Living Ambitions Limited (Doncaster) provides personal care and support to people living in shared, supported living projects and singularly, in their own homes in East Yorkshire and North East Lincolnshire. At the time of our inspection there were 170 people with a learning disability and, or a mental health related condition using the service, mostly on a 24 hour basis. The inspection took place on 18, 19 and 20 April 2017 and was announced. This is the first inspection of the service since it was taken over by the provider, Living Ambitions Limited.
The service had an established registered manager in post. 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 and associated Regulations about how the service is run.
Some people we spoke with had limited verbal communication. However, they very clearly indicated they felt safe and were happy, liked the staff and did the activities they liked to do.
People spoke highly of the staff who supported them. They told us they felt safe and comfortable with the staff and they received a good service. Policies and procedures were in place to safeguard people from harm and the staff we spoke with understood their responsibilities.
Detailed risk assessments helped to protect people from risks they may encounter in their daily lives.
The registered manager monitored the quality of the service; they held electronic records which related to all aspects of the service such as safeguarding, complaints, accidents and incidents.
Person-centred care plans were in place to support staff to provide a personalised service. Records demonstrated that regular reviews were carried out of people's needs and the service they received.
The support plans were centred on people’s individual needs and contained information about their preferences, backgrounds and interests. People were positive about the different social groups they could attend as well as following their own routines like attending adult social centres. Some people we visited told us that they preferred to stay at home and follow their own interests as they were more independent.
People were encouraged to make decisions about meals, and were supported to go shopping and be involved in menu planning. People’s dietary needs were catered for and we saw clear instructions were followed when a person had involvement from the speech and language therapist (SALT).
Our observations, together with our conversations with people, provided evidence that the service was caring. The staff had a clear understanding of the differing needs of people living in their own properties and we saw they responded to people in a caring, sensitive, patient and understanding professional manner.
People told us they were aware of the complaints procedure and said staff would assist them if they needed to use it. We saw that the complaints procedure was written in plain English using pictures and words which described how people should raise any concerns the may have. It also explained to people how they could obtain an independent person to assist them if needed.
Staff records showed the recruitment process was robust and staff were safely recruited. Training was delivered to staff in order to help them support people’s specific needs. An induction process was in place and staff training was up to date. Competency checks were routinely carried out.
Most staff confirmed they received regular supervision and appraisal and team meetings were held within each household. Staff felt there were enough staff employed to manage the services with a consistent team.
We found staff understood the principles of the Mental Capacity Act (2005) and their responsibilities when they assessed people’s capacity. Decisions that were made in people’s best interests had been appropriately taken with other professionals and relatives involved.
Service managers and team leaders carried out spot checks of support workers and they regularly courtesy called people who used the service and their relatives. An annual satisfaction survey was used to formally gather opinions about the service.