Background to this inspection
Updated
19 June 2019
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. This inspection was planned to check whether the provider was meeting the legal requirements and regulations associated with the Act, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.
Inspection team:
The inspection was carried out by an adult social care inspector and an expert 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. They had experience of caring for people with learning disabilities and older people.
Service and service type:
This is a supported living service. It provides personal care to people living in their own homes. It provides a service to younger and older adults and people who may have a learning disability, autism, mental health or physical disability.
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 5 days’ notice of the inspection site visits because we needed to plan to visit people in their own homes and speak with people over the telephone.
Inspection site visit activity started on 24 April 2019 and ended on 3 May 2019. We visited the office location on 24 and 29 April 2019 to see the manager and office staff; and to review care records and policies and procedures.
What we did:
Before our inspection visit, the registered manager completed a Provider Information Return (PIR). This is a form that asks the provider to give some key information about the service, what the service does well and improvements they plan to make. We also reviewed information we held about the service in the form of statutory notifications received from the service and any safeguarding or whistleblowing incidents, which may have occurred. A statutory notification is information about important events, which the provider is required to send us by law. We also checked for feedback we received from members of the public and local authorities. We used all this information to plan our inspection.
During the inspection we spoke with seven people who used the service and nine relatives to ask about their experience of the care provided. We also spoke with the registered manager, four team coordinators and seven support workers.
We reviewed a range of records. This included, four people's care records and two staff files around recruitment. We also looked at various records in relation to medication, training and supervision of staff, records relating to the management of the service and a variety of policies and procedures implemented by the provider.
Updated
19 June 2019
About the service: Cheshire and Midland Support Living provides personal care to people in their own homes within a supported living setting. 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.
At the time of the inspection there were 34 people receiving personal care, some of whom may have a learning disability, autism, mental health or physical disability. There were16 separate properties in various community settings, which ranged from supporting one person to a maximum of five people.
The care service has been developed and designed in line with the values that underpin the Registering the Right Support and other best practice guidance. These values include choice, promotion of independence and inclusion. People with learning disabilities and autism using the service can live as ordinary a life as any citizen.
People’s experience of using this service:
The service was very responsive to people's needs. People's confidence and independence had increased since they had received support from the service. People were encouraged to live full and active lives and the service supported people to achieve their goals. Activities were meaningful and reflected people's interests and personal preferences. People were encouraged to find work opportunities and learn new skills.
People and their relatives were positive about the support they received. They were well supported to have control and choice over their care and support. An in-house support team was available which included professionals providing expertise in autism and positive behaviour support (PBS). This support meant staff were quickly able to seek help, support and guidance and implement effective strategies to support people. There were many examples of how these strategies had resulted in positive outcomes for people.
People felt safe and were supported by staff who understood how to report concerns and manage risks to keep people safe. The registered manager acted and reported safeguarding concerns when these were identified. Staff were recruited safely, and people were generally supported by a regular team of staff. Medicines were given in a safe way and lessons were learnt when things went wrong.
Processes were in place to protect people from avoidable harm. Risks to people had been assessed and were safely managed, people were supported to take positive risks.
Staff received training that was appropriate to their role and supported them in providing care in the way people wanted. Staff worked with health and social care professionals and followed their guidance and advice about how to support people.
Where people lacked capacity to make their own decisions we saw that best interests’ decisions had been made. We noted that one person's capacity assessment and best interest decision needed review to ensure it remained current.
Staff treated people with dignity and respect and took account of their individual needs when providing care and support. People told us they felt listened to and were able to express their views.
The service had recently expanded, and a few new supported houses had been opened. The provider had identified the need to support the registered manager to oversee the larger service and were recruiting a project manager. The registered manager was aware of areas within the service where they needed to focus, such as staffing, promoting person centred care and was supporting the staff to achieve this.
The management team demonstrated a commitment to provide person-centred, high quality care by engaging with everyone using the service and stakeholders. A full range of detailed quality audits we carried out and we saw that actions were identified and addressed to make continuous improvements.
Rating at last inspection: Outstanding (Report published October 2016). At this inspection the overall rating has been judged as Good.
Why we inspected: This was a planned inspection based on the rating at the last inspection.
Follow up: We will continue to monitor this service and plan to inspect in line with our inspection schedule for those services rated outstanding.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk