We carried out a review of the data available to us about Wilmslow Supported Living Network on 6 July 2023. We have not found evidence that we need to carry out an inspection or reassess our rating at this stage.
This could change at any time if we receive new information. We will continue to monitor data about this service.
If you have concerns about Wilmslow Supported Living Network, you can give feedback on this service.
Wilmslow Supported Living Network is managed by Cheshire East Council and is registered to provide personal care to people living in supported living accommodation. The registered provider supports adults with learning disabilities or autistic spectrum disorders and supports them to live as independently as possible as tenants in their own homes.
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’s experience of using this service and what we found
People using the service received planned and co-ordinated person-centred care and support that met their needs and helped them to live a fulfilled lifestyle. People told us how they enjoyed opportunities to gain new skills and become more independent and we could see how this had resulted in positive outcomes for them.
People were supported to have choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests. Improvements were made during the inspection regarding consent to care to ensure peoples’ rights are always upheld in accordance with the law.
People were safe. Risk was managed proportionately, enabling people to live as independent lives as possible. Effective safeguarding systems, policies and procedures ensured people were safe and protected from abuse. Safeguarding concerns were responded to and managed effectively.
There was enough suitably trained and experienced staff who had good relationships with the people who used the service.
New staff were recruited safely and received induction training before they could provide care and support. Staff benefited from ongoing training including the nationally recognised care certificate which had been introduced since our last inspection.
Managers and staff knew the people who used the service well. They understood and respected their needs, wishes and worked effectively to enable them to live healthy lifestyles and achieve their goals and aspirations.
People received appropriate levels of support with their medication to ensure they were safe and their independence promoted. Medicines were managed safely and only given by staff who were trained to do so.
People were supported to maintain a balanced diet and were able to access health care services as and when needed.
Morale amongst the staff team was high. Staff told us that they appreciated support, guidance and direction of the management team and all without exception said they were proud to be associated with the service and the standard of care and support provided.
The management team had worked effectively to make improvements in the service identified at our last inspection. They demonstrated a commitment to provide person-centred, high quality care by engaging with everyone using the service and stakeholders. A range quality audits we carried out and we saw that actions were identified and addressed to make continuous improvements.
Rating at last inspection and update
The last rating for this service was requires improvement (published 15 June 2018) and there was a breaches of regulation on Good Governance . The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection we found improvements had been made and the provider was no longer in breach of regulations.
Why we inspected
This was a planned inspection based on the previous rating.
Enforcement
We have found evidence that the provider needs to make improvements regarding consent to care. We found no evidence during this inspection that people were at risk of harm from this concern. You can see what action we have asked the provider to take at the end of this full report.
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.
Wilmslow Supported Living Network is managed by Cheshire East Council and is registered to provide personal care to people living in supported living accommodation. The registered provider supports adults with learning disabilities or autistic spectrum disorders and supports them to live as independently as possible as tenants in their own homes.
This service provides care and support to people living in ‘supported living’ settings. 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.
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.
At the time of the inspection 19 people were being supported. There were five adjoining bungalows where 18 people lived and one house in the local area where one person lived. The people who lived in the bungalows had support available 24 hours a day; the one person who lived in the local area received scheduled support visits on a daily basis.
At the time of the inspection there was a registered manager in post. 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.
At the last inspection which took place in July 2016, we found a breach of regulation 18 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 (staffing). There was a lack of training and developmental opportunities for staff. The registered provider was awarded an overall rating of 'Requires Improvement'. Following the inspection the registered provider submitted an action plan which outlined how they were improving the standards of care and quality of service. During this inspection, we looked to see if the registered provider had made the necessary improvements.
During this inspection we found a number of improvements had been made however the registered provider was found to be in breach of ‘good governance'. We are taking a number of appropriate actions to protect the people who are being supported by Wilmslow Supported Living Network.
At the last inspection we found that staff were not provided with the necessary training opportunities to support their learning and development. During this inspection we found that training opportunities had improved and staff were being supported with a variety of different training courses.
Although the registered provider was no longer in breach of regulation in relation to ‘staffing’ we recommend that the registered provider consults best practice guidance in relation to training opportunities and 'Care Certificate' requirements.
Individual care plans and risk assessments were in place for each person who was being supported. However the records we reviewed did not always contain the most up to date information. We found inconsistent information and records did not always reflect the most relevant support needs or risks. Quality assurance systems were not always identifying areas of improvement which were required in relation to the quality and standard of care being provided.
