Care service description

This service provides care and support to people living in two ‘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. The 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 the inspection the service provided support for five people, living in two shared houses which were situated next door to each other. Each person had their own room and shared the communal areas and garden. Houses in multiple occupation are properties where at least three people in more than one household share toilet, bathroom or kitchen facilities. People living in the houses shared kitchens and lounges. There was an office on site and sleep in arrangements were available for staff.

Not everyone living in the two houses 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. When they do we also take into account any wider social care provided.

The care service has been developed and designed in line with the values that underpin the Registering the Right Support and other best practice guidance. These values include choice, promotion of independence and inclusion. People with learning disabilities and autism using the service can live as ordinary a life as any citizen.

Rating at last inspection

At our last inspection fully comprehensive inspection in October 2015 we rated the service good overall but there was a breach in one of the regulations. We returned to the service in February 2017 to make sure the registered person had taken action. They had taken the necessary action and the breach in the regulation was met and the rating for the service remained Good. At this inspection we found the evidence continued to support the rating of good and there was no evidence or information from our inspection and ongoing monitoring that demonstrated serious risks or concerns. This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection.

At this inspection we found the service remained Good.

Why the service is rated Good.

People felt safe in the service. Staff understood how to protect people from the risk of abuse and knew the action they needed to take to report any concerns in order to keep people safe. People were encouraged to raise any concerns they had and felt that they would be dealt with appropriately. The management responded appropriately when concerns or complaints were made.

Staff were aware of how to reduce risks to people to try and keep them safe. When people were at risk of falling the falls risk assessment needed further guidance on the action staff should take if a person did fall. Staff were able explain clearly what they would do to make sure the person was safe. Staff were only recruited after the necessary pre-employment checks had been completed. There were enough staff working in the service to meet people's needs.

The management and staff carried out regular health and safety checks to ensure that the environment was safe and that equipment was in good working order. There were systems in place to review accidents and incidents and make any relevant improvements as a result. Emergency plans were in place so if an emergency happened, like a fire, the staff knew what to do. Fire safety checks were carried out regularly. People were protected from the risk of infection.

On the whole staff received the training and support they required to carry out their roles effectively. Some staff had not completed epilepsy training and there were people at the service living with this condition. The registered manager said they would address this shortfall. Staff we spoke with knew what a

Care service description

Fredrick’s House provides supported living for people with a learning disability. Supported living is where people are provided with their own home via a tenancy agreement and personal support is provided by a separate service, Fredrick House. At the time of the inspection the service provided support for five people, living in two shared houses which were situated next door to each other. Each person had their own room and shared the communal areas and garden.

Rating at last inspection

At the last inspection, on 28 September 2015, the service was rated Good overall and Requires Improvement in the 'Safe' domain.

Why we inspected

We carried out an unannounced comprehensive inspection of this service on 28 September 2015 A breach of legal requirements was found. After the comprehensive inspection, the provider wrote to us to say what they would do to meet legal requirements in relation to the breach of Regulation 19 of the Health and Social Care Act Regulated Activities Regulations 2014, Fit and proper persons employed. We undertook this announced focused inspection to check that they had followed their plan and to confirm that they now met legal requirements. This report only covers our findings in relation to those requirements. You can read the report from our last comprehensive inspection, by selecting the 'all reports' link for Fredrick’s House on our website at www.cqc.org.uk.

At this inspection we found the service remained Good overall and is now rated Good in the Safe domain.

Why the service is rated Good

The service has a registered manager who was available and supported us during the inspection. A registered manager is a person who has registered with the Care Quality Commission (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.

Comprehensive checks were carried out on potential staff to ensure they were suitable for their role. The service was very flexible in making sure that there were sufficient numbers of staff available to provide each person with support as needed. Staffing levels were based on people’s needs and choices. .

Assessments of potential risks had been undertaken of people’s personal care needs and their home environment. This included risks involved in mobilising and supporting people with daily household tasks and when going out. Guidance was in place for staff to follow to make sure that any risks were minimised.

