Background to this inspection
Updated
17 February 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.
The inspection was prompted in part due to us receiving an increase in notifications in relation to how people were being supported when they were anxious, and due to the number of times the police were called to incidents to assist staff when people had become anxious .
This inspection took place on the 14, 18, 20 December 2017 and 4 January 2018 and was announced. We gave the provider 24 hour’s notice that we would be visiting the service. This was because Livewell (Care & Support) Ltd provides personal care and support to people with learning disabilities and autism that live in ‘supported living’ settings. We needed to make arrangements to speak with people using the service, staff, and to have access to their records.
Inspection site visit activity started on 14 December 2017 and ended on 4 January 2018. It included visiting people who had agreed for us to visit them in their homes. We visited the office location on 14 December 2017 and 4 January 2018 to see the provider, registered manager, office staff and to review care records.
The inspection was undertaken by one 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. The expert-by-experience area of expertise was supporting people with learning disabilities and autism.
We reviewed the information we held about the service. Providers are required by law to notify us about events and incidents that occur; we refer to these as ‘notifications’. We looked at the notifications the provider had sent to us. We also contacted the local authority who monitor and commission services, for information they held about the service. We used the information we had gathered to plan what areas we were going to focus on during our inspection.
We spoke with 10 people who used the service and 10 relatives, four project managers, four support workers, the deputy manager, the registered manager and the director. We looked at a sample of records including six people’s care records, three staff files and staff training records. We also looked at records that related to the management and quality assurance of the service, such as complaints, rotas and audits.
Updated
17 February 2018
This inspection took place on the 14, 18, 20 December 2017 and 4 January 2018 and was announced. The provider was given a short notice period that we would be undertaking an inspection. At our previous inspection in June 2016, the service was meeting the regulations that we checked and received an overall rating of Good.
Livewell (Care & Support) Ltd provides care and support to 27 people living in 12 ‘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.
There was a registered manager in post who had recently registered with CQC. 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.
Livewell (Care & Support) Ltd met 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.
People told us they felt safe when supported by staff who had received training in recognising and reporting abuse. Risk assessments had been completed to guide and support staff to reduce risks and prevent people from harm. Recruitment checks were undertaken to ensure only suitable staff were employed in sufficient numbers to meet people’s assessed needs. People received their medicines by staff that had been trained to do this safely.
Staff received training and support to enable them to have the skills and knowledge for their role. Staff spoken with understood people's needs and supported them to follow their chosen lifestyles and achieve their goals. People’s human rights were respected by staff because staff applied the principles of the Mental Capacity Act 2005 and the Deprivation of Liberty Safeguards in their work practice. People were supported to maintain their healthcare needs.
People had developed positive relationships with staff that knew them well and promoted their independence and autonomy. People’s privacy and dignity was respected and promoted by the staff team and people were supported to maintain relationships with those who were important to them.
People were involved in making decisions about their support. Staff supported people to live the life they choose and participate in meaningful opportunities. People knew how to raise a complaint and had confidence any issues would be listened to and addressed. Staff were aware of the signs to look out for which may indicate people were unhappy.
People told us the service was managed well and in their best interests. People were involved in developing the service; which promoted an open and inclusive culture. Staff understood their roles and responsibilities and felt valued by the provider. The registered manager and provider understood their legal responsibilities and kept up to date with relevant changes. There were systems in place to monitor the quality of the service to enable the management team to drive improvement.