14 April 2023
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.
Three inspectors and 2 Experts by Experience carried out this inspection. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service
Service and service type
This service provides care and support to people living in a number of ‘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; this inspection looked at people’s personal care and support. This service is also a domiciliary care agency. It provides personal care to people living in their own houses and family homes.
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 were 3 registered managers in post.
Notice of inspection
We gave the provider a short period of notice of the inspection of One Fylde (Libra House), because some of the people using the service could not consent to a home visit from an inspector. This meant that we had to arrange for a ‘best interests’ decision about this. Inspection activity started on 24 January 2023 and ended on 27 January 2023. We visited the location’s office on 24 and 25 January 2023.
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. We used the information the provider sent us in the provider information return (PIR). This is information providers are required to send us annually with key information about their service, what they do well, and improvements they plan to make. We used all this information to plan our inspection.
During the inspection
We visited 9 supported living tenancies and met 12 people and one relative. We observed people’s interactions with staff and if they were happy and comfortable in their presence. We looked to see if people’s homes reflected their personalities, met their physical and sensory needs, were clean and if the culture was caring and empowering. We also telephoned and spoke with 16 relatives for their feedback on One Fylde (Libra House).
During the inspection we spoke with 14 community support workers and one agency staff member. We spoke with 2 directors of operations and quality (1 was also a registered manager), 2 other registered managers and the director of finance and support services. We also spoke with 4 area managers, 1 head of support north, 1 quality and improvement project lead, 6 team leaders and a training consultant.
We reviewed a range of records. This included 12 people’s support plans and several medication records. We looked at a variety of records relating to the recruitment of 5 staff, the management of the service, including policies and procedures, risk assessments and audits. After the inspection we looked at training data and quality assurance records and continued to seek clarification from the registered manager to validate evidence found.
14 April 2023
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.
About the service
One Fylde (Libra House) is a domiciliary care agency and supported living service providing personal care to 90 people. At the time of the inspection there were 76 people receiving support in their homes, mostly in shared supported living houses, and 14 people were visited and supported by the home care service in their own family homes.
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
The service was exceptionally well led and managed to a high standard. It had strong values and principles which were demonstrated in the person centred care and support people received.
People were empowered 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. When people lacked capacity to make specific decisions, we found the service was following the best interest’s principle. Relevant authorisations had been granted by the Court of Protection where people’s liberties were deprived.
People’s needs were assessed, and care plans were developed to promote positive risk taking. People’s homes and décor were personalised and reflected their personalities, showing their choices and decisions had been respected. Adjustments had been made in people’s homes to promote their independence and keep them safe. Staff had been employed following robust recruitment procedures and were trained in the safe storage and administration of medicines. Staff were knowledgeable on what actions to take should they witness any safeguarding concerns or hear any allegations of abuse.
The service had enough staff to meet people’s needs and keep them safe. The management team advocated stability and continuity of care in people’s homes. Staff knew people they were supporting well, including their health and wellbeing needs and championed their likes and wishes and promoted their best interests. Staff were trained and skilled to offer support and guidance to quickly lessen or minimise people’s distress. Staff and visitors had access to protective personal equipment to limit the risk of infection. Staff knew how to ensure people had the option of eating a healthy diet.
The service recognised the need to promote people’s mental health. They had created opportunities for people to be valued members of their local communities and for external peers to have the opportunity to share in their hobbies and passions. Vocational and social activities were implemented to develop people’s skills and enhance their self-worth.
Staff were very caring, kind, and showed a genuine interest in the wellbeing of people. They provided care and support to people in a respectful and compassionate way, respecting their individuality and culture. People were comfortable and relaxed in the company of staff.
The management team created new roles within the service that focused on challenging discrimination and worked in partnership with community based services to ensure people received the same care, treatment, and services all citizens received. The management team collaborated with staff and with outside agencies to make reasonable adjustments so people could experience daily living experiences while managing risks and keeping people safe. The provider carried out regular audits and could evidence lessons were learnt when things went wrong.
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 the service One Fylde (Church Road) was good, published on 09 March 2018.
The last rating for the service One Fylde (Headroomgate) was requires improvement, published on 20 October 2021.
These two locations merged and were registered under One Fylde (Libra House) on 22 March 2022.
Why we inspected
This inspection was prompted by a review of the information we held about this service.
We will continue to monitor information we receive about the service, which will help inform when we next inspect.