This comprehensive inspection took place on 11 and 12 July 2018 and was announced. This was first inspection since a new provider, United Response, registered the service on 27 June 2017. United Response Supported Living Exeter and East Devon (formerly known as Robert Owen Communities) provides personal care to 12 people in supported living in Exeter, Exmouth and Honiton areas. Support ranged from a few hours a week to 24 hours a day. This was so people could live in their own home as independently as possible. United Response is a UK wide registered charity that supports adults and young people with learning disabilities, including autism, sensory impairment, and people living with dementia, mental health needs and physical disabilities.
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. People using the service lived in houses with their own bedroom and shared toilet, bathroom, kitchen and lounge facilities. Everyone paid rent to a landlord and contributed towards shared utility bills and other expenses.
Not everyone using United Response Supported Living Exeter and East Devon receives the regulated activity; CQC only inspects the service being received by people provided with ‘personal care’; help with tasks related to personal hygiene and eating.
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, the service did not have a registered manager. The previous registered manager had moved to a new post and deregistered. Another manager who worked in the service had taken on the role and was in process of registering with the Care Quality Commission. 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.
People were at the heart of the service, which was organised to suit their individual needs and aspirations. People were supported by exceptionally committed staff that were compassionate and treated them with the utmost dignity and respect.
Care and support was person centred and well planned. People were part of their local community and led interesting and fulfilling lives. Staff supported them to live as independently as possible and do their own cooking, shopping, laundry and housework, according to their ability. People had a wide range of hobbies and interests, and were part of their local community.
Prior to the inspection we received several safeguarding alerts from the service about a person whose behaviours others found challenging. Although none of the people involved received a regulated activity, the service kept us up to date about how they were working with those people and with other agencies to protect them and meet their individual needs.
People felt safe and well cared for by sufficient staff who received good training and support to do their job safely and effectively. The risk of abuse was minimised because staff demonstrated a good understanding of what constituted abuse and knew how to report concerns within the service and to external agencies.
Risk assessments were in place for each person to minimise risks as much as possible in the least restrictive way. People received their medicines safely and on time. Accidents and incidents were carefully monitored, analysed and lessons learnt from mistakes.
Safe recruitment practices were followed before new staff were employed to work with people. People had a range of ways through which they could raise concerns. People’s concerns and complaints were listened and responded to.
People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice. People's consent to care and treatment was sought. Staff used the Mental Capacity Act (2005) (MCA) and understood how this applied to their practice.
The service was well led by the manager and area manager, who led by example. Robust quality monitoring systems were used to monitor and continually improve. People, relatives and staff were regularly consulted and involved in developing the service. Staff used evidence of what works best to continually review and improve their practice.