Supported Living

Updated 29 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 overall quality of the service and provided a rating for the service 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 team consisted of one inspector.

Service and service type:

This service provides care and support to people living across four ‘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 had a manager registered with the CQC. 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.

Notice of inspection:

This inspection was announced. We gave the provider 24 hours’ notice to enable them to ensure they could accommodate an inspection as safely as possible. Inspection activity started on 23 June 2021 and ended on 29 June 2021.

What we did before the inspection:

We reviewed information we had received about the service since the last inspection. We reviewed statutory notifications submitted by the provider. Statutory notifications contain information providers are required to send to us about significant events that take place within services. We used all of this information to plan our 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 spoke with the registered manager, the operations manager and the compliance manager. We reviewed a range of records including two people’s care records and other records relating to the management of the service.

After the inspection:

We spoke with one person about their experiences of the service. We also spoke with three care support workers. We continued to speak with the registered manager and seek clarification about the evidence gathered. We also reviewed additional documentation relating to the management of the service.

Updated 29 July 2021

About the service

Supported Living provides care and support to people living in ‘supported living’ settings so that they can live as independently as possible. People’s care and housing are provided under separate contractual agreements. The Care Quality Commission (CQC) only inspects where people receive personal care. This is help with tasks related to personal hygiene and eating. Where they do, we also consider any wider social care provided. Not everyone who used the service received personal care. At the time of this inspection two people who used the service were receiving personal care.

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

Recruitment practices were unsafe as the provider had not made sure checks on staff’s suitability to support people were thorough and robust.

The provider’s current governance arrangements were not always effective. They had not picked up issues we found about recruitment practices at this inspection. The provider’s checks had also not identified missing, incomplete and inconsistent information we found in people’s records.

People said they were safe at the service. Staff had been trained to safeguard people from abuse. There were enough staff to support people. Staff understood identified risks to people’s safety and wellbeing and what action to take to support people to stay safe.

Health and safety checks were carried out of people’s homes to make sure people were safe. Staff made sure people’s homes were clean and hygienic. They followed current practice to reduce infection and hygiene risks within people’s homes.

People were involved in planning their care and support and could state their preferences for how this was provided. People’s records reflected their needs and preferences. People were supported to be as independent as they could be with daily living tasks. Staff knew people well and understood how their identified needs should be met. People were supported to undertake activities and interests that were important to them.

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.

People were supported to take their prescribed medicines and staff made sure people could access support from healthcare professionals when needed. People were involved in planning and preparing meals. Staff encouraged people to make healthy food and drink choices and checked they were eating and drinking enough to meet their needs.

People said staff were kind and helpful. Staff received relevant training and supervision to help them meet people’s needs. Staff felt well supported by managers and were encouraged to learn, develop and improve in their role.

The provider had arrangements in place to make sure accidents, incidents and complaints were investigated and people kept involved and informed of the outcome.

People and healthcare professionals had positive experiences of using the service. The provider had systems in place to obtain their feedback about how the service could be improved.

The provider worked proactively with other agencies and healthcare professionals and acted on their recommendations to improve the quality and safety of the service for people.

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

This service was registered with us on 31/07/2020 and this was the first inspection.

Why we inspected

The inspection was prompted in part due to concerns we received about staff’s competence and experience, medicines administration and the overall quality of care and support provided to people.

We also looked at infection prevention and control measures under the safe key question. We look at this in inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to coronavirus and other infection outbreaks effectively.

We found evidence that the provider needs to make improvements. Please see the safe and well-led sections of this full report. You can see what action we have asked the provider to take at the end of this full report.

After this inspection the provider wrote to us to tell us what action they had taken to mitigate risks. This included introducing new processes to validate and check application forms and employment references.

Enforcement

We have identified breaches in relation to good governance and fit and proper persons employed. Please see the action we have told the provider to take at the end of this report.

Follow up

We will request an action plan from the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.