CCS Homecare Services Limited

Some people received personal care in supported living accommodation. At the time of our inspection, support was provided at 16 supported living sites. Accommodation ranged in size, from single person flats to a development of 16 one-bedroom flats, with shared facilities such as a communal lounge and garden. Most sites supported around five to seven people living with learning disabilities, and some people also required mental health support.

The service supported individuals at four extra care housing sites within the London Borough of Hillingdon. People using the service lived in flats, with access to care support. The size of these buildings ranged from 47 to 88 flats. One of the buildings contained a six-flat unit, used to provide short term care support for people discharged from hospital.

The service also supported people living in their own homes. Some people received support as part of discharge to assess arrangements, meaning they received short-term care following hospital discharge. Other people received care support on an ongoing basis.

Not everyone who used the service received personal care. CQC only inspects where people receive personal care. This is help with tasks related to personal hygiene and eating. Where they do we also consider any wider social care provided.

Most people felt safe whilst receiving discharge to assess support. Some people provided positive feedback. One relative told us, "It was an excellent transition from hospital to home. She feels safe with the carers who come as they help her confidence and trusts them to do a good job." Another person advised, "I felt safe with the carers as whatever I asked them to do, they did it. They reminded me of the risks with walking and how to use the zimmer frame."

We also spoke with people and families in relation to long-term care and support at home. Most people told us they felt safe with the care and support they received. One person told us, "The carers inspect me for sores as it is part of my plan, I self-medicate and I'm treated with dignity and respect". Another person added, "I feel safe and comfortable when carers are here".

We heard varying feedback about the consistency of people's support, particularly regarding punctuality of staff. One person told us, "Lunchtime can be anywhere between 11.00am and 2.00pm. They have never missed a call but won't give me a time." Other comments included, "they are fairly punctual", "carers are often late" and "schedules given to carers don't seem to correspond with what has been agreed."

People we spoke with did not know the name of the manager, but there was generally positive feedback about communication with the office. One person told us, "The staff and carers are pleasant and friendly… I'm happy with the office." Another person told us, "If I have concerns, my relative deals with the office for me. A lady comes out and asks me questions about the support I'm getting and if I need anything from my plan changing". People also confirmed they were contacted for feedback as part of quality assurance monitoring.

We also gathered feedback from people and families using extra care services. People told us they felt safe and spoke positively about the support they received. People used an alarm system to call for assistance when staff weren't present. We heard staff responded promptly to the alarm. People received support from regular staff, and we heard staff understood people's needs and preferences. One person told us, "They do everything they are supposed to do for me, I like all the girls." At one site we visited, people knew there was a new manager and one person said, "She pops in to see me". Another person at the same site told us the manager acted quickly when they requested an earlier morning visit, to ensure they received pain relief medicines at the right time.

People spoke positively about safe care received within supported living settings. This helped people achieve good outcomes. People felt there were enough staff to support them and told us they felt supported in relation to medicines and managing the risks associated with COVID-19 infection. Some people's routines and preferred activities had been impacted by the pandemic, with one person commenting, "It's difficult to set goals. College finished early." However, people told us the service had supported them during this period. One relative told us, "[person's name] used to go to a day centre. They definitely get one to one support three days a week and since he's been in hospital, he needs extra help. They've done really well." Another person described the activities they now access and enjoy, advising, "I like shopping, television and music. I go to college to do maths, English and cookery."

We found risks in relation to people's care and support were not always clearly identified within records. We also identified concerns in relation to the recording of medicines support. We made recommendations the service develop their approach in relation to risk assessments and medicines recording. The service responded to our feedback immediately to confirm they were taking action to address the concerns we found.

We found records in relation to people's care and support were not always person-centred. Some records contained contradictory or incorrect information. The language used within care plans was not always person-centred. The service was responsive to our feedback and immediately confirmed they would work to make improvements. This included plans to revise staff training and review the content and wording of all care plans and risks assessments.

We expect health and social care providers to guarantee autistic people and people with a learning disability

the choices, dignity, independence and good access to local communities that most people take for granted. Right Support, right care, right culture is the statutory guidance which supports CQC to make assessments and judgements about services providing support to people with a learning disability and/or autistic people.

This service was able to demonstrate how they were meeting the underpinning principles of right support and right culture. We did not look at the component of right care as part of this inspection.

Right support: • Model of care and setting maximises people's choice, control and independence.

Right care: • We did not inspect the Caring domain as part of this inspection and did not look at all the components in relation to right care.

Right culture: • Ethos, values, attitudes and behaviours of leaders and care staff ensure people using services lead confident, inclusive and empowered lives.