Livability York House Shrewsbury

About the service

Livability York House Shrewsbury, is registered as both a care home and a supported living service providing personal care to eight people at the time of the inspection. The service currently supports five people in the care home and three people in the community. We reviewed both aspects of the service as part of this inspection.

People’s experience of using this service and what we found

Right Support

People received a service which supported them with their faith. People maintained an active relationship with their church and were involved in activities in the community.

Staff completed care records, but we found some gaps in people’s documentation and areas where action was required. For example, there were gaps in fluid records which meant we could not be sure if people were getting the right amount of fluid for their individual needs.

The building was being refurbished but more work was required to ensure all areas could be effectively cleaned.

People received their medicine from trained staff and action was taken to ensure there was clearer instruction for medicine given on an ‘as required’ basis.

The provider produced action plans outlining improvements they were going to make to the service, but more detail was required for the progress to be successfully monitored.

Right Care

Staff completed incident reports when something happened, but they did not always refer to the incident in the daily records of everyone involved. People impacted by the behaviour of others needed to have their wellbeing monitored.

New staff and agency workers were given an induction and time to read people’s care plans to ensure they understood each person’s individual needs.

The manager of the service worked with people and the staff team in a kind and considered way. People responded well to this approach.

Right culture

People were supported by a growing team of permanent staff. Agency staff were well supported in the service and, all staff working in the community received increased monitoring and support throughout the day.

The provider had not always ensured information was handed over in a timely manner and care plans were updated when information was reviewed.

Families told us there had been reduced communication due to changes within the staff team. The provider was addressing this and actions taken included newsletters showing activities people had been involved in and plans for the future.

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

Rating at the last last inspection.

The last rating for the service was good (published 15 August 2018). At this inspection we found the provider was in breach of regulation.

You can see what action we have asked the provider to take at the end of the full report.

Why we inspected

This inspection was prompted in part due to concerns about agency staff use. Also, in response to a serious incident involving an agency worker. The incident is subject to criminal investigation and as a result we did not examine the circumstances of the incident. The information CQC received about the incident indicated concerns about the management of agency staff. This inspection examined those risks and the subsequent actions taken by the provider.

We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.

Follow up

We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.

This was the first inspection of the service since it registered with the Care Quality Commission in June 2017.

Livability York House Shrewsbury is a ‘care home’. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection. Livability York House Shrewsbury also provides care and support to people living in three 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.

The care home provides a service for up to 10 adults who have a learning disability, associated physical disability and/or autistic spectrum disorder. At the time of our visit there were six people living at the home. Four people were receiving a service in their own homes.

The care service has been developed and designed in line with the values that underpin the Registering the Right Support and other best practice guidance. These values include choice, promotion of independence and inclusion. People with learning disabilities and autism using the service can live as ordinary a life as any citizen. Registering the Right Support CQC policy

There was a registered manager in post who ensured the home was well managed. 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 received a safe service. The provider ensured that people were supported by sufficient staff who knew how to protect people from the risk of harm or abuse. The provider’s procedures for staff recruitment helped to ensure people were only supported by staff who were suitable to work with the people who used the service. People were able to live their lives with reduced risks to themselves. Staff followed safe procedures for the management and administration of people’s medicines. Staff followed the provider’s health and safety procedures which helped to ensure people lived in a safe and well-maintained environment. There were procedures to deal with foreseeable emergencies and these were understood and followed by staff. People were protected from the risks associated with the spread of infection because staff had received training and followed appropriate procedures.

People received effective care and support from staff who had the skills, training and knowledge to meet their individual needs. Staff understood the importance of ensuring people’s rights were respected. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service support this practice. People were supported to eat well in accordance with their needs and preferences. People’s health and well-being were regularly monitored.

People were supported by staff who were kind, compassionate and who took time to get to know what was important to people. Information about advocacy services had been produced in an accessible format for the people who used the service. Staff treated people with respect and ensured people could spend time alone whenever they wanted. People were supported to plan their day in accordance with their needs and preferences. Staff communicated with people in accordance with their needs and abilities which helped people make an informed decision. People were supported to maintain contact with the important people in their lives.

People received a service which was based on their needs and preferences and there was an emphasis on enabling people to be as involved in the planning and review of the support they received. People enjoyed a variety of activities and social events within the service and the local community. The service had not received any complaints however systems were in place to enable people to raise concerns. People were supported to practice their faith and attend religious services if and when they wanted. People’s care plans detailed their preferences following death which helped staff to ensure their wishes were respected.

People benefitted from a provider and registered manager who promoted an open and honest culture, learned from mistakes and continually looked at how the quality of the service could be improved. People were supported by a staff team who embraced the provider’s ethos and who felt valued and well supported. People’s views were valued and responded to and people were enabled to be part of the wider community.

Further information is in the detailed findings below