Background to this inspection
Updated
15 July 2023
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 was carried out by 1 inspector.
Service and service type
This service provides care and support to people living in ‘supported living’ settings, so that they can live as independently as possible. People’s care and housing are provided under separate contractual agreements. CQC does not regulate premises used for supported living; at the time of our inspection there were no people living in ‘supported living’ settings. However, the service was providing domiciliary care. This is personal care to people living in their own houses and flats.
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
We gave the service 48 hours’ notice of the inspection. This was because it is a small service and we needed to be sure that the provider or registered manager would be in the office to support the inspection.
Inspection activity started on 9 June 2023 and ended on 15 June 2023. We visited the location’s office 9 June 2023.
What we did before the inspection
We reviewed information we had received about the service since their registration. We sought feedback from the local authority and professionals who work with the service. We used all this information to plan our inspection.
The provider was not asked to complete a Provider Information Return (PIR) prior to this inspection. A PIR is information providers send us 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 4 people who used the service and 1 relative about their experience of the care provided. We spoke with 5 members of staff including the registered manager and care workers.
We reviewed a range of records. This included 3 people’s care records. We looked at records in relation to recruitment and staff supervision. A variety of records relating to the management of the service, including policies and procedures were also reviewed.
Updated
15 July 2023
About the service
Living Support 4 U is a 'supported living' service that provides personal care to people living with dementia, mental health conditions, sensory impairments and physical disabilities. At the time of our inspection there were no people living in ‘supported living’ settings, however, the service was providing personal care to 8 people living in their own houses and flats.
Not everyone who used the service received personal care. CQC only inspects where people receive personal care. This is help with tasks related to personal hygiene and eating. Where they do we also consider any wider social care provided.
People’s experience of using this service and what we found
Medicines were not safely managed. Staff were not assessed as competent before they supported people with their medicines. The provider’s medicine policy lacked detail and did not cover all aspects about managing people’s medicines safely.
Moving and handling risk assessments were not always detailed.
Recruitment checks were not always robust to ensure staff were suitable to work with vulnerable adults.
Although people were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the systems in the service did not always support this practice. The provider had not assessed people’s mental capacity and people’s care plans lacked details around their cognition and understanding.
Elements of care plans were person-centred and provided some guidance for staff about how to support people’s needs, however, there was room for improvement. The care plans in place did not consider the person’s end of life wishes. Although people’s communication needs were met by the staff (as they knew people well) and the service was aware of the AIS, people’s care plans lacked information about their communication styles and needs.
Systems and processes to assess, monitor and improve the service required embedding into practice.
People's needs were assessed prior to starting with the service and meet and greets were carried out as part of people’s initial assessments. People and relatives were involved in the care planning, which was reviewed regularly or when people’s needs changed.
People’s views and decisions about care were incorporated when their care packages were devised. People were involved in making decisions about their day to day care.
People were treated with dignity, privacy, and respect. People’s independence was encouraged where possible and this was reflected in people’s care plans. Staff had received training in equality and diversity, and they were committed to ensuring people were treated well. People told us staff treated and supported them well.
People were protected from the risks of abuse and staff were trusted to keep them safe. Staff had received training in safeguarding people. Staff we spoke with were confident on how to report concerns.
No formal or informal complaints had been made at the time of our inspection.
Staff demonstrated a commitment to people, and they displayed person-centred values. People and relatives’ feedback were sought through regular contact and feedback forms. Staff views were sought through regular meetings and supervisions.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk.
Rating at last inspection
This service was registered with us on 13 October 2021 and this is the first inspection.
Why we inspected
This inspection was prompted by a review of the information we held about this service.
Enforcement
We have identified a breach in relation to the management of people’s medicines and mitigating risks relating to the health, safety and welfare of people.
Please see the action we have told the provider to take at the end of this report.
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. We will continue to monitor information we receive about the service, which will help inform when we next inspect.