About the service:

Heather Brae Supported Living service provides support to adults living with learning disabilities and complex health needs. At the time of the inspection the service was supporting 18 people within their own tenancies. The service is located within a residential area of Congleton and is made up of 5 mews houses which are all adjoining. Each house can accommodate four people. CQC does not regulate the premises used for supported living; this inspection only looked at people's personal care and support.

People’s experience of using this service:

The management team ensured that they worked in line with 'Registering the Right Support' and other best practice guidance. These values include choice, promotion of independence and inclusion to ensure that people with learning disabilities or autism can live as ordinary a life as any citizen.

People received safe and effective care from staff that were kind, caring and compassionate. People's needs had been fully assessed prior to them being supported by the service. Care plans were person centred and were regularly reviewed to ensure the most up-to-date information and guidance was available for staff. Staff demonstrated a good understanding of people's individual needs and had developed positive relationships with them.

Safe recruitment practices were in place and people were supported by staff that had undertaken an induction and training for their roles. Sufficient staff were employed to meet the needs of the people supported. Staff were supported through supervision and team meetings.

Risks to people had been clearly identified and guidance was in place to ensure that staff could minimise these risks. People were protected from the risk of harm and abuse. Staff had all undertaken safeguarding training and felt confident to report any concerns they had. Medication was managed in accordance with best practice guidelines by trained and competent staff. Medication administration records (MARs) were fully completed and audits regularly undertaken.

People participated in activities of their choice. People spoke positively about the activities they participated in. People were supported to maintain contact with friends and relatives. People's independence was promoted and their privacy and dignity was respected. People and their relatives spoke positively about the staff team. We saw that people's views were regularly sought regarding their care, activities and meals.

A complaint policy and procedure was in place for people and their relatives to follow. Complaints were fully investigated and responded to in accordance with the policy.

The registered provider complied with the principles of the Mental Capacity Act (MCA) 2005. Staff understood and respected people's right to make their own decisions where possible, and encourage people to make decisions about the care they received. Mental capacity assessments and best interest decisions were completed in line with the MCA.

Rating at last inspection:

Good (Report published August 2016).

Why we inspected:

This was a planned inspection based on the rating of the last inspection.

Follow up:

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

This announced inspection took place on 20 July 2016. The provider was given 48 hours’ notice because the location provides a domiciliary care service and we needed to be sure someone would be in.

Heather Brae Supported Living Network is registered to provide personal care to people in their own homes. The service is located within a residential area of Congleton and is made up of 5 mews houses which are all adjoining. Each house can accommodate four people. At the time of inspection there were 16 people receiving a service from the supported living network. Eighty staff were employed to provide personal care within the service.

There was a registered manager in place. A registered manager is a person who has registered

with the Care Quality Commission 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 service was last inspected in February 2014. We identified no concerns and found the registered provider was meeting all standards we assessed.

At this inspection carried out in July 2016, observations demonstrated people who used the service were happy with the service provided. Relatives confirmed people were happy living at Heather Brae Supported Living Network.

Staff told us staffing levels were sufficient and allowed them to carry out their roles effectively. We observed staff taking time out to communicate with people.

Suitable recruitment procedures meant staff were correctly vetted before starting employment. Staff retention was good and staff said people benefited from staff who knew them well.

People were protected from risk of abuse. Procedures were in place to monitor incidents which had the potential to cause harm. Staff had knowledge of safeguarding procedures and were aware of their responsibilities for reporting any concerns.

Suitable arrangements were in place for managing and administering medicines. Regular audits took place to ensure safe practices were maintained. There was an open and transparent culture for reporting medicines errors.

Staff were positive about ways in which the service was managed and the support received from the management team. They described a positive working environment which led to positive outcomes for people.

The registered provider had established links with health professionals to enable people to maintain good health. Care plans were developed and maintained for people who used the service. Care plans covered support needs and personal wishes. Plans were reviewed and updated at regular intervals and information was sought from appropriate professionals as and when required.

People were supported to live active lives that were meaningful to them. Relationships with families were encouraged.

The registered manager monitored and managed risk to promote people’s safety. Good practice guidelines were considered when developing risk assessments.

Staff told us they were provided with training which allowed them to carry out their tasks effectively. Ongoing training was provided for staff to enable them to carry out their tasks proficiently. However documentation relating to staff training was difficult to access and understand.

Records demonstrated people who required support with eating and drinking were given appropriate assistance. Strategies were developed with relevant health professional and were implemented to promote nutrition where appropriate.

The registered provider had a range of assurance systems to monitor quality and effectiveness of the service provided. Feedback was gained from all parties as a means to develop and improve the service.

When we visited the Heather Brae Supported Living Network we visited the homes of three people who used the service. We also contacted their relatives and one told us ““They definitely have my brother’s best interests at heart”. We saw that people lived in small groups of three or four people each in one of five mews properties clustered around another building which provided staffing support and administrative facilities.

We saw that people were involved in their care and that staff treated them with dignity and respect. We looked at the arrangements for eating and drinking and found that these supported people’s individual preferences as well as any special requirements that had been identified for them.

We talked to two support staff as well as to three senior staff and the manager. Staff told us that they felt well-supported at the Heather Brae Supported Living Network. They told us that their supervisors and the manager were “very approachable” and were “top notch”. They said “If ever I need support then it is there”. We found that the provider had systems for assuring the quality of service.

Heather Brae provides personal care and supported living services to people who have their own tenancies. People who use the service live in small groups of three or four each group residing within one of five mews houses. The personal care and supported living services are provided to people in these properties from offices in a sixth building located with the other houses. The services are provided over 24 hours and 7 days a week.

During the inspection we saw how the people who use the service have a variety of special needs which may include complex communication difficulties and severe forms of epilepsy. We observed how the service provided extends beyond care in the home to supporting people in using their time outside the home as well as with other agencies. The service provides separate waking night cover in each of the mews houses.

We met with five people who use the service and three of them allowed us to interview them. We also met with two relatives of a person living at the service and spoke with the Manager, two senior staff, and two support workers. We visited people who use the service in their own homes of which they are tenants and looked at the ways in which people could summon help if they required it as well as the arrangements in place for the administration of medicines. We also reviewed care plans and other relevant documentation.

During our visit to the network we spoke with four tenants who live there. They said they are treated well and with respect and they are involved in making decisions about the care and support they receive and what they do. For example, they choose the activities they want to do and agree menus for the week. They said they are happy living at the network and talked about the things they enjoyed doing during the week. These included going shopping, bike riding, drawing and colouring, going to the pub, attending the local day centre, cooking and listening to music.

Two said they could speak with staff if they had concerns or worries and that staff would listen to them and help sort things out. One said that there had been changes to staff which had unsettled him at first but now he had got to know the new staff this was no longer a concern. They all said there are enough staff to meet their needs and they get on well with staff who are caring and supportive.