Cooper Noble Care Ltd

Updated 22 February 2024

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.

As part of this inspection, we looked at the infection control and prevention measures in place. This was conducted so we can understand the preparedness of the service in preventing or managing an infection outbreak, and to identify good practice we can share with other services.

Inspection team

The inspection was undertaken by 1 inspector.

Service and service type

This service provides care and support to people living in seven '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.

Inspection activity started on 22 January 2023 and concluded 25 November 2023. We visited the services' office location and one of the supported living settings on 22 January 2023.

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 CQC 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. The registered manager was also the registered provider.

Notice of inspection

This inspection was unannounced.

What we did before the inspection

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

During the inspection

We spoke with the registered manager, service manager, service co-ordinator, senior support worker and a support worker. We spoke with 7 people who lived in the home and 5 relatives about their experience of the care provided.

We reviewed a range of records. This included 3 people's care records and medication records. We looked at records in relation to safe recruitment and a variety of records relating to the management of the service.

Updated 22 February 2024

About the service

At the time of our inspection, the service provided support to a total of 109 people living their own tenancies in a supported living community. Additional support was also provided on an outreach basis. Only 14 out of the 109 people however were in receipt of personal care regulated by CQC.

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

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. At the time of the inspection, the location provided support to three people with a learning disability or an autistic person.

Right care

There was a quality assurance system in place to check that people were in receipt of the support they needed. The manager monitored the completion of support tasks daily to ensure people received the support they needed. However, the number of people being supported with personal care had grown since our last inspection from 5 to 14 people, and we found that the quality assurance systems in place required further development to ensure they were fully able to effectively monitor the quality and safety of the service.

We saw that the provider had already identified the current management and governance framework was no longer fit for purpose. They were in the process of implementing a management structure to improve the governance arrangements in place. We recommended that the audits and checks in place were reviewed and expanded as part of this process.

Staff recruitment was safe. The number of staff on duty was sufficient to meet people’s needs and to ensure support was provided in a person centred way. People told us the same staff usually supported them and most were more than happy with the support they received. Comments included, “I’m really happy”; “They’re (Staff) versatile, they listen to your needs” and “All made me feel welcome, very kind, caring. We have a laugh, but they do their job”.

Right Support

Information about people’s medical needs needed to be more detailed and some risks were not adequately assessed. We found no evidence that anyone had been placed at risk or experienced harm with regards to this. We recommended however that the provider reviews the system in place to ensure it is fully able to identify and mitigate risk.

Medicines were managed safely. People were supported to administer their own medicines were possible. This was good practice. People told us they received the medicines they needed. Staff were trained in the administration of medication and had their competency assessed appropriately. There were some minor improvements needed with regards to the recording of medicines with variable doses, self administration and the checking of handwritten MARs. We spoke with the provider about this.

Accident, incidents and safeguarding events were recorded and reported with appropriate action taken. Where people needed additional support, staff had liaised with other external health and social care professionals appropriately.

Right Culture

During the inspection both the provider and the service manager involved in the running of the service were open and honest. We found that they had a good understanding of the service and were committed to ensuring people received good quality care that helped them achieve positive outcomes.

Staff spoken with were passionate about their roles and spoke with genuine warmth about the people they supported. They were knowledgeable about people’s needs and preferences and told us the provider was really supportive of their training and development needs and aspirations.

People told us they felt safe. They said staff supported them well and helped them live independently in their own home. They told us of the activities and interests they were supported to enjoy, and several people spoke about the positive outcomes they had achieved since receiving support from the service.

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

Rating at last inspection

The last rating for this service was good (published 14 December 2017).

The overall rating for the service remains good. 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 Cooper Noble Care Ltd on our website at www.cqc.org.uk.

Recommendations

We recommend the provider develop the systems in place to ensure people’s individual needs and risks are fully assessed and described.

We recommend the provider reviews and develops the quality assurance systems in place to ensure they are robust.

Why we inspected

This inspection was prompted by a review of the information we held about this service. We undertook a focused inspection to review the key questions of safe and well-led only.

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 remained as 'good' based on the findings of this inspection.

Follow up:

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