Archived: yourAbility Hillingdon Also known as Yew Tree Lodge

Updated 8 August 2019

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.

Inspection team

One inspector conducted the inspection over two days.

Service and service type

yourAbility Hillingdon provides care and support to people living in a ‘supported living’ setting, 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 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.

Notice of inspection

We gave the service 48 hours’ notice of the inspection. This was because it is a small service and we needed to be sure that the provider or registered manager would be in the office to support the inspection. Inspection activity started on 3 June 2019 and ended on 5 June 2019. We visited the office location on both dates.

What we did before the inspection

We reviewed information we had received about the service since the last inspection to plan our inspection. This included what the provider had told us when important events had happened.

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 used all this information to plan our inspection.

During the inspection

During the inspection we spoke with two people who used the service and one person’s relative about their experience of the care and support provided. We spoke with staff, including three support workers, the team leader, the interim service manager and the provider’s nominated individual. The nominated individual is responsible for supervising the management of the service on behalf of the provider. We observed people being supported throughout the inspection visits. We looked at the support plans for three people, personnel files for four staff and other records relating to the management of the service.

After the inspection

After the inspection we spoke with another relative of a person who used the service and 10 adult social care and healthcare professionals involved with the service.

Updated 8 August 2019

About the service

yourAbility Hillingdon, also known as Yew Tree Lodge, is a supported living service registered to provide personal care for up to 13 people aged 18 and over. A team of support staff provide 24-hour care and support to adults with learning disabilities, mental health needs and physical disabilities. 12 people were using the service at the time of the inspection.

The service has been developed and designed in line with the principles and values that underpin Registering the Right Support and other best practice guidance. These are to ensure that people who use the service can live as full a life as possible and achieve the best possible outcomes. The principles reflect the need for people with learning disabilities and/or autism to live meaningful lives that include control, choice, and independence. People using the service should receive planned and co-ordinated person-centred support that is appropriate and inclusive for them.

The service is larger than current best practice guidance. However, the size of the service having a negative impact on people was mitigated by people having their own flats with kitchens and en-suite bathrooms. They shared the communal kitchen, dining room, laundry facilities, garden and two living rooms. The building design fitted in with the surrounding residential area. Staff were not wearing anything that suggested they were care staff when coming and going with people.

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

The service applied the principles and values of Registering the Right Support and other best practice guidance. People were supported to develop more independence and to access some meaningful opportunities and activities. Staff supported people to access mainstream services and specialist health and social care support. The service worked with other professionals to support people to manage behaviours that may challenge others.

Some aspects of the service were not consistently safe as the provider had not sufficiently assessed staff to ensure they were always competent to give the medicines support being asked of them.

The provider did not always promote people’s rights when people were unable to consent to their care arrangements. People were not supported to have maximum choice and control of their lives and staff supported did not support them in the least restrictive way possible and in their best interests; the policies and systems in the service did not support this practice.

However, people's care and support was person-centred, planned and coordinated.

The provider had systems to monitor the quality of the service, but these had not been sufficiently robust to have identified, or taken timely action, on the areas for improvement we identified.

People had detailed support plans in place and these were regularly reviewed and updated. Plans reflected people’s physical, mental, emotional and social needs and their care and support preferences.

Staff were aware of people's individual needs and preferences and used this knowledge to deliver person centred care. People and their relatives felt staff cared and treated them with respect and dignity.

Staff supported people to manage behaviours that may challenge others in line with good practice.

Staff received training, induction, supervision and support to perform their roles effectively.

We have made a recommendation about safely supporting some people with their food.

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 was good (published 5 December 2016).

Why we inspected

This was a planned inspection based on the previous rating.

Enforcement

We have identified two breaches in relation to supporting people in line with the principles of the Mental Capacity Act 2005 and having systems in place to monitor the quality of the service. Please see the action we have told the provider to take at the end of this report.

Follow up

We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.