Background to this inspection
Updated
23 October 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. 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 Care Act 2014.
Inspection team
The inspection was carried out by one inspector and two assistant inspectors.
Service and service type
This service provides care and support to people living in two ‘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.
At the time of our inspection, 12 people were receiving the regulated activity of personal care.
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 four days’ notice of the inspection. This was because it is a small service and we needed to be sure that the provider or registered manager would be in the office to support the inspection.
What we did before the inspection
We used the information the provider sent us in the provider information return. This is information providers are required to send us with key information about their service, what they do well, and improvements they plan to make. 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 all of this information to plan our inspection.
During the inspection
We spoke with two people who used the service and five relatives about their experience of the care provided. We spoke with three members of staff, the registered manager, service manager and operations director.
We reviewed a range of records. This included two people's care and medication records. We looked at staff training and supervision records and records in relation to recruitment of staff.
After the inspection
We continued to seek clarification from the provider to validate evidence found. We looked at training data, best interest decision documents, quality assurance records, and written and email feedback from four staff and three healthcare professionals.
Updated
23 October 2019
About the service
Voyage (DCA) (Lincs) is a supported living service providing personal care to people with learning disabilities or autistic spectrum disorders and physical disabilities. At the time of the inspection the service was supporting 12 people at two separate locations in Sleaford.
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
The Secretary of State has asked the Care Quality Commission (CQC) to conduct a thematic review and to make recommendations about the use of restrictive interventions in settings that provide care for people with or who might have mental health problems, learning disabilities and/or autism. Thematic reviews look in-depth at specific issues concerning quality of care across the health and social care sectors. They expand our understanding of both good and poor practice and of the potential drivers of improvement.
As part of thematic review, we carried out a survey with the registered manager at this inspection. This considered whether the service used any restrictive intervention practices (restraint, seclusion and segregation) when supporting people.
No restrictive intervention practices were used.
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 new skills and become more independent.
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. However, the records relating to decision-making were not always in place or completed to a consistent standard. We made a recommendation to improve practice.
There were enough care staff to meet people's needs. We received mixed feedback regarding the deployment of sufficient numbers of staff to meet people's needs. One person said, “There has been a lot of agency staff but there is always someone I know on duty.” The registered manager was actively seeking to recruit staff at the time of the inspection. Staff were recruited safely, and their backgrounds checked before they started working in the home.
An effective system was in place to manage medicines. People were protected from abuse by staff who understood how to identify and report any concerns. The risks to people's health, safety and welfare had been assessed, recorded and plans put in place to reduce these.
People were supported to lead their lives in their chosen way. Staff engaged with people to enable them to follow their preferred hobbies and interests.
Staff were observed to be respectful and caring towards people. They understood the importance of promoting equality and independence. People's dignity and privacy were maintained by staff.
People and their relatives were involved in the planning of their care. Their care records contained good detail of their personal preferences and choices.
People could choose their meals and were supported to maintain a balanced diet to suit their needs..
Staff supported people to access appropriate healthcare services, including annual health reviews.
Peoples environments were well maintained and met people's needs appropriately.
Information was available in a variety of formats to help people understand. Staff told us they knew people's preferred methods of communication which was recorded in care records.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection
The service was rated as Good. (Last report published 16 January 2017).
Why we inspected
This was a planned inspection based on the previous rating.
Follow up
We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.