Real Life Options - Yorkshire was rated Requires Improvement overall following a January 2023 inspection, with breaches of Regulation 17 (Good Governance) and Regulation 18 (Staffing) identified. Key concerns included unmonitored late calls, heavy reliance on agency staff unfamiliar with people's needs, and governance systems insufficiently embedded to ensure safe oversight.
Concerns (6)
criticalStaffing levels: “The provider did not monitor late calls to people living in their own homes. Therefore, we could not be assured people were receiving care as planned.”
criticalStaffing levels: “Staff and relatives felt staffing levels were poor. "We are firefighting, the priority has to be keeping staff and service-users safe."”
critical
Governance
: “Systems were not yet robust enough to demonstrate good governance. This placed people at risk of harm. This was a continued breach of regulation 17.”
moderateSupervision / appraisal: “Recent management changes meant there were gaps, for example with supervision and surveys however there was evidence these were being addressed.”
moderateInfection control: “One of the supported living houses we visited was unclean and although we saw evidence of cleaning records there was not enough time allocated.”
minorMedication management: “People had medicine support plan and protocols describing when they should be offered some of their 'when required' medicines however we found some documentation lacked details.”
Strengths
· Risks to people were recognised, assessed and managed safely with regular reviews whenever needs changed.
· Staff were knowledgeable about the people they supported and had established good rapport.
· Safeguarding systems were in place including a safeguarding log and regular team meeting discussions.
· Staff understood STOMP principles and medicines were administered, recorded and stored safely with audits in place.
· Staff recruitment was safe with DBS checks, employment history and references completed.
Quality-Statement breakdown (8)
safe: Staffing and recruitmentRequires improvement
safe: Using medicines safelyRequires improvement
safe: Preventing and controlling infectionRequires improvement
safe: Systems and processes to safeguard people from the risk of abuseGood
safe: Assessing risk, safety monitoring and management; Learning lessons when things go wrongGood
well-led: Managers and staff being clear about their roles, quality performance, risks and regulatory requirements; Continuous learning and improving careRequires improvement
well-led: Engaging and involving people using the service, the public and staff; Working in partnership with othersRequires improvement
well-led: Promoting a positive culture that is person-centred, open, inclusive and empowering; Duty of candourGood
Real Life Options - Yorkshire was rated Good across all five key questions at its first CQC inspection in June–July 2018, demonstrating person-centred care, strong safeguarding practice, and an open management culture. Minor improvements were identified around medicines guidance personalisation, complaints oversight, and embedding a new incident-tracking system, all of which were being actively addressed.
Concerns (7)
minorMedication management: “Some improvements were needed to fully ensure the safe management of medicines. The management team took prompt action to ensure the concerns were addressed by the end of the inspection.”
minorCare planning: “We found some guidance for these medicines was in place but this needed more personalisation regarding people's individual needs for these medicines.”
minorGovernance: “There was no overview of complaints in the service...the new computer system which was yet to be fully embedded, would in the future provide an overview of reports so any trends and patterns could be more easier identified.”
minorRecord keeping: “Some recruitment records were not immediately available at the location office as they were held at the provider's head office. They were obtained during the inspection.”
minorIncident learning: “A new system was in place to provide overview of accidents, incidents and safeguarding concerns. This had not been fully embedded but would provide reports to identify any patterns and trends.”
minorPerson-centred care: “One relative told us they did not think their family member was encouraged to be as independent as they could be.”
minorCommunication with families: “Another relative did not have confidence and felt there was poor communication from the management team.”
Strengths
· Staff received appropriate safeguarding training and understood responsibilities to identify and report concerns
· Personalised risk assessments were in place and regularly reviewed for each person
· Staff received regular supervision, appraisal, and a rolling programme of relevant training including PBS
· Care records were person-centred, detailed, and regularly updated to reflect changing needs
· People were supported to maintain maximum independence and choice in line with MCA principles