Livability York House Ossett

About the service

Livability York House Ossett is a care home that can accommodate up to 23 people who require support with personal care needs, some of whom have a learning disability. At the time of inspection, there were 14 people living at the service.

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

The provider was not able to demonstrate how they were meeting some of the underpinning principles of Right support, right care, right culture.

Right Culture

The environment was not well maintained to meet people’s sensory and physical needs. For example, some parts of the premises were bare, there were no pictures fixed on walls, and we saw tape on some floor areas as a temporary repair and uneven surface on the floor in one corridor. We saw staining of ceiling tiles, damaged flooring and, carpets and a leaking roof.

People received good quality care, support and treatment because staff were trained to meet the needs and wishes of the people. people and those important to them were involved in planning their care. People were enabled to personalise their own rooms. Staff knew and understood people and were responsive to ensure their needs were met. Staff were knowledgeable and spoke confidently on how they supported people to lead an empowered life.

Right Support

People were well cared for by staff that valued them. Staff communicated with people in ways that met their needs. The provider supported people to have the maximum possible choice, control and independence. We saw evidence of people having the opportunity to participate in community life that matched their interests and maintained good relationships.

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Right Care

People received kind and compassionate care. People received care that respected their privacy and dignity. Staff protected people from poor care and abuse. Staff had training on how to recognise and report abuse and they knew how to apply it. The provider had skilled staff to meet the needs of the people and keep them safe.

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

Why we inspected

We undertook a targeted inspection in January and February 2022 to routinely provide assurance in relation to infection, prevention and control. We inspected and found there was a concern with some areas of the infection prevention and control and the management of medicines, so we widened the scope of the inspection to become a focused inspection which included the key question of safe and well-led. We undertook this inspection to assess the service is applying the principles of right support, right care, right culture.

We found evidence the provider needs to make improvements. Please see the safe and well-led sections of this full report.

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.

Livability York House Ossett is a care home that can accommodate up to 23 people who require support with personal care needs, some of whom have a learning disability. At the time of inspection, there 14 people living at the service.

We expect health and social care providers to guarantee people with a learning disability and autistic people respect, equality, dignity, choices and independence and good access to local communities that most people take for granted. ‘Right support, right care, right culture’ is the guidance CQC follows to make assessments and judgements about services supporting people with a learning disability and autistic people and providers must have regard to it.

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

People’s care and support were not provided in a clean and well-maintained environment. For example, we observed damaged carpets and tiles that were missing from the wall in the home. We also found concerns around the recording of some medicines.

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

Ratings at last inspection

The last rating for this service was good (published on 14 November 2019).

Why we inspected

We undertook this targeted inspection to look at information received from the local authority about medicines and to follow up on concerns found at the last inspection about infection and prevention control. The overall rating for the service has not changed following this targeted inspection and remains good.

We use targeted inspections to follow up on Warning Notices or to check concerns. They do not look at an entire key question, only the part of the key question we are specifically concerned about. Targeted inspections do not change the rating from the previous inspection. This is because they do not assess all areas of a key question.

Follow up

We will continue to monitor information we receive about the service, which will help inform when we next inspect.

You can read the report from our last inspection, by selecting the ‘all reports’ link for Livability York House Ossett on our website at www.cqc.org.uk.

We found the following examples of good practice.

Safe visiting procedures were followed. There was a buzzer at the entrance to the home which allowed entry into an enclosed area. On arrival, we were asked to sanitise our hands, sign in, have our temperature taken. We were asked for evidence of our vaccination record and a lateral flow test taken on the day which was then recorded.

Staff had been trained in infection prevention and control and competency checks undertaken.

We observed staff were wearing appropriate PPE and there were enough supplies available.

PPE stations and hand sanitising gel were located throughout the home for ease of access to staff.

The registered manager and staff communicated regularly with families of people living in the home. They had good relationships with other professionals such as GPs and District Nurses for the benefit of people living in the home.

Livability York House is a residential care home providing personal and nursing care to 17 people with a learning disability at the time of the inspection. Livability York House was a large home, bigger than most domestic style properties. It was registered for the support of up to 20 people. This is larger than current best practice guidance. However, the size of the service having a negative impact on people was mitigated by the varying types and styles of property in the residential area.

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

We found improvements could be made in the governance of the home to ensure standards did not fall below expected. For example, the internal audits conducted by the provider did not pick up on the issues we found at inspection. We have made a recommendation about the transcribing of medication on the Medication Administration Records.

