3 June 2019
During a routine inspection
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.