Supported Futures, a small domiciliary care agency supporting autistic people and those with a learning disability, was rated Requires Improvement overall following a focused inspection in August 2023, with breaches of Regulation 17 (Good Governance) identified due to ineffective quality monitoring systems, absent registered manager, gaps in care planning, incomplete staff training, and lack of formal supervision. The provider responded promptly to all concerns raised during the inspection, implementing daily care records, medication audits, formal supervisions, updated care plans, and initiating the registered manager application process.
Concerns (9)
criticalGovernance: “The provider's governance systems to record, assess and monitor the quality of service provided to people were ineffective.”
criticalRecord keeping: “Daily care notes were not being recorded. This meant there were no records to document the care and support being delivered to people using the service.”
criticalLeadership: “In order to comply with regulatory requirements a registered manager was required to be in post. However, a registered manager had not been in place for over 12 months.”
moderateCare planning: “People's health conditions, which impacted upon their health and wellbeing, were not always clearly documented in care plans.”
moderateStaff training: “There were gaps in staff training such as autism and epilepsy training. In addition, some training had expired, therefore some staff required refresher training.”
moderateSupervision / appraisal: “Formal supervisions were not taking place with staff, this meant there were no records evidencing staff were discussing concerns or reviewing their practice with the manager.”
moderateMedication management: “Medicines were administered by suitably trained staff, although we could not be assured medicine administration was being monitored.”
moderateIncident learning: “Incidents were documented, but incident analysis and staff debriefs were not recorded. This meant the provider could not demonstrate they were implementing strategies to support people.”
moderateConsent / capacity: “One person required Lasting Power of Attorney (LPA) protections. However, their care plan did not detail who held this responsibility and there was no reference the LPA documentation had been viewed.”
Strengths
· Relatives told us people felt safe and respected by the staff who supported them.
· Staff were recruited safely and received training and development opportunities.
· Safeguarding policies were regularly updated and included in a staff induction booklet.
· Care plans were person centred and people were supported to take positive risks.
· The culture was inclusive and focused on promoting the best outcome for people.
Quality-Statement breakdown (15)
safe: Assessing risk, safety monitoring and managementRequires improvement
safe: Learning lessons when things go wrongRequires improvement
safe: Staffing and recruitmentRequires improvement
safe: Using medicines safelyRequires improvement
safe: Systems and processes to safeguard people from the risk of abuseGood
safe: Preventing and controlling infectionGood
effective: Ensuring consent to care and treatment in line with law and guidanceRequires improvement
effective: Staff support: induction, training, skills and experienceRequires improvement
effective: Staff working with other agencies to provide consistent, effective, timely careRequires improvement
effective: Supporting people to eat and drink enough to maintain a balanced dietGood
effective: Assessing people's needs and choices; delivering care in line with standards, guidance and the lawGood
well-led: Managers and staff being clear about their roles, and understanding quality performance, risks and regulatory requirementsRequires improvement
well-led: Working in partnership with othersRequires improvement
well-led: Continuous learning and improving careGood
well-led: Promoting a positive culture that is person-centred, open, inclusive and empoweringGood