1st Enable Cheshire East

Updated 21 December 2022

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 was carried out by 3 inspectors.

Service and service type

This service provides care and support to people living in 6 ‘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.

What we did before inspection

We reviewed information we had received about the service since they were registered. We sought feedback from the local authority and professionals who work with the service. 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 used all this information to plan our inspection.

During the inspection

We spoke to 11 people supported. We spoke with 16 members of staff including the registered manager, area manager, service managers, positive behaviour support regional manager, positive behaviour support facilitator, senior support workers and support workers. We spent time observing the support and communication between people and staff in shared areas of the houses we visited.

We reviewed a range of records. This included 7 people’s care records and medication records. We looked at 8 staff files in relation to recruitment and staff supervision. A variety of records relating to the management of the service, including policies and procedures were reviewed.

The nominated individual is responsible for supervising the management of the service on behalf of the provider.

We continued to seek clarification from the provider to validate evidence found. We looked at training data and quality assurance records. We spoke to 4 relatives by telephone.

Updated 21 December 2022

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

About the service

1st Enable Cheshire East is a supported living service providing personal care to 27 people at the time of the inspection.

People’s experience of using this service and what we found

Right Support:

Trained and competent staff supported people to manage their medicines. Medicine care plans held sufficient information to support staff to meet people's individual needs. Staff supported people to manage their medicines and promoted their independence where possible. The provider had used STOMP (stopping over-medication of people with a learning disability, autism or both) to reduce the use of unnecessary medicines.

People could choose their living environment and had personalised their living space. We received positive comments that included, “I’ve got my Flat how I like it.”, “I love my flat, I feel so safe here.” and, “I didn’t like the last place I lived in. I moved here a few months ago and I am so happy.”

People were supported to maintain their own health and wellbeing where possible.

People were supported by safely recruited regular staff who knew them well. Staff had the necessary skills and knowledge to meet their individual needs.

Risks to people's safety were assessed and monitored and people had personalised risk assessments in place.

People spoke positively about their participation in activities of their choice. People described the many activities they participated in including shopping, theatre visits, shows, café outings, volunteering opportunities and holidays.

People were supported with their communication needs. Staff understood individual communication styles. Information was made available in accessible formats, such as, easy read and pictorial.

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.

Right Care:

People described staff respecting their privacy and dignity. People told us staff were kind and caring.

Staff wore PPE (Personal protective equipment) in accordance with good practice guidelines and ample supplies were available. Staff had received training in infection prevention and control.

Staff had a good understanding of how to protect people from poor care and abuse. They were very clear of the actions they would take to keep people safe and were confident any concerns raised would be promptly acted upon.

People and their relatives had been involved in the development of their care plans. The plans were personalised and included information on people's healthcare needs, preferences, challenges and hobbies.

People could take part in activities and pursue interests of their choice. Comments from people included, "I went to see Abba Mania and danced all night." and "I love playing games on my computer."

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.

Right Culture:

The provider and registered manager had developed a positive culture at the service and continually involved staff and people supported in its development.

People, their relatives and appropriate health and social care professionals fully participated in the review of people’s care plans and the support they received.

The management team undertook regular audits to look at ways of developing and improving the service.

Staff were complimentary about the management of the service. They told us they felt valued and were encouraged to raise concerns as well as new ideas with the registered manager.

Staff demonstrated a desire to make a positive difference to people’s lives and continually worked to improve people’s independence.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection

This service was registered with us on 26 March 2020 and this is the first inspection.

Why we inspected

This inspection was prompted by a review of the information we held about this service. We undertook this inspection to assess that the service is applying the principles of Right support, right care, right culture.

Follow up

We will continue to monitor information we receive about the service, which will help inform when we next inspect.