Background to this inspection
Updated
25 April 2018
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 service is a domiciliary care agency. It provides personal care to people living in supported houses. It provides a service for people with learning difficulties. In addition they support people who have a physical disability and younger adults.
We gave the service 48 hours’ notice of the inspection visit to ensure we had access to the office base and because we needed to be sure that they would be in.
The inspection team on the day consisted of two adult social care inspectors.
The inspection site visit was on 13 March 2018. It included an on-site office visit. We visited three supported houses, telephone interviews with people who lived in the houses and relatives. In addition we visited the office location on 13 March 2018 to see the registered manager and management team.
Prior to this inspection, as part of our planning, we reviewed all the information we held about the service, including data about safeguarding and statutory notifications. Statutory notifications are required to be submitted by the provider to the Care Quality Commission to advise of important events.
We received information from the local authority to gain their feedback about the care people received. This helped us to gain a balanced overview of what people experienced when accessing the service.
We used information the provider sent us in the Provider Information Return. This is information we require providers to send us at least once annually to give some key information about the service, what the service does well and improvements they plan to make.
During the inspection, we spoke with six people who lived in supported houses, three relatives and nine staff that included, team leaders and support workers. In addition we spoke with the registered manager, area manager, two service managers and members of the audit team. We looked at the care records of four people who lived in supported houses, training and recruitment records of staff.
In addition we looked at records relating to the management of Living Ambitions Chorley and medication records. We did this to ensure the management team had oversight of the service and they could respond to any concerns highlighted or lead the agency in ongoing improvements. We also looked at staffing levels focusing on how staff provided care within the supported homes.
Updated
25 April 2018
This inspection visit took place on 13 March 2018 and was announced. The provider was given 48 hours’ notice because the service delivered domiciliary care to people who lived in supported living. We needed to be sure staff in the office and people the service supported would be available to speak with us. This service is a domiciliary care agency. It provides 24 hour care for people living in supported houses.
At the time of our inspection there were 18 supported living homes and 49 people who received support from the service.
This service provides care and support to people living in 18 ‘supported living’ settings, so that they can live in their own home as independently as possible. People’s care and housing are provided under separate contractual agreements. CQC does not regulate premises used for supported living; this inspection looked at people’s personal care and support.
At the last inspection in December 2016 we asked the provider to take action to make improvements because breaches of legal requirements were found. The provider had failed to ensure there were effective systems in place to monitor the safety and quality of all aspects of the service.
There was 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.
During this inspection we found the management team had addressed the issues and had implemented systems to ensure people were safe.
Audits were completed and conducted by independent auditors, they included, medication processes, each environment at the supported houses and care records. These were now taking place regularly. Any issues found on audits were quickly acted upon and any lessons learnt to be implemented to improve the quality of service provided for people.
The management team had addressed the issues and had implemented systems to ensure people were safe. For example risk assessments were completed for all people living in supported houses to ensure they were safe.
Medication administration had been improved and made safer to ensure people received their medicines on time and correctly.
People who lived in supported houses and their relatives told us staff were caring and kind towards them. Staff we spoke with understood the importance of high standards of care to give people meaningful independent lives. One person who was a tenant in supported housing said, “Yes they are great always looking after me so well.”
The service had systems in place to record safeguarding concerns, accidents and incidents and took necessary action as required. Staff had received safeguarding training and understood their responsibilities to report unsafe care or abusive practices.
We found there was an appropriate skill mix of staff to ensure the needs of people who lived in supported houses were met. New staff worked alongside experienced staff members and shadowed them to ensure they understood their role.
Care plans were organised and had identified care and support people required. We found they were personalised and informative about care people received. They had been kept under review and updated when necessary. They reflected any risks and people’s changing needs.
People were supported to have maximum choice and control of their lives and staff support them in the least restrictive way possible; the policies and systems in the service support this practice.
Staff received regular training and were knowledgeable about their roles and responsibilities. They had skills, knowledge and experience required to support people who lived in supported housing.
People who lived in supported houses were sufficiently supported to maintain their physical and mental health. Staff escorted people to appointments and maintained contact with community health and social care professionals.
We spoke with people in the houses and they told us mealtimes were a relaxed social occasion. One staff member said, “We generally pick and choose on the day and it is their choice what anyone wants.” People had a choice of what they wanted to eat and staff were aware of people's needs in this area. One person who lived in one of the houses said, “I like pizza a lot and help cooking it.”
People told us staff, the registered manager and management team were polite, sensitive and respectful in their approach to caring for people in supported houses.
People who lived in supported housing and their relatives knew how to raise a complaint and who to speak with. The management team had kept a record of complaints received and these had been responded to in a timely manner.
The service used a variety of methods to assess and monitor the quality of the service. These included staff meetings, surveys and visits to the supported houses.