About the service Coquet Trust provides personal care and support or enablement to people with learning disabilities, autism or associated related conditions and/or mental health needs. 49 people received support with personal care. Although after the inspection, the management team confirmed this figure was to be reviewed as it was thought more people received personal care than they originally advised. CQC only inspects where people receive personal care. This is defined as help with tasks related to personal hygiene and eating. Where they do, we also consider any wider social care provided.
The service has been developed and designed in line with the principles and values that underpin Registering the Right Support and other best practice guidance. This ensures that people who use the service can live as full a life as possible and achieve the best possible outcomes. The principles reflect the need for people with learning disabilities and/or autism to live meaningful lives that include control, choice, and independence. People using the service receive planned and co-ordinated person-centred support that is appropriate and inclusive for them.
People’s experience of using this service and what we found
People received a caring and responsive service, but other aspects required improvement. There were issues and gaps in records which had not been effectively identified and addressed by the provider's quality assurance system.
Staff had not always received the support they needed, including regular supervisions or annual appraisals. Some staff had not received competency checks to ensure they were following safe working practices. There were enough staff to support people. However, we have made a recommendation regarding reviewing the number of hours staff work to ensure it is not excessive.
Medicines management needed some improvements, including in connection with recording medicines applied in the form of creams or ointments. The provider confirmed these issues were to be addressed immediately.
People were protected from abuse and staff advised they would report any concerns. Risks had been assessed for people and the provider was working through paperwork to ensure these were all up to date and relevant.
People were treated with kindness by caring staff. Care was person centred, but records needed to be further reviewed to fully reflect this. People were supported to maintain social inclusion.
Arrangements were in place for people and their relatives to raise complaints. We noted the associated policy needed to be updated.
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. Some best interest decisions records needed updated and reviewed. We have made a recommendation about the records in relation to keeping copies of lasting power of attorney or court of protection.
The service applied the principles and values of Registering the Right Support and other best practice guidance. These ensure that people who use the service can live as full a life as possible and achieve the best possible outcomes that include control, choice and independence.
The outcomes for people using the service reflected the principles and values of Registering the Right Support by promoting choice and control, independence and inclusion. People's support focused on them having as many opportunities as possible for them to gain skills and become more independent. However, outcomes were not always recorded fully or reflective of support or opportunities provided.
There was a registered manager formally registered with the service but they were no longer working for the provider and had not requested the CQC cancel their registration at the time of the inspection.
We found two breaches of regulations in connection with staffing and good governance.
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 good (published 18 May 2017). The service has now deteriorated and is rated as overall required improvement.
Why we inspected
This was a planned inspection based on the previous rating.
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 local authority to monitor progress. We will return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.