People felt safe and found staff were supportive. Care plans and risk assessments were kept up to date and regularly reviewed. 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.

Staff received appropriate induction, training, supervision and appraisal. Staff were supportive of people and encouraged them to be as independent as possible.

People, their relatives and staff found the management team to be approachable and supportive.

The service applied 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 3 April 2017).

Why we inspected

This was a planned inspection based on the previous rating.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Livability York House on our website at www.cqc.org.uk.

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.

York House provides support and personal care for up to 23 adults with learning and physical disabilities, including complex needs. There were 18 people living at the home at the time of the inspection. The accommodation is accessible for people with physical disabilities, with private rooms and communal bathrooms, communal lounge and communal dining area. There is a self-contained flat that is available for visiting relatives to use. There is an enclosed, well maintained, and garden.

The service had a registered manager in place. 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 a legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

People told us they felt safe in their home. People were comfortable with staff and there was a positive atmosphere in the service.

There were systems in place to ensure that people received their medication as prescribed.

People were cared for by sufficient staff who knew them and their needs. Recruitment procedures were robust to ensure that staff were suitable and fit to be employed.

Staff were aware of the processes in place to report incidents of abuse; and had been provided with training on how to keep people safe from abuse and harm. Processes were in place to manage identifiable risks and to promote people’s independence.

Staff received an induction and training and were provided with these skills and knowledge in a timely fashion to fulfil their role. Staff were given effective supervision and appraisals.

People were supported to eat and drink well and to maintain a varied balanced diet of their choice. People had access to healthcare facilities and support that met their needs.

People had developed good relationships with the staff team who treated them with kindness and compassion. Systems were in place to ensure that their views were listened to; and their privacy and dignity was upheld and respected.

People's needs had been assessed and care plans outlined their preferences and how they should be supported. Staff showed a good knowledge of these preferences.

People were able to enjoy activities of their choice. Arrangements were in place for people to maintain links with the local community, friends and family. However we did not see evidence of in house activities on the day of inspection. The home previously had an activity coordinator who supported this in the home. We spoke to the registered manager about this and the benefit this would have in the home when recruiting staff in the near future.

The service had quality assurance systems in place which were used to drive continuous improvements.

The service had completed some renovation within the home and improvements were noticeable on the day of inspection. A refurbishment plan was in place to replace the carpets in the home.

We asked our 5 questions;

' Is the service safe?

' Is the service effective?

' Is the service caring?

' Is the service responsive?

' Is the service well led?

Below is a summary of what we found.

If you want to see the evidence supporting our summary please read the full report.

Is the service safe?

There were systems were in place to monitor the service. Auditing tools were completed by the manager at the service and regional managers for the organization.

We found the home to be clean with no offensive odours in communal areas.

We found some issues regarding the number of staff at the service, where staff did not have time to carry out meaningful daytime activities with the people who used the service.

Is the service effective?

People's care records were assessed with their involvement or with the involvement of relatives and other healthcare professionals.

We found that people's care records were up to date and contained relevant information.

Is the service caring?

People were supported by kind and attentive staff. We saw staff showed patience and gave encouragement when supporting people. People we spoke with said staff were kind and caring.

People's preferences, interests, aspirations and diverse needs had been recorded in care records.

Is the service responsive?

People did not partake in many activities at the home. On the day of our visit we observed people sitting in lounges and listening to the radio. We also observed people who used the service sitting in lounges and dining areas with no interaction from staff members for a considerable length of time. People who lived at the home told us they would like more activities to partake in and would like staff to be able to spend more quality time with them.

Is the service well led?

Audits at the home were up to date. There was clear documented evidence of the provider's management of the service. We saw regular audits were carried out and actions identified were followed up and 'signed off' when completed.

Staff told us they were clear about their roles and responsibilities.

We saw the service had its own corporate safeguarding and whistle blowing policies in place and staff had received safeguarding training.

We observed that the home was clean and did not have any unpleasant odours. We saw there were cleaning schedules in place which detailed the standard of cleanliness required and the frequency of cleaning.

We reviewed staff rotas and found there were sufficient staff on duty to respond to people's needs. People who used the service told us that they liked the staff who worked there and said they felt there were generally sufficient numbers of staff to meet their needs.

We spoke with three people who used the service who told us they were aware of the complaints process and felt complaints were responded to.