Staff had received training in medicines management and their practical skills in giving medicines had been checked to ensure they were doing so safely and in line with the agencies policy.

The inspection took place on 28 September 2015 and was announced. We gave ‘48 hours’ notice of the inspection, as this is our methodology for inspecting supported living services.

This is our first inspection of the service since it was registered with us in June 2014.

Fredrick’s House provides supported living for people with a learning disability. Supported living is where people are provided with their own home via a tenancy agreement and personal support is provided by a separate agency, Fredrick House. At the time of the inspection the service provided support for four men who were living in a shared house. Each person had their own room and shared the communal areas of a lounge, small upstairs lounge, dining room, kitchen and garden.

The service has a registered manager who was available and supported us during the inspection. A registered manager is a person who has registered with the Care Quality Commission (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.

Checks on staff were carried out on potential staff, but they did not always make sure that staff were suitable for their role.

Relatives said that they had confidence in staff team and felt that their relative was in safe hands at all times. Staff had received training in how to safeguard people and knew how to report any concerns so that people could be kept safe.

Assessments of potential risks had been undertaken of people’s personal care needs and their home environment. This included risks involved in mobilising and supporting people with daily household tasks and when out in the community. Guidance was in place for staff to follow to make sure that any risks were minimised.

The agency was very flexible in making sure that there were sufficient numbers of staff available to provide each person with support as needed. Staffing levels were based on people’s needs and choices and the staff rota often changed weekly.

The agency had a comprehensive medicine policy which clearly set out the responsibilities of the agency with regards to medicines management. Staff had received training in medicines management and their practical skills in giving medicines had been checked to ensure they were doing so safely and in line with the agency policy.

New staff received a comprehensive induction which ensured they had the skills they required, before they started to support people in their own homes. Staff undertook face to face training in essential areas and were supported by the deputy manager, who was a qualified assessor. Staff had undertaken or had been book to receive training in The Mental Capacity Act 2005. They understood and ensured that people had the capacity to make day to day decisions and choices. The Mental Capacity Act 2005 provides the legal framework to assess people’s capacity to make certain decisions, at a certain time.

People’s health care and nutrition needs had been assessed and clear guidance was in place for staff to follow, to ensure that their specific health care needs were met. Staff were knowledgeable about people’s health care needs and the agency liaised with health professionals as appropriate.

People’s care, treatment and support needs were clearly identified in their plans of care. They included people’s choices and preferences. Staff knew people well and understood their likes and dislikes. Staff treated people with kindness, respect and compassion and understood how to communicate with people so they could understand.

People’s needs were assessed before they were provided with a service and people and their relatives were fully involved in this process. These assessments were developed in to a personalised plan of care. Care plans gave detailed guidance to staff about how to care for each person’s individual needs and routines. Staff were very knowledgeable about people’s likes, dislikes, choices and preferred routines.

People received information, in an accessible format, about their roles, responsibilities and rights of living in their own home. They were informed of the responsibility of the agency to provide them with support and the rules of renting their home from their landlord. People were also informed how they could raise any concerns about the agency and were regularly asked if they were satisfied with the service that they received.

People were supported by the agency to budget their own monies, plan their meals, shop for their own food, and take responsibility for keeping their home clean. The agency also supported people to take part in a range of activities in the local community and had links with a local charity to provide additional activities.

The agency was run by a registered manager who was clear about the aims and values of the service and the ways in which these should be met. Staff understood these aims and put them into practice by providing personalised care. Staff had confidence in the management of the agency which they said was fair and supportive.

There were effective systems in place to assess and monitor the quality of the service. People and staff were regularly asked for their views about the service and these were listened to and acted upon. Relatives said they would recommend the agency to other people.

We found one breach of the Health and Social Care Act 2008 (Regulated activities 2014). You can see what action we told the provider to take at the back of the full version of the report.