A supported living provider in Bucks received a new rating after a visit by the health care watchdog. 

Aylesbury Supported Living Service run by The Fremantle Trust, which supports 27 adults with learning and physical disabilities across four sites, was inspected by the Care Quality Commission.

Following inspections in December last year, the CQC downgraded the service from previous ‘requires improvement’ to ‘inadequate’ overall.

The key categories of safety and how well led the service is were rated as ‘inadequate’, while the effectiveness, care, and responsive categories remained good.

The inspectors found “people were not always protected from avoidable harm”.

A person was injected regularly with a contraceptive injection, the inspector reported.

When the inspector asked about it, they were told “it was not clear if the person understood.”

“There was the potential for the person to be receiving the injection without informed consent being in place,” they concluded.

There was no risk assessment in place for someone at risk of choking, and for another person on blood thinning therapy treatment, the inspector found. 

The report said: “There was a period between 28 November and 8 December 2022 when there was no record of the person having their bowels open. Staff were unable to provide verbal confirmation whether they had or not.”

Because of concern for the individual, the inspector asked the manager to contact the GP straight away to seek advice, the report noted.

The CQC was concerned that financial contributions had been taken from a person without “proper authorisation or consent” after their financial support plan said they had “no understanding around the value of money”.

Relatives told the inspectors that their loved-ones were safe.

A relative commented: "In terms of safety she's not unsafe at all. She knows what's happening, they take her where she needs to go, she knows what's going on.

The provider had made enough improvements to control the spread of infection from the previous inspection, and standards of cleanliness had improved, the CQC said.

However, records relating to people’s medicines “were not always accurate”, and expectations of record-keeping across the service were “inconsistent,” the report noted.  

People had not been refunded monies they had previously paid into a household fund that had stopped and that they were owed as a result.

This was £60 per week at one point.

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The inspectors were told the matter was being dealt with by the service’s account department, but no date for payment was provided, the CQC said.

At the time of the inspection in December 2022, the service had no registered manager.

The inspector said the service felt uncoordinated, and individual premises relied on the skills and knowledge of individual team leaders rather than “robust” oversight.

However, the senior management team were well known by people and staff in the supported living settings, and they engaged with each other easily, the inspectors noted.

The Fremantle Trust was contacted for a comment.