About the service:

Fitzroy Support at Home provides care and support to people living in four ‘supported living’ settings, so that they can live in their own home as independently as possible. People’s care and housing are provided under separate contractual agreements. Care Quality Commission (CQC) does not regulate premises used for supported living; this inspection looked at people’s personal care and support. At the time of our inspection there were eight people using the supported living side of the service who received personal care.

This service is also a domiciliary care agency (DCA). It provides personal care to people living in their own houses and flats in the community. It provides a service to adults with learning disabilities, sensory impairment and physical disabilities and/or autistic spectrum disorder in and around Basingstoke. At the time of our inspection there were 14 people using the DCA side of the service who received personal care.

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

People’s experience of using this service:

People told us they felt safe, and appropriate systems were in place to protect people from the risk of abuse.

There were enough staff to meet people’s needs. The provider had effective systems in place to ensure safe recruitment practices.

People’s needs were met in a personalised way by staff who were competent, kind and caring. Staff respected people’s privacy and protected their dignity.

Individual and environmental risks were managed appropriately.

People’s rights and freedoms were upheld. When appropriate staff acted in the best interests of the people they supported.

People were empowered to make their own choices and decisions. They were involved in the development of their personalised care plans.

People felt listened to and knew how to raise concerns.

Management processes were in place to monitor and improve the quality of the service. There was a positive, open and empowering culture.

Rating at last inspection:

The service was rated as requires improvement at the last comprehensive inspection, the report was published on 13 April 2018. We identified four breaches of the regulations. After the last inspection the provider sent us an action plan to tell us how they would address the areas we raised on inspection. At this inspection we found the provider had taken action and the service was no longer in breach of the regulations.

Why we inspected:

This was a planned, announced comprehensive inspection as part of our inspection schedule methodology for services.

Follow up:

We will continue to monitor the intelligence we receive about this service and plan to inspect in line with our re-inspection schedule for those services rated as Good.

Our inspection took place on 19, 21 December 2017 and 5 January 2018 and was announced.

Fitzroy Support at Home provides care and support to people living in five ‘supported living’ settings, so that they can live in their own home as independently as possible. People’s care and housing are provided under separate contractual agreements. Care Quality Commission (CQC) does not regulate premises used for supported living; this inspection looked at people’s personal care and support. This service is also a domiciliary care agency. It provides personal care to people living in their own houses and flats in the community. It provides a service to adults with learning disabilities, sensory impairment and physical disabilities and/or autistic spectrum disorder in and around Basingstoke.

Not everyone using Fitzroy Support at Home received a regulated activity; CQC only inspects the service being received by people provided with ‘personal care’; help with tasks related to personal hygiene and eating. Where they do, we also take into account any wider social care provided.

At the time of our inspection there were 24 people using the service who received personal care.

The service had a registered manager in place. A registered manager is a person who has registered with the CQC to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run. The registered manager managed the supported living services; the provider had appointed another manager to manage the community services. This person was in the process of applying to CQC to become registered.

Medicines were not always managed safely. People did not always receive their medicines as prescribed. Staff were administering prescribed medicines to people that were not recorded on their Medicines Administration Records (MAR). There were gaps in the recording on MAR with no explanation of why the dose had been missed.

Risks were not always identified so that safety measures could be put in place. Whilst some risk assessments were in place and were comprehensive this was not found to be the case across the service.

Staff we spoke to demonstrated some knowledge of the Mental Capacity Act (MCA) 2005 however; records did not always contain the documents needed to demonstrate that the service was working within the principles of the MCA.

The systems in place for assessing the quality and safety of the service were not always effective. The service had not identified the shortfalls we found during the inspection. This placed people at risk and compromised the quality and safety of the service.

Complaints had not been managed effectively. Relatives told us they had tried to complain but felt due to the changes in management their voices were not always heard. The provider had not routinely sought feedback from people or relatives so opportunity to raise concerns had not been formally provided.

Out of hours arrangements were not always effective. Relatives and staff told us they had no confidence in the out of hour’s arrangements; they were not always able to get in touch with the provider. When they left messages on an answerphone these were not always responded to.

We had mixed comments from relatives about staffing. Relatives told us that workers did not always arrive for planned visits or changes were made at short notice, which was not always satisfactory. The service had relied on the use of agency staff so people had not received a consistent worker. This had caused anxiety and disappointment for people and their relatives.

Staff understood how to keep people safe and knew what actions to take if they had any concerns.

The service had robust recruitment procedures to make sure that staff were recruited safely.

People were supported by staff who had the knowledge and skills necessary