About the service:

This service provides care and support to people living in a ‘supported living’ setting, 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.

People’s experience of using this service:

¿ People were supported by staff who knew how to recognise potential abuse and who they should report any concerns to. People’s care considered their risks and reduced the risk of harm and where required, had access to equipment to support them. People's medicines were managed safely and there were enough staff to meet people’s social and care needs.

¿ People were supported to maintain a healthy diet in line with their needs and preferences. Staff were trained to meet people’s needs and acted promptly to refer people to healthcare professionals when required.

¿ People enjoyed positive relationships with the staff team and were treated with kindness and respect. People’s independence was promoted by staff who encouraged them.

¿ People’s needs and routines were know and supported by staff who ensured these were met and respected. People knew how to complain if needed, and were confident any comments or concerns were listened and acted on.

¿ People and staff were happy with the way the service was led and managed and the provider worked well with external professionals to ensure people’s needs were met.

¿ Service management and leadership was consistent and areas for improvements were identified. The manager gathered people’s views and experiences and made any necessary improvements.

¿ We found the service met the characteristics of a “Good” rating; More information is available in the full report

Rating at last inspection: Good (report published May 2018)

Why we inspected: This inspection was brought forward due to information of risk or concern in relation to an increase in safeguarding notifications. During the inspection the provider and manager demonstrated they had acted to promote and protect people’s safety.

Follow up: There will be ongoing monitoring

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

We carried out an announced comprehensive inspection of this service on 13 September 2017 and awarded a rating of ‘Good’ overall. After that inspection we received concerns in relation to how the service supported people to maintain their properties, how some people and staff were supported to remain safe and the skills and abilities of the management team. As a result we undertook a focused inspection on 14 February 2018 to look into those concerns. This report only covers our findings in relation to those topics. You can read the report from our last comprehensive inspection, by selecting the 'all reports' link for Proactive Life - Birmingham on our website at www.cqc.org.uk.

This service provides care and support for up to 24 people in ‘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 in their own flats. The flats are in three purpose built blocks on one site. The provider’s office is also on this site. At the time of our inspection the service was supporting 24 people. Some people were receiving up to 24 hour support each day, according to their assessed needs and level of independence. Most of the people who used the service had the mental capacity to decide how they wanted to be supported.

At the time of the inspection the service had a registered manager who was present during our visit. 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.

We found the provider had taken or had on-going processes which addressed recent concerns about people’s safety and leadership at the service. However processes to monitor people’s calls did not identify if people had received support in line with their care plans. Records did not always identify if people had been supported appropriately to resolve long-standing maintenance issues with their flats which were relevant to their personal care.

People told us they felt safe in their flats, and the provider had worked with the landlord to prevent uninvited people from entering the buildings. Staff knew how to keep the people they supported and themselves safe from physical and emotional abuse. The registered manager had taken action to reduce and prevent the reoccurrence of incidences or behaviours which could cause people distress or harm.

Staff were aware of the action to take should they suspect that someone was being abused or the factors which may make someone more vulnerable to abuse. Processes were in place to minimise the risk of people experiencing financial abuse. Staff said the registered manager was approachable and would take appropriate action to keep people safe.

There were processes in place to prevent and control the spread of infection. Staff conducted regular health and safety audits to ensure communal areas and people’s flats were clean and safe environments to live and work in. Fire detection and prevention systems had been approved by the fire brigade.

People were supported by staff who knew their latest care needs. The provider had taken action after our last inspection and appropriate checks were undertaken to ensure staff were suitable to support the people who used the service. There were sufficient numbers of suitably trained staff to meet people’s needs. People received their medicines safely and as prescribed.

There were systems in place to monitor and promote staff development. Staff had regular meetings with senior staff to review and identify how they could improve their performance. Staff were provided with opportunities to express their views

This service is registered to provide personal care and treatment for disease, disorder or injury to people in their own homes. At the time of our inspection the service was supporting 23 people. Some people were receiving up to 24 hour support each day, according to their assessed needs and level of independence.

At the last inspection in April 2015, the service was rated Good. At this inspection we found the service remained Good. The service remained Good in all the key questions we look at except, “Is the service Safe?” We rated this key question Requires Improvement.

People felt safe when they received support from staff. Staff demonstrated that they were aware of the action to take should they suspect that someone was being abused. There were enough staff on each shift to meet people’s care and support needs promptly. People who needed support received their medication as prescribed. Written assessments and systems in place were not all being used effectively when helping people to stay safe and reduce the risks associated with their care and support.

Staff received appropriate training and supervision in order to carry out their role. People were supported to have the 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.

When necessary staff encouraged people to prepare and eat a healthy diet and supported people to attend medical appointments.

People told us staff were friendly, caring and helpful. People received person-centred care from staff that treated them with dignity and respect.

People were involved in the planning and review of their care needs. Staff were aware of people’s individual needs and supported them according to their preferences. People were aware of how to raise issues or concerns and these were responded to.

People and staff were complimentary about the registered manager. Staff were aware of their roles and responsibilities. Systems were in place to assess and monitor the quality of service people received.

Further information is in the detailed findings below.

This unannounced inspection visit, which took place on 22 April 2015, was the first inspection of this service.

This service is registered to provide personal care and treatment for disease, disorder or injury to people in their own homes. At the time of the inspection the service was providing care and support to seven people in flats in the same building as the office and in flats next door. Some people were receiving 24 hour support and others received fewer hours support each day, according to their assessed needs and level of independence.

There should be a registered manager at this service. 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. At the time of the inspection, the manager had applied for registration and has subsequently been registered.

People using the service told us that they felt safe and were receiving a good service from staff.

Staff understood their responsibilities in relation to take action to protect people from the risk of abuse. There were good systems to ensure that staff were recruited appropriately and were subject to the necessary checks so that people were protected from the risks of being supported by unsuitable staff.

People told us that the staff were caring. Staff showed that they had an understanding of the needs of the people they were supporting. Staff received appropriate training and supervision in order to carry out their role.

People, told us that there were enough staff to care for them and they received enough support to be able to live their lives in the ways they wanted to. People were supported to attend activities of their choice and to maintain relationships with family and friends.

People, where they needed support in this area, were supported to eat and drink in ways which supported their health and respected their choices.

The Mental Capacity Act 2005 (MCA) states what must be done to ensure the rights of people who may lack mental capacity to make decisions are protected. The MCA Deprivation of Liberty Safeguards (DoLS) requires providers to submit applications to the Court of Protection for authority to deprive someone of their liberty.

We spoke to staff and looked at records to see if the service was complying with this legislation. We found that the manager and staff demonstrated understanding of the principles and requirements of the legislation and that people’s rights were respected.

Staff supported people to attend medical appointments and to make changes in their lifestyles in order to improve their health. People who needed support received their medication as prescribed. People’s medication was stored in their accommodation. Improvements were needed in the recording of medication as we found that not all doses given had been recorded on the recording sheets.

There were systems in place to assess and monitor the quality of the service. However, audits that had been conducted had not been always been effective in identifying areas in need of improvement or when staff recording practice had not been maintained in line with guidance.