This inspection took place on 19 and 20 January 2015. We gave the provider 48 hours' notice to make sure there would be someone in. We found the service was compliant with the regulations we inspected against when we last inspected in October 2013.
Liberty Centre is a service specialising in supporting people with autism and learning disabilities. It provided domiciliary care for one person and supported living for four people. The service has a registered manager in place. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are 'registered persons'. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.
People were not always protected from abuse and harm. We saw there had been a number of incidents of violent behaviour that had resulted in injury. These had not been reported or effectively followed up.
Medicines were not always managed safely. We saw that there were mistakes in the recording of people's medicines, there were stocks of medicines that could not be accounted for and some medicines were not being stored in accordance with their instructions.
Staff were not always following the Mental Capacity Act 2005 for people who lacked capacity to make a decision. For example, the provider had not made an application with the local authority to the court of protection, even though people's liberty may have been restricted.
The provider had not followed safe recruitment processes. Staff had been employed before their criminal records checks had been returned and the gaps in people's employment history had not been explored.
People's backgrounds were respected. We saw that people were provided with food that related to their cultural background and personal preferences, and they were supported to access religious services in the community.
Care did not meet people's individual needs. The provider did not keep accurate records about the needs of each person, with risk assessments and care plans not relating to the person's current needs.
People using the service and their families were encouraged to give their feedback about the service. We saw that family members were involved in people's care and had been consulted about decisions made about people's care.
The provider did not have effective systems for monitoring and auditing the quality of the service.
CQC registration requirements, including the submission of notifications in relation to safeguarding and applications to the court of protection and their outcomes had not been met.
At this inspection we found breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2010 in relation to care and welfare of service users; assessing and monitoring the quality of service provision; safeguarding service users from abuse; management of medicines; consent to care and treatment; records; requirements relating to workers; and, supporting workers. You can see what action we told the provider to take at the back of the full version of this report.