records we required.

Inspection activity started on 01 February 2022 and ended on 14 February 2022. We visited the office location on 01 and 08 February 2022.

What we did before inspection

We reviewed information we had received about the service since the last inspection. We sought feedback from the local authority who work with 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. We used all this information to plan our inspection.

During the inspection

We visited seven people in their own homes and spoke with them about their experience of the care provided. We spoke over the telephone with a further eight people who used the service and 13 relatives about their experience of the care provided.

We spoke with nine members of staff including five senior carers, two managers, the registered manager and the nominated individual. The nominated individual is responsible for supervising the management of the service on behalf of the provider.

We reviewed a range of records. This included nine people’s care records and five medication records. We looked at three staff files in relation to recruitment and staff supervision. A variety of records relating to the management of the service, including policies and procedures were reviewed.

After the inspection

We continued to seek clarification from the provider to validate evidence found and we looked at training data. We spoke with one professional who regularly visited the service.

Updated 12 March 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 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

Sandwell Community Care Trust is located in West Bromwich in the West Midlands. It is a charity run trust and supports people who live in their own home. It is registered to provide personal care to people who have a learning disability and autistic people. At the time of the inspection Sandwell Community Care Trust provided support to 150 people.

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

Right Support

The service had not always supported people in a safe way when staff tested positive for COVID-19. On two occasions staff who had tested positive for COVID-19 had isolated with people in their own homes. One staff member had isolated with a person who had recently tested positive for COVID-19 and another staff member with a person who was displaying symptoms of COVID-19. Although the provider had completed a risk assessment and made a best interest decision this meant staff were working without a break and everything possible had not been done to minimise the risk of infection. This increased the risk to people of receiving unsafe care. When we discussed our concerns, the management team gave us assurances this would not happen again.

People were supported by staff to pursue their interests. Lots of people and relatives told us about holidays they had been on and activities they carried out. One person told us, “I go line dancing, Zumba, swimming, bingo, yoga and walks.” Another person liked technology and enjoyed going on their iPad and laptop. We observed staff helping them to update their laptop after they had been having difficulties so they could use it again.

Right Care

People’s care, treatment and support plans did not always accurately reflect their needs. In some people’s care plans, there was different guidance for staff on how to support people, and it wasn’t clear which one was the correct one. However, staff did know people’s needs well.

People received personalised care and staff understood and responded to people’s individual needs. People and most relatives spoke very highly of the support received, their comments included, “They make me feel everything is in hand,” “Couldn’t wish for better care and service” and “I would give 10 out of 10 as it’s what I need to live a full life.”

Staff understood how to protect people from poor care and abuse. The service worked well with other agencies to do so. Staff had training on how to recognise and report abuse and they knew how to apply it. People and most relatives told us they felt safe.

Right culture

The management team were making changes to ensure they were a reflective organisation with a learning culture to ensure people received good quality care and support. This culture needed to be further embedded to ensure they reflected on decisions and involved other professionals as appropriate.

Staff knew and understood people well and were responsive, supporting their aspirations to live a quality life of their choosing. Staff listened to people and supported them to do the things they liked to do. People told us about different activities and holidays they had undertaken supported by staff.

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.

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 inadequate (published 23 November 2021) and there were breaches of regulation. The provider completed an action plan and sent monthly reports to show what they would do and by when to improve. At this inspection we found improvements had been made to consent to care, safeguarding and staff competency and training. However, enough improvement had not been made in governance and we identified a breach of safe care and treatment.

The service has been in Special Measures since 21 September 2021. During this inspection the provider demonstrated that improvements have been made. The service is no longer rated as inadequate overall or in any of the key questions. Therefore, this service is no longer in Special Measures.

Why we inspected

We carried out an announced focused inspection of this service on 10 June 2021. Breaches of legal requirements were found. The provider completed an action plan and monthly reports after the last inspection to show what they would do and by when to improve consent, safeguarding, governance and staffing.

We undertook this focused inspection to check they had followed their action plan and to confirm they now met legal requirements. This report only covers our findings in relation to the key questions safe, effective and well-led which contain those requirements.

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 has changed from inadequate to requires improvement. This is based on the findings at this inspection.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Sandwell Community Caring Trust on our website at www.cqc.org.uk.

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 a breach of regulation in relation to safe care and treatment. Please see the action we have told the provider to take at the end of this report.

We have identified a continued breach of regulation relating to governance. We will continue to monitor the improvement within the service through existing conditions we have placed on the providers registration. This includes the provider sending a monthly report of the action they are taking to make improvements within the service.

Follow up

We will meet with the provider following this report being published to discuss how they will make changes to ensure they improve their rating to at least good. We will work with the local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.