1-3 The Courtyard, Unit 24

Updated 3 May 2023

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 Health and Social Care Act 2008.

Inspection team

This inspection was carried out by 1 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.

Service and service type

1-3 The Courtyard, Unit 24 is a domiciliary care agency. It provides personal care to people living in their own houses and flats.

The service also provides support to people living in 1 separate ‘supported living’ setting, so 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.

Registered Manager

This provider is required to have a registered manager to oversee the delivery of regulated activities at this location. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Registered managers and providers are legally responsible for how the service is run, for the quality and safety of the care provided and compliance with regulations.

At the time of our inspection there was a registered manager in post.

Notice of inspection

We gave the service 24 hours’ notice of the inspection. This was because the service is small, and people are often out, and we wanted to be sure there would be people at home to speak with us.

Inspection activity started on 19 May 2023 and ended on 21 May 2023. We visited the location’s service on 19 and 20 May 2023.

What we did before the inspection

We reviewed information we had received about the service. We asked the registered manager to send us information relating to people's communication needs and asked the registered manager to gain consent from people and their relatives for us to visit or contact them. We used the information the provider sent us in the provider information return (PIR). This is information providers are required to send us annually with key information about their service, what they do well, and improvements they plan to make. We sought feedback from health professionals who worked with the service. This information helped support our inspection and we used all this information to plan our inspection.

During the inspection

We communicated with 10 people who used the service and 6 relatives about their experience of the care provided. We observed people's care and their interactions with staff to understand their experience. We used the Short Observational Framework for Inspection (SOFI). SOFI is a way of observing care to help us understand the experience of people who could not talk with us.

We spoke with 6 members of staff including the registered manager, service manager, team leader, and support workers. We reviewed a range of records. This included 3 people's support records and 3 medication records. We looked at 3 staff files in relation to recruitment. A variety of records relating to the management of the service, including policies and procedures were reviewed.

Updated 3 May 2023

About the service

1-3 The Courtyard, Unit 24 is a domiciliary care service providing personal care to people living in the Bolton area. The service provides support to people with a learning disability and autistic people as well as people with mental health needs. 1-3 The Courtyard, Unit 24 also provides a supported living service at one separate location.

At the time of our inspection there were 32 people using the domiciliary care service and 6 people using the supported living service. Not everyone who used the service received personal care. CQC only inspects where people receive personal care. This is help with tasks related to personal hygiene and eating. Where they do, we also consider any wider social care provided. At the time of the inspection there were 15 people receiving personal care in total.

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.

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

Right Support:

Staff focused on people's strengths and promoted what they could do, so people had a fulfilling and meaningful everyday life. People had a choice about their living environment and were able to personalise their flats. Staff supported people with their medicines in a way which promoted their independence and achieved the best possible health outcome. Staff supported people to play an active role in maintaining their own health and wellbeing. People had access to education and employment where this was identified as their preference.

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/ did not support this practice.

Right Care:

People received kind and compassionate care. Staff protected and respected people's privacy and dignity. They understood and responded to their individual needs. Staff understood how to protect people from poor care, abuse, and harm. The provider had robust safeguarding systems which included working alongside other agencies when things went wrong. Staff had training on how to recognise and report abuse and they knew how to apply it. People could communicate with staff and understand information given to them because staff supported them consistently and understood their individual communication needs. People could take part in activities and pursue interests tailored to them. The provider gave people opportunities to try new activities which enhanced and enriched their lives.

Right Culture:

People received good standard of care, support, and treatment because trained staff and specialists could meet their needs and wishes. Staff placed people's wishes, needs, and rights at the heart of everything they did. People and those important to them, including advocates, were involved in planning their care. Managers ensured risks of a closed culture were minimised so people received support based on transparency, respect, and inclusivity.

People told us they felt safe and knew how to raise concerns. Staff assessed health and safety risks and supported infection prevention and control processes. There were enough staff to meet peoples' needs and recruitment processes were ensured staff were suitable to work with vulnerable people. Peoples' health and nutrition needs were supported, and staff were aware of their responsibility to promote peoples' rights. Systems were in place to monitor quality and safety, and the provider sort regular feedback from people to improve their support.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection

The last rating for this service was good (published 20 July 2017)

Why we inspected

This inspection was prompted by a review of the information we held about this service.

For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for 1-3 The Courtyard, Unit 24 on our website at www.cqc.org.uk.

Follow up

We will continue to monitor information we receive about the service, which will help inform when we next inspect.