Mencap - Trowbridge

Updated 6 October 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

The inspection team consisted of 2 inspectors, 2 medicines inspectors 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

This service provides care and support to people living in 10 “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.

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

This inspection was unannounced.

Inspection activity started on 25 July 2023 and ended on 30 August 2023. We visited the location’s office on 25 July 2023 and 16 August 2023.

What we did before the inspection

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 reviewed information we held about the service and sought feedback from the local authority. We used all this information to plan our inspection.

During the inspection

We visited 2 homes and the registered office. We spoke to 5 people, 12 relatives, 1 professional, the registered manager, an area manager, 2 service mangers and 6 staff. We reviewed a range of care plans, risk assessments and medicine records. We also reviewed recruitment records for 3 staff, training records for all staff, accident and incident reporting and quality assurance audits.

Updated 6 October 2023

About the service

Mencap – Trowbridge is a supported living service providing support to people with a learning disability and/or autism living in their own homes. At the time of the inspection there were 30 people using the service in 10 houses based in Wiltshire and Gloucestershire.

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 the Care Quality Commission follows to make assessments and judgements about services supporting people with a learning disability and autistic people and providers must have regard to it.

Right Care:

There were some effective quality systems in place. However, in one home the checks did not identify the concerns we found on inspection in relation to people's medicines.

Medicines were not always managed safely. Medicine profile sheets did not have information about people’s allergies, nor did they show how and where people preferred to take their medicine.

There was a high dependency on agency staff at one home which meant people were not always being supported by staff that knew them well. However, other homes were being supported by regular staff who knew people.

Right Support:

People were mostly supported to have 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. The provider had not always recorded they had consulted and involved people in decisions, such as choices around healthy eating.

People and their relatives told us they were happy and felt the staff supported them safely.

People had comprehensive care and support plans in place.

Right Culture:

There was a new registered manager in post who demonstrated their understanding of supporting people in a least restrictive and person centred way. We saw people were involved in their support plans and in 1 service we saw that most of their culture was person centred.

Relatives told us they felt involved in peoples’ care and were listened to by staff.

Staff received training through an electronic system and face to face. All new staff were expected to complete the care certificate.

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 19 November 2018).

Why we inspected

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

We received concerns in relation to how people were being supported and lack of regular staff. As a result, 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.