This unannounced inspection took place on 28 April 2015. Although this service has been in existence for many years it has been re-registered on 13 August 2014 to the current provider, Walsingham Supported Living and Community and Home Support Service. This is the first inspection under the new registration.
Walsingham- Supported Living and Community and Home Support Services provide personal care, support and assistance to people with a physical and learning disability living in their own flats and homes. 34 Maldon Road is a supported living scheme where people have tenancy agreements for their accommodation. There were three people living at Maldon Road, which is divided into four self-contained flats, based on two floors, with lift and stair access. There is a shared garden and office space at the house. In addition, the service also provides care and support to two people living in their own homes within the community.
The service had a registered manager at the time of the inspection. A registered manager is a person who has registered with the Care Quality Commission (CQC) to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.
People at the supported living accommodation were not always able to verbally communicate their needs. Staff used assistive technology such as telecare and fall mats to alert them when a person may have fallen or had a seizure. All these measures helped to ensure that people were kept safe. Healthcare professionals we spoke with were happy with the systems that had been put in place at Maldon Road to keep people safe.
Staff had received training to ensure the safety of the people they supported. Staff were able to describe what abuse and keeping people safe meant to them and the people they worked with. The registered manager told us that concerns or safeguarding incidents were reported and we saw documented evidence to confirm this.
People had individual risk assessments and risk management plans in their care files. Action plans were in place to help minimise the risks faced by people. These measures helped to ensure that people were kept safe while giving them the freedom to do what they liked doing.
The provider had arrangements for health and safety checks on the flats people lived in. These checks ensured people using the service were living in a safe and maintained environment. The provider had systems in place for the investigation and monitoring of incidents and accidents. Staff would monitor any actions implemented to reduce the risk of the incident or accident reoccurring.
We saw that safe recruitment processes had been carried out before staff started to work with people. There were enough staff employed to meet people’s needs. People’s medicines and medicines administration records (MAR) were kept securely and monthly monitoring checks helped to ensure the safe administration of medicines to people in their homes.
People were cared for by staff who had appropriate support and training to do their job. The provider had identified a range of mandatory training courses for staff including safeguarding adults, awareness of the Mental Capacity Act 2005 (MCA), the safe administration of medicines, health and safety and food hygiene. Staff had supervision sessions with the registered manager every six to eight weeks and felt supported by the registered manager.
Although many of the people using the service were unable to verbalise their consent, it was clear from speaking with staff that people were actively involved in making decisions about their care and support needs whenever they could. Staff had a good understanding of how and why consent must be sought and what to do if they felt people were not able to make decisions. The provider had policies and procedures which provided staff with clear guidance about their duties in relation to the MCA and consent.
We saw the dietary requirements for each person using the service were detailed and staff responded to people's individual dietary needs. Staff had developed menus which were based on people’s favourite meals. People were encouraged to help with the preparation of meals and tidying up afterwards.
People had access to healthcare professionals when they required this. Records showed that people could visit their GP at any time, and that other healthcare professionals were available when required. People had annual health checks and staff understood the importance for people to maintain good health and supported people with this.
Not all people were able to tell us if they were happy with the care they were receiving but we could see from our observations that they appeared happy and were comfortable with staff. We saw staff treated people with kindness and compassion and were enthusiastic in delivering the support people needed.
We saw that people's support plans were comprehensive and focussed on who the person was, this helped staff to have a better understanding of the people they were caring for. People using the service had regular reviews of their care and support plan. Whenever possible people were encouraged to make decisions. If a person needed additional support to make decisions they had access to advocacy services and social workers who could help them.
We saw that people privacy and dignity was maintained by staff.
The provider carried out an initial assessment of peoples support needs to check the person’s care and support needs could be provided by the service. People lived in individual self-contained flats. Staff said this could make people isolated and could have an effect on their behaviour. The registered manager in response to people’s changing needs has appointed an activities co-ordinator to find out what activities were available in the community, so that if people wanted to they could be supported to join in with events.
Support plans and risk assessments were reviewed annually or sooner if needed. Additional information from other people involved in people’s care was also included. There was a day to day breakdown of how a person liked to spend their time and how staff could help the person achieve this. This helped to ensure that people’s needs were met and changes made when necessary.
The provider had a complaints policy and procedure. The forms used by people wishing to make a complaint were in an easy to read format to help people understand the process.
The service was well-managed. The service had a registered manager in place who was aware of all aspects of the service including the support needs of all the people using the service. The registered manager encouraged a positive and open culture by being supportive to staff and by making themselves approachable.
Systems were in place to monitor and improve the quality of the service, such as annual satisfaction surveys. The manager attended local and national forums to ensure they kept up to date with any changes that may affect the support they offered to people.