28 September 2022
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.
The inspection was carried out by one 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; this inspection looked at people’s personal care and support.
This service is required to have a registered manager. A registered manager is a person who has registered with the Care Quality Commission to manage the service. 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 service was in the process of recruiting a manager who would subsequently seek to register with the Care Quality Commission.
Notice of inspection
We gave the service 12 hours’ notice of the inspection. This was because we needed to be sure that the provider would be in the office to support the inspection. Inspection activity started on 20 July 2022 and ended on 25 July 2022. We visited the office location on 20 July 2022.
What we did before inspection
We reviewed information we had received about this 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 (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. This information helps support our inspections. We used all this information to plan our inspection.
During the inspection
We met with nine people who used the service and spoke with six relatives about their experience of the care provided. We spoke with 12 members of staff including the nominated individual, director of operations, managers, team leaders and support workers. The nominated individual is responsible for supervising the management of the service on behalf of the provider.
We reviewed a range of records. This included five people’s care records and three medication records. We looked at three 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. We spoke with four professionals who regularly visit the service.
28 September 2022
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
Liberty Support - Midlands is a supported living service providing personal care to 19 people at the time of the inspection. People lived in shared houses, flats and bungalows across different areas within the West Midlands. 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
People were not always supported by staff who had received training in line with their needs. However, staff knew people well and people told us they felt safe. People received their medicines safely, but the systems in place to manage medicines weren't always effective.
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.
People were assessed so any potential risks were identified, and steps taken to keep them safe. Systems in place safeguarded people from abuse and staff were knowledgeable about how to support people safely. People were protected from harm through infection control measures.
Observations and records showed that people experienced choice and control over their support and care planning was person-centred. People's religion, culture and sexuality was considered as part of their care and staff knew people's likes and dislikes.
Systems and processes in place promoted a positive culture at the service. However, ongoing improvements were required to ensure the governance systems were effective. Action plans were in place to drive further changes to the service such as a new process for gaining feedback from people, relatives, staff and professionals.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection and update
The last rating for this service was requires improvement (published 27 June 2022) and there were breaches of regulation. The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection we found improvements had been made and the provider was no longer in breach of regulations.
Why we inspected
We carried out an announced focused inspection of this service which commenced on 23 March 2022. Breaches of legal requirements were found. The provider completed an action plan after the last inspection to show what they would do and by when to improve safe care and treatment and good governance.
We undertook this focused inspection to check they had followed their action plan and to confirm they now met legal requirements. This report only covers our findings in relation to the Key Questions safe, effective and well-led which were considered at the last inspection.
For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating. The overall rating for the service has remained requires improvement. This is based on the findings at this inspection.
You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Liberty Support - Midlands on our website at www.cqc.org.uk.
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.