Background to this inspection
Updated
17 July 2021
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 safety and leadership of the service and provided a rating under the Care Act 2014.
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 completed by one inspector, two assistant 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
MENCAP – East Cornwall Support Service provides personal care and support to people living to the east of St Austell in Cornwall. This service provides care and support to people living in 11 '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.
The service is required to have 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. There was a registered manager in post.
Notice of inspection
We gave the service 24 hours’ notice of the inspection. This was done to ensure the inspection could be completed safely during the covid-19 pandemic and to gain people’s consent before visiting their homes.
What we did before the inspection
We reviewed information we had received about the service since the last inspection. The provider was not asked to complete a provider information return prior to this inspection. This is information we require providers to send us to give some key information about the service, what the service does well and improvements they plan to make. We took this into account when we inspected the service and made the judgements in this report.
During the inspection
We visited two of the settings in which people were supported and spoke briefly with four people who used the service. We had longer conversations with six members of staff, a setting manager and the registered manager.
We reviewed a range of records. This included three people’s care records and multiple medication records. A variety of records relating to the management of the service, including policies and procedures were requested.
After the inspection
We looked at two staff files in relation to recruitment.
We spoke via telephone with five people’s relatives and a further 12 staff. In addition, we reviewed the documents requested during the site visits and completed an analysis of the services rotas.
Updated
17 July 2021
About the service
MENCAP – East Cornwall Support Service is a supported living service which provides personal care to people living in 11 settings in the east of Cornwall. Some of the settings had previously been registered as care homes. In supported living, people's care and housing are provided under separate contractual agreements. CQC does not regulate premises used for supported living and this inspection is focused on the quality of care and support people received.
People’s experience of using this service and what we found
People were comfortable with their staff and sought support without hesitation. Relatives told us people were safe and said, “[The staff] have fantastic patience”.
Staff were using PPE correctly and were following current infection prevention and control guidance to help keep people safe. All staff had been provided with additional training in relation to the Covid-19 pandemic and regular testing was underway.
Risks had been appropriately assessed and staff were provided with detailed guidance on the action they must take to ensure people’s safety. Accidents had been investigated to identify areas of improvement or learning and to prevent similar incidents from reoccurring.
The service’s recruitment practices were safe. In most settings there were enough staff employed to meet people’s support needs. One setting was short staffed. Agency and bank staff had been used to ensure safe staffing levels were always achieved. A recruitment drive was underway to address this situation.
Managers and staff had a good understanding of the Mental Capacity Act and people were supported to make meaningful decisions and choices. Restrictive care practices had been reviewed following our last inspection with appropriate input from involved health professionals. People’s care plans included clear guidance for staff on how to meet their support needs if they became upset or anxious.
Staff were sufficiently skilled to meet people’s support needs and their training had been regularly updated.
Staff told us they were well supported and confident any issue they reported to managers would be addressed. The provider had supported the registered managers learning and development. On promotion they had initially allocated the registered manager to an adjacent ‘good rated’ service to give them time to complete additional training and develop their skills.
Quality assurance systems were effective and action plans had been developed to ensure all issues identified were resolved.
The duty of candour was understood by the registered manager. Relatives told us the service communicated with them effectively and had kept them informed throughout the pandemic.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection and update
The last rating for this service was Requires Improvement (published 23 December 2019) when breaches of the regulations were identified.
At this inspection we found improvements had been made and the provider was no longer in breach of regulations.
Why we inspected
We carried out an unannounced comprehensive inspection of this service on the 12 and 15 November 2019. Breaches of legal requirements were found. The provider completed an action plan after that inspection to show what they would do and by when to help ensure service users were protected from the risk of abuse and improper treatment and poor governance.
We undertook this focused inspection to check they had followed their action plan and to confirm they now met legal requirements. This report only covers our findings in relation to the key questions Safe, Effective and Well-led which contain those requirements.
We looked at infection prevention and control measures under the Safe key question. We look at this in all inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.
The ratings from the previous comprehensive inspection for those key questions were not looked at on this occasion or were used in calculating the overall rating at this inspection. The overall rating for the service has changed from Requires improvement to 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 MENCAP – East Cornwall Support Service on our website at www.cqc.org.uk.