7 April 2020
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 Care Act 2014.
This inspection was completed by two inspectors.
Service and service type
This service provides care and support to people living in their own homes, 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; this inspection looked at people’s personal care and support.
The service had a manager registered with the Care Quality Commission. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided. The registered manager was also a director of LDC Care Company Ltd, the provider.
Notice of inspection
This inspection was unannounced.
What we did before the inspection
We reviewed information we had received about the service since the last inspection. We sought feedback from the local authority and professionals who work with the service. The provider was not asked to complete a provider information return prior to this inspection. This is information we require providers to send us to give some key information about the service, what the service does well and improvements they plan to make. We took this into account when we inspected the service and made the judgements in this report.
During the inspection
We met with four people who used the service. We spoke with seven members of staff including the provider, registered manager, human resources manager, head of operations, operations manager, executive assistant, two service delivery managers and two support staff.
We reviewed a range of records. This included six people’s care records. We looked at five staff files in relation to recruitment and staff supervision. A variety of records relating to the management of the service, including policies and procedures were reviewed, meeting minutes and improvement plans.
After the inspection
We spoke with two relatives about their experience of the care provided. We spoke with six support workers about the service their experiences of the service. We continued to speak with professionals about their experiences of the service. We reviewed evidence sent to us by the provider.
7 April 2020
About the service
LDC Supported Living is a supported living service for people with a learning disability and autism. Some people lived with others and shared houses and shared amenities such as kitchens, bathrooms and lounges with other people. Other people lived alone. People received care and support to help them live independently in the community. There were 41 people receiving a personal care service at the time of our inspection.
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
Staff received safeguarding training, however, we found this had not always been effective with staff’s actions on occasions leaving people at risk. Staff did not always feel confident that all the managers in the service would take action about concerns. The provider did take appropriate actions when made aware of issues.
Staff recruitment systems were not always effective in ensure staff were suitable for their roles. Action was taken by the provider to resolve this after the inspection. Some records relating to people’s care were not accurate or required updating. Documents were not always easily accessible and on occasions used language about people which could be perceived as derogatory. Information was not always shared with other professionals in a timely fashion. After the inspection, the provider put in place a new system for recording information which should address many of these concerns.
People were supported to take part in a range of activities they enjoyed. This gave them the opportunity to develop new skills and have new experiences. People were supported by staff who knew them well and who gave them information in the way they understood such as pictures or their first language. People were supported and encouraged to maintain relationships with friends and family who were important to them.
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 policies and systems in the service supported this practice. The provider and staff advocated for people and supported them to challenge discrimination. People were supported in the way they preferred by staff who had the training and support to carry out their roles. People were supported to stay healthy, by attending health appointments and having a healthy diet.
The provider used recognised tools such as person-centred planning and positive behaviour support to form the foundation of people’s care. The provider worked with other agencies such as the police and educational organisations to raise awareness of the needs of people with a learning disability. The provider was an active member of local care organisations and took part in projects with the NHS. People’s complaints were responded to appropriately. People, staff and relatives were asked for their views of the service, which were used to form the basis of action plans.
The service applied the principles and values the principles and values of Registering the Right Support and other best practice guidance. These ensure that people who use the service can live as full a life as possible and achieve the best possible outcomes that include control, choice and independence. The outcomes for people using the service reflected the principles and values of Registering the Right Support by promoting choice and control, independence and inclusion. People's support focused on them having as many opportunities as possible for them to gain new skills and become more independent.
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 8 September 2017).
Why we inspected
The inspection was prompted in part due to concerns received about safeguarding risks, poor communication, low staffing levels and staff not working with professionals to meet people’s needs. A decision was made for us to inspect and examine those risks.
We have identified breaches in relation to safeguarding, staff recruitment, governance and leadership.
Please see the action we have told the provider to take at the end of this report.
We will meet with the provider following this report being published 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 return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.