About the service:

Social Care Solutions Ltd (Bedford & Northampton) provides care and support to people living in a variety of '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.

Not everyone using Social Care Solutions Ltd (Bedford & Northampton) receives 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 this inspection 90 adults were using the service who had a range of care needs including learning disabilities, autistic spectrum disorder, dementia, mental health, physical disabilities and sensory impairments. Of these, 49 were receiving personal care.

People’s experience of using this service:

There had been lots of changes in the management team since our last inspection. A new manager had started around two months before this inspection. They understood their responsibilities and had some good ideas about how to improve the service.

Staff provided care and support in a kind and compassionate way, but there were many staff vacancies. These were being covered by agency staff and people told us they wanted regular staff who would get to know them well and provide consistency of care and support. New training was being arranged to make sure staff had the right skills and knowledge to meet people’s needs.

The service generally acted in line with legislation and guidance regarding seeking people’s consent but improvements were needed to make sure people always agreed about what they spent their money on.

Systems to protect people from abuse and avoidable harm and risks were in place and the new manager was making changes to improve these.

The service acted in line with the principles and values that underpin Registering the Right Support and other best practice guidance. This ensures 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 were enabled to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice. The new area manager had plans to improve communication methods for people, where needed and to increase opportunities for people to achieve their goals and aspirations.

People’s privacy, dignity, and independence was respected and promoted.

Systems were in place for people to raise any concerns or complaints they might have about the service. Feedback was responded to in a positive way, to improve the quality of service provided.

Arrangements were in place to involve people in developing the service and seek their feedback.

Improvements were taking place to enhance the systems to monitor the quality of service provision and to drive continuous improvement. Opportunities for the service to learn and improve were welcomed and acted upon, and the service worked in partnership with other agencies for the benefit of the people living there.

Rating at last inspection:

The service was rated Requires Improvement (report published on 14 September 2018).

After the last inspection on 7 and 8 August 2018, we asked the provider to act to make improvements to manage identified risks to people, staff recruitment checks, supporting people to make their own decisions in line with relevant legislation and guidance and quality monitoring processes.

During this inspection we found that improvements had been made in all these areas but due to changes in the manag

Social Care Solutions Ltd (Bedford & Northampton) provides care and support to people living in a variety of ‘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.

Not everyone using the service receives 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 this inspection 108 adults were using the service who had a range of care needs including learning disabilities, autistic spectrum disorder, dementia, mental health, physical disabilities and sensory impairments. Half were receiving personal care.

This was the first inspection of Social Care Solutions Ltd (Bedford & Northampton) since it registered with CQC in August 2017. This means the service has not previously been rated. During this inspection, which took place on 7 and 8 August 2018, we found that the service had breached a number of legal requirements. We rated the service as Requires Improvement. This is the first time the service has been rated Requires Improvement.

Risks to people were being identified, but the arrangements to mitigate these risks were not always robust enough in order to keep people safe.

Action had been taken to address a number of medicine errors that had happened across the service. However, more work was needed to ensure people consistently received their medicines in a safe way and as prescribed.

The provider checked to make sure staff were safe to work at the service, but the checks being made did not fully meet the legal requirements.

The service generally acted in line with legislation and guidance regarding seeking people’s consent. More work was needed however, to ensure ‘best interest decisions’ were recorded for financial expenditure where people did not have capacity to understand or manage their own money.

Improvements were needed to ensure all staff had the right training to carry out their roles in order to meet people’s assessed needs.

New support plans were being introduced across the service, to help people to receive personalised care that was responsive to their needs. However, this essential work had not been completed when we inspected the service.

More work was needed to determine people’s end of life care preferences and choices, should the need arise.

The service was working to ensure people’s care and support was consistently delivered in line with current standards and evidence based guidance. However, the systems in place to monitor the quality of service provision and drive continuous improvement, needed to be strengthened.

You can see what action we told the provider to take at the back of the full version of the report.

People were protected from abuse and avoidable harm. Staff had been trained to recognise signs of potential abuse and knew how to keep people safe.

There were enough staff to meet people’s needs and help them to stay safe. They understood how to protect people through the prevention and control of infection too.

The service responded in an open and transparent way when things went wrong, so that lessons could be learnt and improvements made.

People were supported to eat and drink enough. People were actively involved in choosing what they ate and preparing their own meals. Risks to people with complex eating needs were understood by staff.

Staff worked with other external teams and services to ensure people received effective care, support and treatment. People had access to healthcare services, and received appropriate support with their on-going healthcare needs.

Staff provided care and support in a kind and compassionate way.

The care service has been develope