You can see what action we told the provider to take at the back of the full version of the report.
We reviewed medication management processes. Medication was administered safely by staff who had received the appropriate medication training. Medication audits were being completed on a monthly basis and areas of improvement were being identified.
We have recommended that the registered provider reviews the PRN protocols in respect of ‘as and when needed’ medication which need to be in place.
The registered provider was operating in line with the principles of the Mental Capacity Act 2005 (MCA). However ‘consent’ records were not always completed by the people being supported. Records indicated that people were involved in the decisions being made about the day-to-day care but a further review of ‘consent’ documentation was needed.
Policies and procedures were available and accessible to all staff and staff were able to explain the importance of having policies and procedures in place. However, we identified that some were out of date and did not always contain the most relevant information
Staff were knowledgeable around the area of safeguarding procedures. Staff knew how to report their concerns and who they would report their concerns to. Staff had completed the necessary safeguarding training and there was an up to date safeguarding policy in place.
‘Accidents and incidents’ were being reported, recorded and monitored accordingly. Safeguarding incidents were routinely recorded by all staff and trends were monitored and analysed.
We received mixed feedback about staffing levels during the inspection. We were informed that the staffing levels and the use agency staff had improved but on occasion staffing levels needed to be better managed. We were informed by the registered manager that recruitment was an on-going issue but staffing levels had improved over recent months.
Staff personnel files demonstrated that safe recruitment practices were in place. This meant that all staff who were working for the registered provider had sufficient references and Disclosure and Barring System checks (DBS) in place.
The registered provider worked in conjunction with the local housing association to ensure the environment was well-maintained and the health and safety provisions were safely managed. Health and Safety audit tools were in place to monitor, assess and improve the quality and standards of the environments people lived in.
The bungalows we visited during the inspection were clean, odour free and well-maintained. There was a daily cleaning rota in place and there was evidence to suggest that infection control policies were being adhered to. This meant that people were living in safe and hygienic environments.
People and relatives we spoke with during the inspection expressed that the care which was provided was safe. People expressed that staff were approachable, responsive and would listen to their views and opinions.
People felt they were treated with respect and staff provided dignified and compassionate care. Relatives we spoke with told us they felt the staff were kind, caring and provided good quality care. Staff supported people to make decisions around their own nutrition and hydration.
People’s choices, preferences, likes and dislikes were taken into account and people told us that staff provided advice and guidance in relation to balanced diets.
There was a complaints policy and procedure in place and people and relatives knew how to make a complaint. The complaints procedure was evident in all care records and was visible in each of the bungalows we visited.
There was a range of different activities taking place for each person who was being supported. Activities were individually tailored and people expressed that they were supported to take part in activities and hobbies they enjoyed.
Processes were in place to gather feedback regarding the provision of care being provided. Processes ranged from ‘tenant’ meetings, care reviews and staff meetings.
Staff and managers promoted a culture of warmth, kindness and compassion towards the people they were supporting. Staff expressed that they felt supported by both the registered manager and senior members of staff. Staff explained that the team worked collaboratively for the benefit of the people they were providing care for.
The registered manager was aware of their regulatory responsibilities and was aware that CQC needed to be notified of events and incidents that occurred in accordance with the CQC’s statutory notifications procedures.
Wilmslow Supported Living Network is managed by Cheshire East Council. It provides personal care and a supported living service. It enables adults with learning disabilities or autistic spectrum disorder with additional associated needs to live as independently as possible as tenants in their own homes. At the time of our inspection visit there were 20 people being supported. There were five adjoining bungalows where 17 people lived and two houses in the local area where three people lived. The people who lived in the bungalows had support available 24 hours a day; the three people who lived in the local area received planned visits from staff during the day.
The service operates 24 hours a day, 365 days a week. The main office is situated at the Redesmere Centre. It has disabled access and a large car parking facility attached to the building.
The service had a registered manager in place. A registered manager is a person who has registered with the Care Quality Commission 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.
At the last inspection on 22 and 24 July 2014, we found training records and supervision for staff needed to be updated. The provider was rated as ‘requires improvement’ in the effective domain but achieved an overall rating of good.
Staff told us training was inconsistent, the provider did not consistently provide learning and development opportunities to maintain necessary skills to meet the needs of the people they care for and support.
This was a breach of Regulation 18 of Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 Staffing. You can see what action we told the provider to take at the back of the full version of the report.
Staff had received abuse training and understood their responsibilities to report any unsafe care or abusive practices related to the safeguarding of vulnerable adults. Staff we spoke with told us they were aware of the safeguarding procedure.
