Living Glory Social Care

Updated 12 April 2024

The inspection

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Health and Social Care Act 2008.

Inspection team

The inspection team consisted of 4 inspectors and 3 Experts 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.

Service and service type

Domiciliary care and Supported Living;

This service is a domiciliary care agency. It provides personal care to people living in their own houses and flats. Although this service is registered to provide care and support to people living in ‘supported living’ settings, so that they can live as independently as possible. The provider told us they were not supporting anyone via the supported living service at the time of the inspection.

Registered Manager

This provider is required to have a registered manager to oversee the delivery of regulated activities at this location. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Registered managers and providers are legally responsible for how the service is run, for the quality and safety of the care provided and compliance with regulations.

At the time of our inspection there was a registered manager in post.

Notice of inspection

The inspection was announced. We gave the service 24 hours’ notice of the inspection. This was to ensure that the provider or registered manager would be in the office to support the inspection.

What we did before the inspection

We sought feedback from commissioners who work to find appropriate care and support services for people and fund the care provided. We used the information the provider sent us in the provider information return (PIR). This is information providers are required to send us annually with key information about their service, what they do well, and improvements they plan to make.

During the inspection

We spoke with 2 directors and the registered manager who is also the nominated individual. The nominated individual is responsible for supervising the management of the service on behalf of the provider. We also spoke with the operations manager who is also a director, 2 care coordinators, office administrator and care staff who also worked as office staff. We reviewed records relating to the management of the service including quality audits, training data and people's feedback. We also reviewed 8 staff files to check staff had been recruited safely.

After the inspection

We spoke with 20 care staff, 12 people who use the service and 25 relatives/representatives via the telephone to gather further feedback on the service. We also reviewed care records for 16 people including care plans, risk assessments, daily notes and medication administration records, policies and procedures and other supporting records.

Updated 12 April 2024

About the service

Living Glory Social Care is a domiciliary care agency providing personal care to people living in their own homes, including children, younger adults, older people, and people with learning disabilities. At the time of our inspection 228 people were in receipt of personal care, 44 of these were children. The provider told us at the time of inspection they were not supporting any people in supported living settings.

People’s experience of the service and what we found:

We expect health and social care providers to guarantee autistic people and people with a learning disability the choices, dignity, independence and good access to local communities that most people take for granted. Right support, right care, right culture is the statutory guidance which supports CQC to make assessments and judgements about services providing support to people with a learning disability and/or autistic people. We considered this guidance as there were people using the service who have a learning disability and or who are autistic.

Right Culture

People were not consistently supported to have maximum choice and control of their lives and staff did not always support them in the least restrictive way possible and in their best interests; the policies and systems in the service did not support this practice.

The provider did not have robust systems in place to monitor the quality and safety within the service. This meant the provider had failed to identify some of the issues we found. This included concerns about the lack of care plans and risk assessments for people’s known health conditions, lack of guidance for staff to follow in relation to prescribed medicines and lack of monitoring for people for whom methods of restraint had been approved. Where the provider's systems had highlighted concerns, the systems in place to action and follow up on these were not robust and did not evidence appropriate actions had been taken.

The registered manager told us how they had communicated with staff and people using the service to ensure the culture within the service was open and inclusive.

Right Support

Risks to people were not always well managed which meant risk of harm to people had not always been considered. There was no evidence that people had been harmed. There was little evidence to demonstrate people had been supported with things which were important to them such as their interests. However, staff knew people well. Medicines were not always well managed, including a lack of robust guidance for staff to follow in relation to ‘as required’ medicines.

People were supported to live in their own homes. Although there were adequate numbers of staff to support people, calls did not always take place at the time people wanted and for some, they were often shorter than commissioned.

Right Care

People's care plans and risk assessments did not always provide robust guidance for staff to follow in relation to people’s known health needs. This included how to support people who expressed emotional distress to minimise the risks to themselves and staff. This meant people could be placed at risk as staff may not have information in relation to how known health conditions impact on people’s needs, wishes and abilities. However, there was no evidence to demonstrate people had been harmed. People were not always supported and encouraged, to promote their independence.

We found overall there was a stable team of staff who knew people's needs.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection

The last rating for this service was Good (published 02 September 2019).

Why we inspected

The inspection was prompted in part due to concerns received about staffing, poor care practices, missed, short or late call times, and poor medicines management. A decision was made for us to inspect and examine those risks.

Enforcement

We have identified new breaches in relation to Person centred care, Need for consent, Safe care and treatment, Safeguarding service users from abuse and improper treatment, Receiving and acting on complaints, Good governance, Staffing and Fit and proper persons employed.

Follow Up

We will request an action plan from the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. Once the report has been published, we will arrange a meeting with the provider to discuss how they will make changes to ensure they improve their rating to at least good. We will work with the local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.

Special Measures

The overall rating for this service is ‘Inadequate’ and the service is therefore in ‘special measures. This means we will keep the service under review and, if we do not propose to cancel the provider’s registration, we will re-inspect within 6 months to check for significant improvements.

If the provider has not made enough improvement within this timeframe and there is still a rating of inadequate for any key question or overall rating, we will take action in line with our enforcement procedures. This will mean we will begin the process of preventing the provider from operating this service. This will usually lead to cancellation of their registration or to varying the conditions the registration.

For adult social care services, the maximum time for being in special measures will usually be no more than 12 months. If the service has demonstrated improvements when we inspect it, and it is no longer rated as inadequate for any of the five key questions it will no longer be in special measures.