Background to this inspection
Updated
22 September 2022
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.
Inspection team
This inspection was completed by one inspector and one 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 three ‘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.
This service is required to have a registered manager. A registered manager is a person who has registered with the Care Quality Commission to manage the service. 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.
At the time of our inspection there was a registered manager in post.
Notice of inspection
We gave the service a short period of notice because the service is small and we needed to ensure the provider could support the inspection.
What we did before the inspection
We used the information the provider sent us in the provider information return. This is information providers are required to send us with key information about their service, what they do well, and improvements they plan to make. This information helps support our inspections. We contacted stakeholders for their feedback; this included the housing provider and commissioners.
During the inspection
We spoke with three people who lived in the service. We met with the community leader and deputy manager. We sought feedback from five staff using questionnaires and spoke with three staff. We spoke with the relatives of six people. We reviewed the care records of four people and several medicine records. We looked at the recruitment files of three staff, training records and a range of governance records relating to the quality of care, care records and maintenance.
Updated
22 September 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 the Care Quality Commission (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. The service was able to demonstrate how they were meeting this standard.
About the service
L'arche Preston provides personal care to people with learning disabilities and/or autism in a supported living service for up to seven people in a property named 'The Loom'. Accommodation is provided in self contained flats. There are both shared and single person flats on two floors. There are communal garden areas outside.
People's experience of using this service and what we found
Right support
People had not always been safe because the provider had not ensured all risks had been assessed and plans put in place to mitigate them. Not all staff had received training in moving and handling which meant there was a risk of harm. Not all external activities had been individually risk assessed which meant there had been a potential for harm during a holiday. Staff felt they were able to support people safely and found there was enough guidance in people's support plans.
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 effectively by staff who understood their needs. The providers assessment processes involved people and their relatives in the development of their support plans which helped ensure they were holistic.
Right care
People received kind and respectful support from staff who were compassionate and committed to supporting people achieve their aims and wishes. Particular care was taken to engage with people and involve them in making decisions about important aspects of their life.
Right culture
People received bespoke care which reflected their individual experiences, culture and preferences. Person-centred plans included enough detail about what was important for each person which helped ensure their preferences had been respected. Activity timetables included a broad range of activities. People were actively involved in reviewing their goals and plans for the future.
Information about the service and how to raise concerns was provided in accessible formats, this helped ensure people were empowered to express their views and opinions.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection
The last rating for this service registered at the previous premises was good. (Published 8 January 2020)
Why we inspected
This inspection was prompted by a review of information we held about this service. We also undertook this inspection to assess that the service is applying the principals of Right support right care right culture.
Enforcement and Recommendations
We are mindful of the impact of the COVID-19 pandemic on our regulatory function. This meant we took account of the exceptional circumstances arising as a result of the COVID-19 pandemic when considering what enforcement action was necessary and proportionate to keep people safe as a result of this inspection. We will continue to discharge our regulatory enforcement functions required to keep people safe and to hold providers to account where it is necessary for us to do so.
We have identified breaches in relation to the assessment and mitigation of risks. We have made a recommendation about the recording of medicines prescribed 'when required'.
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 for 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.