Archived: Living Ambitions Limited - Chorley

Updated 2 August 2016

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

This inspection took place on 14 and 17 March 2016, and was unannounced. The inspection team composed two adult social care inspectors, a pharmacy inspector and an expert by experience. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service.

Prior to this inspection, we looked at all the information we held about this service. We reviewed notifications of incidents that the provider had sent us. Before the inspection, the provider completed a Provider Information Return (PIR). This is a form that asks the provider to give some key information about the service, what the service does well and improvements they plan to make. We received feedback from a social work professional whose feedback is included within this report.

At the time of our inspection there were 58 people who used the service. We met with nine people and spent some time observing them receiving care and support. However, not everyone could provide us with verbal feedback. We were able to speak to 14 relatives of people who used the service on a regular basis. We also spoke with seven care workers, and the registered manager. This enabled us to determine if people received the care and support they needed and if any identified risks to people’s health and wellbeing were appropriately managed.

We also looked at a wide range of records. These included; seven care records, five staff personnel records, a variety of policies and procedures, training records, medicines records and quality monitoring systems.

Updated 2 August 2016

Living Ambitions Limited - Chorley supports people to live independently. There are 23 properties in the area. There is a staff team on hand 24 hours a day to cater to any support or healthcare needs. Every person has full control over their life in a space which looks and feels very much like home.

Each supported tenancy is managed on a day to day basis by a support team leader and is provided line-manager support by the registered manager. 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.

We looked at how the service protected people from avoidable harm. We found the quality of risk assessments to be variable. Some risk assessments did not provide clear guidance for staff about the action they needed to take to help maintain people’s safety.

We looked at how the service managed people’s medicines. Medicines were not always given as prescribed by the doctor. We found there were no care plans for "as and when required" medication.

We identified concerns about staffing levels in some parts of the service. We looked at recruitment processes and found the service had recruitment policies and procedures in place to help ensure safety in the recruitment of staff.

We found that staff were able to tell us about safe guarding principles and recognised signs of abuse. We felt reassured by the level of staff understanding regarding abuse and their confidence in reporting concerns.

The principles of the Mental Capacity Act 2005 (MCA) had not been embedded into practice and we identified concerns relating to how people’s mental capacity had been assessed prior to asking people who use the service to consent to care.

Staff were not provided with effective support. Supervisions were not always undertaken with staff.

We observed people being supported and saw that staff interacted with people in a kind and caring way. Staff understood the needs of people they supported and it

was obvious that trusting relationships had been created.

We found a number of breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. In relation to safe care and treatment,safeguarding people from abuse, valid consent, good governance and staffing.

You can see what action we told the provider to take at the back of the full version of this report.