Archived: Your Lifestyle LLP

Your Lifestyle LLP provides care to adults with diverse needs living in a variety of ‘supported living’ settings. Not everyone using the service receives regulated activity. The Care Quality Commission only inspects the service being received by people provided with personal care, help with tasks related to personal hygiene and eating. Nine people living in four different types of accommodation were, currently, receiving regulated activity and supported so they are able to live as independently as possible. One further person was in hospital for a short period of time. Accommodation ranges from four people sharing a tenancy to people living alone. People’s care and housing are provided under separate contractual agreements. The Care Quality Commission (CQC) does not regulate premises used for supported living, this inspection looked at people’s personal care and support.

At the last inspection, on 17, 19 and 23 January 2017, the service was rated as good in three domains and requires improvement in two domains, effective and well-led. It was consequently rated as overall requires improvement. At this inspection we found the service was rated as good in all domains and therefore overall good.

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

People, staff and visitors were protected from harm and safety was maintained by staff who had been trained in safeguarding vulnerable adults and health and safety policies and procedures. Staff understood how to protect the people in their care and knew what action to take if they identified any concerns. The service responded appropriately if any safeguarding concerns were brought to their attention. General risks and risks to individuals were identified and action was taken to reduce them, as far as possible.

People benefitted from adequate staffing because individual’s needs were carefully identified and an exceptionally person centred package of care was developed. The required number of staff was provided to ensure people’s needs could be met safely and effectively.

People were supported by staff who were appropriately trained and supported to make sure they could meet people’s complex and varied needs. Care staff were effective in meeting people’s needs as described in plans of care. The service was exceptionally flexible and worked closely with health and other professionals to ensure they were able to meet people’s specific needs.

People were supported to have maximum choice and control of their lives and care staff supported them in the least restrictive way possible. The policies and systems in the service supported this practice.

People were supported by a committed,kind and caring staff team. Those staff who did not adhere to these values were not tolerated. Care staff built strong, caring relationships with people and knew them well. The service and care staff were fully aware of people’s equality and diversity needs which were noted in detail on plans of care. People were supported to be as independent as they were able to be by knowledgeable and informed care staff.

The service was exceptionally person centred and flexible. It was responsive to individual’s current and quickly changing needs. The well-being of the individual was at the centre of the care packages provided. People’s needs were regularly reviewed to ensure the care provided was up-to-date. Care plans included detailed information to ensure people’s individual communication needs were understood.

The registered manager and the management team ensured the service was well-led. Management was described as open, approachable and supportive. The registered manager and his team were committed to ensuring there was no discrimination relating to staff or people in the service. There was a robust and effective system of assessing, reviewing and improving the quality of care provided.

We carried out an inspection of Your Lifestyle LLP on 17, 19 and 23 January 2017. This was an announced inspection where we gave the provider 48 hours’ notice. This was because the location provides a domiciliary care service and we wanted to make sure the manager would be available to support our inspection, or someone who could act on their behalf.

A registered manager was in post and available throughout the inspection. 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 legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

Whilst staff supervision and training were undertaken, staff were not always given training in response to people’s needs, in a timely manner. Most staff received competence assessments to ensure they had the sufficient skills and knowledge to support people effectively. However, one staff member required additional training in medicines management and a further competency assessment which had not been completed prior to them carrying out this task unsupervised.

Staff told us they were supported to have the necessary training and supervision to equip them with the confidence and knowledge to support people effectively. However, there was no system in place to ensure issues identified during staff supervisions were sufficiently followed up. In addition to this, although the service had a system in place to monitor when staff training was due, not all staff were sufficiently trained prior to carrying out specific tasks.

Whilst regular audits were completed to monitor service provision and to ensure the safety of people who used the service, the system to monitor issues, such as those raised during staff supervisions was not always sufficiently robust to ensure these issues were followed up. This included follow up from incidents, staff supervisions and training. There was also no system in place to monitor complaints and feedback received from people and their relatives. Although feedback from people, their relatives and staff had been sought, the responses the service received were not sufficiently analysed or followed up to ensure the service continued to improve and to ensure people were supported to meet their needs. The registered manager told us they had identified prior to the inspection that their quality assurance systems needed to improve. They showed us how they would implement these changes. However, where the need for some improvements had been identified, this was not the case for all.

Staff had received training about safeguarding and knew how to respond to allegations of abuse. Staff were aware of the whistleblowing procedure which was in place to report concerns and poor practice.

People’s medicines were well managed and documentation for the administration of medicines was completed in line with the service’s policies and procedures. However, there was no documentation to confirm what pharmacist advice had been sought for a person who required their medicines to be crushed or added to their food. At the time of the inspection, the registered manager told us this person was not receiving their medicines covertly although guidance for staff stated they could be given this way. When we raised this with the registered manager they took action to ensure the necessary advice was sought.

There were sufficient staff to provide consistent and safe care to people. Relatives told us the right number of staff were available to support and meet their family member’s needs. Staff supported the same people which meant they knew them well. The service had suitable arrangements in place to cover any staff absences.

Effective systems were in place to manage risk and ensure people were cared for in a safe way. Risk assessments had been completed and actions recorded to manage identified hazards and concerns.

Staff had received training about the Mental Capacity Act 2005. Staff had a good understanding of the importance of people consenting to the support they provided. When people lacked the capacity to make a specific decision, decisions were made in their best interests. Consent forms were filed in people’s care plans and signed by people receiving care.

Staff ensured people had sufficient food and drink to meet their needs. Staff supported people to access health care professionals to make sure they received appropriate care and treatment. The service maintained accurate records of people’s healthcare and GP contacts in case they needed to contact them.

Staff knew people well and were able to tell us about people’s likes, dislikes, preferences and personal goals. Staff respected people’s privacy and dignity and told us they asked people’s permission before carrying out any tasks. People using the service were unable to give us their view of the service they received. We spoke with their relatives who gave us their feedback.

Staff were knowledgeable about people’s care and support needs. Support plans were personalised and detailed how they liked to be cared for. Clear guidance was available for staff on how to support people in line with their needs.

People had the opportunity to give their views about the service. A complaints procedure was available and people said they knew how to raise a complaint if they needed to. Complaints and concerns were handled in an appropriate way. There was regular consultation with people and staff on their views on how they felt about the support they were receiving.

Staff said they felt supported by the management team. There was an open door culture and staff said the management team were approachable.