Wigan DCA is a branch of the national charity United Response, which provides a range of support services for adults and young people with learning disabilities, autism, mental health needs or physical disabilities. This service provides care and support to people living 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. At the time of our inspection, the service was supporting 42 people living in Salford, Stockport and Wigan.

This comprehensive inspection took place on 21 and 22 November 2018. The service has been developed 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. By following these principles, services can support people with learning disabilities and autism to live as ordinary a life as any other citizen.

We last inspected the service in March 2016 when we found it met all the regulations of the Health and Social Care Act (2008) Regulated Activities 2014. We rated the service ‘Good’ overall. At this inspection we found the service was in breach of one of the regulations of the Health and Social care Act (2008) regulated activities 2014. This is in relation to governance of the service.

The service had a new registered manager. 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.

Systems were in place to help safeguard people from abuse. Staff knew how to identify signs of abuse and what action to take to protect people they supported. Risk assessments had been completed to show how people should be supported with everyday risks, while promoting their independence. Recruitment checks had been carried out to ensure staff were suitable to work with vulnerable people.

People were looked after by small teams of staff who were committed to providing support in a person-centred and caring way. We saw many kind and caring interactions between staff and people they supported during our inspection. People were helped to be as independent as possible.

A safe system of medicine management was in place. Staff received medicines training and competency assessments were carried out before they were permitted to administer medicines.

The service was working within the principles of the Mental Capacity Act (MCA) 2005 and the Deprivation of Liberty Safeguards (DoLS). People were helped to make their own choices and decisions where able, such as what activities they would like to do.

All new staff received a thorough induction. Staff completed training to ensure they had the knowledge and skills to support people safely. However, we found some staff had not received individual supervision. This meant they had not had the opportunity to discuss their work and plan any training and development they needed.

Staff worked closely with health and social care professionals to ensure people were supported to maintain good health and remain as independent as possible. People's support plans contained detailed information about their preferred routines, likes and dislikes and how they wished to be supported. However, we found some support files contained old and out of date information. The service is already working towards improving its documentation.

The service had a formal process for handling complaints and concerns. We saw that complaints had been dealt with appropriately.

Audits and quality checks were undertaken on a regular basis and any issues or concerns addressed with appropriate act

This inspection took place on 22 and 23 March and was announced. We gave the provider 24 hours’ notice of our inspection to ensure there would be someone at the office we could speak with and in order to help us plan the inspection. We last inspected Wigan DCA on 22 January 2014 when we found the service to be meeting all standards inspected.

Wigan DCA is a branch of United Response, which is a national charity. The service provides care and support to people living with learning disabilities, physical disabilities, mental health needs and people on the autistic spectrum. The service provides support to people living in shared or single occupancy accommodation as part of a supported living service. Wigan DCA also provides domiciliary or ‘outreach’ support to people living in their own home. We did not inspect this aspect of service provision, as this part of the service was not providing any regulated activities at the time of our inspection. The supported living service was providing support to people living at 18 addresses across the Salford, Stockport and Wigan areas. Wigan DCA had taken over the running of the Stockport service in December 2015.

At this inspection we found the service was meeting the requirements of the regulations. We have made one recommendation for the provider to review guidance in relation to the safe management of medicines.

There was a registered manager in post at the time of our inspection. 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 medicines were being kept safely and had been administered as prescribed. However, at one house we found the administration record did not list the correct medicines on it. Staff had not identified that the administration record was incorrect and had signed to show medicines had been administered when they had not. This meant an accurate record of the medicines given had not been kept.

People told us they felt safe being supported by staff working in their home. We saw risk assessments had been completed and staff were aware of the control measures identified in risk assessments and support plans to reduce risk to people. However, risk assessments were not always clearly laid out and sometimes contained limited information. The registered manager told us they would conduct a review of all risk assessments.

At one house we found hazardous substances including ant powder and bleach were being kept in an unlocked cupboard and there had been no risk assessment in relation to these items. We felt there had not been a risk to the individuals living at that house; however this was also against the services policy on control of substances hazardous to health (COSHH). The registered manager confirmed the items had been removed after we made them aware of this concern.

Staff were positive about supporting people’s independence and had a person-centred approach. Staff at one house told us about how they had supported people to become more independent in making their own drinks through consistency of approach, prompting and using hand-on-hand techniques. Staff had an understanding of supporting positive, considered risk taking. For example they talked about supporting people to gain independence to travel alone.

Care plans were person-centred and contained information on people’s preferences and interests. Current goals had been set for people and staff were able to tell us about some of the goals they had recently supported people to achieve. There was evidence that consideration had been given to supporting people to access employment and education opportunities if this is what they wished to do.

People were supported by consistent teams of the same staff members

Following a recent re-structuring by Salford social services which had effectively split the council area into patches Wigan DCA had lost three properties where they were providing support to people. They had however gained 10 new properties within the patch they had been allocated by the council. This change had only just taken place and Wigan DCA had inherited staff under TUPE arrangements from the providers who had been providing the service. As a result Wigan DCA were undertaking a review of staff training in order to bring it up to date and were also implementing new support plans for the people they were now supporting.

The people who were able to do so told us that their support needs were being met and that they liked the staff members supporting them. Comments included; “It’s good here”, “I am fine” and “I am very happy”.

Wigan DCA had a safeguarding policy in place. This was designed to ensure that any problems that arose were dealt with openly and people were protected. Support plans held information in pictorial and easy read formats for people outlining what to do if they suspected abuse had occurred or was ongoing.

There were effective recruitment and selection processes in place.

Information about the safety and quality of service provided was gathered on a continuous basis with feedback from the people who used the service. There were regular reviews so people using the service and their representatives could comment on the service.

"I have always been happy with the care they provide for X".

"They really make a big difference; X is able to lead a much more independent life with their support".

"I like it here; I do lots of good things. X is great, she looks after me".

"I have my own room and can play lots of music”.

“I like X, she looks after me: We always have a laugh”.

“This is my house: I love living here”.

We spoke with one person who was using the service, three relatives and five members of staff. We also looked at the comments and compliments folder.

Their comments were very positive and everyone agreed that they liked the service provided. They used words to describe it such as ''On the whole everything is ok. But sometimes there is a little inconsistency when staff need to change. But we can discuss anything at the regular monthly meetings.''

''I am very satisfied with the support my relative receives. They go away on holiday and I can always talk to the manager or the staff.''

''My relative is happy and I feel that a weight has been taken off me.''

There was also a positive comment from a member of the professional healthcare team.

People expressed a lot of confidence in the staff and the managers and felt that they had no problems.Everyone spoken with knew how to access staff, although one relative did not know about the 24 hour on call access.

We found that documentation showed that staff followed company procedures and that the daily records were signed by staff members

We contacted the quality monitoring team from the local social services department. They stated that they had no concerns about this service provider