The provider had recruitment and selection procedures to minimise the risk of inappropriate employees working with vulnerable people. Checks had been completed prior to any staff commencing work at the service. This was confirmed from discussions with staff.
Staff responsible for administering medicines were trained to ensure they were competent and had the skills required. Medicines were safely kept and appropriate arrangements for storing medicines were in place.
People and their representatives told us they were involved in their care and had discussed and consented to their care. We found staff had an understanding of the Mental Capacity Act 2005 (MCA) and Deprivation of Liberty Safeguards (DoLS).
Comments we received demonstrated people were satisfied with their care. The registered manager and staff were clear about their roles and responsibilities. They were committed to providing a good standard of care to people at the supported living network.
A complaints procedure was available and people we spoke with said they knew how to complain. Staff spoken with felt the registered manager was accessible, supportive, approachable, and had listened and acted on concerns raised.
The registered manager had sought feedback from people who used the service and staff. They had formally consulted with people they supported and their relatives for input on how the service could continually improve. The provider had regularly completed a range of audits to maintain people’s safety and welfare.
We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was announced, We gave the provider 48 hours’ notice of our inspection to provide an opportunity for tenants to meet the inspection team during the visit .
This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008 and to pilot a new inspection process being introduced by CQC which looks at the overall quality of the service. Before we visited Wilmslow Supported Living Network we checked the information that we held about the service and the service provider. No concerns had been raised and the service met the regulations we inspected against at their last inspection on 23 and 27August 2013.
Wilmslow Supported Living Network is managed by Cheshire East Council. It provides personal care to 22 people and is a supported living service enabling adults with learning disabilities or autistic spectrum disorder with additional associated needs to live as independently as possible as tenants in their own homes.
The service operates 24 hours a day, 365 days a year. The main office is situated at the Redesmere Centre. It has disabled access and a large car attached to the building.
The registered manager had moved to another service and the new manager was in the process of applying for their registration with the Care Quality Commission. A registered manager is a person who has registered with the Care Quality Commission to manage the service and has the legal responsibility for meeting the requirements of the law; as does the provider.
Staff advised that the people they supported had chosen to be referred to as ‘tenants.' We have used this preferred term throughout our report.
Staff had a good understanding of the need to ensure tenants were safe. They understood their safeguarding procedures and told us they would not hesitate to report any type of allegation.
Tenants being supported by this service and their relatives were very happy with the standard of support provided. They were all very positive about the staff and gave lots of compliments about the staff team and the managers. Some of the tenants invited us into their own homes and during these visits we saw lots of examples of good communication and rapport delivered by staff to the people they were supporting.
Tenants told us they felt included and consulted in the planning of their support and that staff always helped them with choosing what they wanted to do. Those tenants that lacked capacity had relatives/representatives that acted on their behalf. Their relatives were wholly positive about the standard of support provided by the service.
Tenants, relatives and staff were all positive about how the service was managed. Tenants felt safe and secure and had no concerns about the service provided to them.
Training records and supervision for staff needed updating and access to updated training needed to be reviewed. Records could not always evidence that staff were being regularly supported and supervised by line managers and were not always accessing training when they needed it. Some staff had to wait for the next round of training to come up with the provider, rather than being able to access training whenever they needed it which meant that some staff were not always provided with training to meet the needs of the people they supported.
Tenants being supported by the service told us they were very happy with the support provided by the staff team. They made various comments such as:
'I like all of the staff especially the older staff'; 'The service is good' and 'I'm happy I'm going out later.'
Staff were positive about working for the service. They were well supported with their training needs to be able to meet tenants' individual needs. They had been supported with a lot of training to help them in their work including training on the 'Mental Capacity Act.'
The manager produced various quality assurance documents carried out recently by her line manager and the local authority contracts team. These quality audits helped to show on-going checks on the standards provided to tenants. They helped ensure that standards were consistently offered to show overall compliance in a variety of topics such as: supporting tenants with their finances; medications; complaints and safeguarding.
The two tenants we spoke to told us they "felt safe" and that they liked living in the accommodation on Henbury Road. They also told us that staff "were great and really kind".
Relatives who regular visitors to tenants told us and they had always seen staff treat people with respect and maintain their dignity.
One of the relatives told us that " never a day goes by that we don't give grateful thanks for the expert caring services that our relative receives from all staff, this is reassuring to us as parents to know that they are safe and happy".
The relatives told us they had no concerns or worries about the safety and well-being of their family members.