Date of assessment: 21 January to 11 February 2025 Diverse Abilities Plus – Supported Living is a domiciliary care and supported living service that supports adults with a learning disability and who may be autistic. It provided personal care to 33 people at the time of the inspection. We carried out this inspection to check the provider had rectified the shortfalls we identified at our previous inspection in February 2023. The service had made improvements and is no longer in breach of regulations. The registered managers now had oversight of the service. They ensured CQC were notified of any reportable incidents. There were effective systems for assessing, monitoring and improving the quality and safety of the service. They had rectified shortfalls we identified at our previous inspection. Staff treated people with respect and kindness, upholding their privacy and dignity. Care and support maximised people’s choice, control and independence. Staff worked in partnership with people, families and professionals to plan and deliver care tailored to people's individual needs and preferences. Staff had training and support to maintain the skills and confidence needed for safe, effective working. Their roles and responsibilities were clear. We have assessed the service against ‘Right support, right care, right culture’ guidance to make judgements about whether the provider guaranteed people with a learning disability and autistic people respect, equality, dignity, choices, independence and good access to local communities that most people take for granted.
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Date of assessment: 21 January to 11 February 2025 Diverse Abilities Plus – Supported Living is a domiciliary care and supported living service that supports adults with a learning disability and who may be autistic. It provided personal care to 33 people at the time of the inspection. We carried out this inspection to check the provider had rectified the shortfalls we identified at our previous inspection in February 2023. The service had made improvements and is no longer in breach of regulations. The registered managers now had oversight of the service. They ensured CQC were notified of any reportable incidents. There were effective systems for assessing, monitoring and improving the quality and safety of the service. They had rectified shortfalls we identified at our previous inspection. Staff treated people with respect and kindness, upholding their privacy and dignity. Care and support maximised people’s choice, control and independence. Staff worked in partnership with people, families and professionals to plan and deliver care tailored to people's individual needs and preferences. Staff had training and support to maintain the skills and confidence needed for safe, effective working. Their roles and responsibilities were clear. We have assessed the service against ‘Right support, right care, right culture’ guidance to make judgements about whether the provider guaranteed people with a learning disability and autistic people respect, equality, dignity, choices, independence and good access to local communities that most people take for granted.
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Diverse Abilities Plus – Supported Living received an overall rating of Requires Improvement at its first inspection, with breaches found for failing to notify CQC of at least 14 notifiable incidents (Regulation 18) and inadequate governance systems that missed missing mental capacity assessments, incorrect contact records, and the negative impact of heavy agency staff reliance (Regulation 17). Strengths included highly personalised support plans, a compassionate and open culture among regular staff, effective partnership working with health professionals, and prompt managerial responses to issues identified during inspection.
Concerns (9)
criticalIncident learning: “The provider had not notified CQC of at least 14 notifiable incidents...This meant CQC was not aware of incidents that might have affected the way we monitored the service.”
criticalGovernance: “Systems and processes had not enabled the registered managers to assess, monitor and improve the quality and safety of the service.”
criticalConsent / capacity: “No best interests decision was recorded in relation to the splints...there was a risk the service may not have identified restraint was happening.”
moderateConsent / capacity: “The service did not always assess people's mental capacity to make particular decisions, or did so in a way that did not meet legal requirements.”
moderatePerson-centred care: “Agency staff who did not know people well and were not as attentive to their individual needs and preferences as regular staff.”
moderateSafeguarding: “The safeguarding adults policy reviewed in November 2022 referenced outdated national and local policies and guidance.”
minorCommunication with families: “Relatives had mixed views about how well staff kept them informed from day to day...Communication is not good. We used to get newsletters, that all stopped.”
minorComplaints handling: “The complaints policy wrongly instructed complainants to escalate their complaints to CQC, which does not have the legal powers to investigate individual complaints.”
minorRecord keeping: “A relative highlighted how they had alerted the service to incorrect contact details for a close family member...The quality assurance checks should have identified this but had not.”
Strengths
· People and relatives said regular staff were kind, caring, patient and attentive to individual needs and preferences.
· Support plans were holistic and highly personalised, reflecting people's strengths, equality characteristics, preferences and needs.
· People each had a health passport summarising key information for care staff and professionals in other settings.
· Staff understood people's communication needs and provided support as set out in support plans, including communication passports.
· The provider exercised duty of candour; registered managers were open and honest with people and families when things went wrong.
Quality-Statement breakdown (21)
safe: Systems and processes to safeguard people from the risk of abuse; learning lessons when things go wrongRequires improvement
safe: Staffing and recruitmentGood
safe: Assessing risk, safety monitoring and managementGood
safe: Using medicines safelyGood
safe: Preventing and controlling infectionGood
effective: Ensuring consent to care and treatment in line with law and guidanceRequires improvement
effective: Assessing people's needs and choices; delivering care in line with standards, guidance and the lawGood
effective: Staff support: induction, training, skills and experience
Good
effective: Supporting people to eat and drink enough to maintain a balanced dietGood
effective: Supporting people to live healthier lives and access healthcare servicesGood
caring: Ensuring people are well treated and supported; respecting equality and diversityRequires improvement
caring: Supporting people to express their views and be involved in making decisions about their careGood
responsive: Planning personalised care to ensure people have choice and controlGood
responsive: Meeting people's communication needsGood
responsive: Supporting people to develop and maintain relationships; support to follow interests and activitiesGood
responsive: End of life care and supportGood
responsive: Improving care quality in response to complaints or concernsGood
well-led: Managers and staff being clear about their roles; understanding quality performance, risks and regulatory requirementsRequires improvement
well-led: Promoting a positive culture that is person-centred, open, inclusive and empoweringGood
well-led: How the provider understands and acts on the duty of candourGood