Independent Living Centre

Updated 27 March 2018

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

At a comprehensive inspection at the Independent Living Centre on 30 November and 02 December 2016, we found breaches of legal requirements and served a warning notice. We undertook a focused inspection on 14 June 2017 in two of the five key questions we ask about services: is the service safe, and, is the service well led. We found that action had been taken but there was still room for improvements.

This inspection was carried out by a one inspector on 8 February 2018 and was announced. We gave the service 48 hours' notice of the inspection visit because it is small and the manager is often out of the office supporting staff or providing care. We needed to be sure that they would be in.

Prior to the inspection we reviewed information we had about the service. This included the notifications that the provider had sent us. A notification is information about important events which the provider is required by law to send us. Before the inspection, the provider completed a Provider Information Return (PIR). This is information we require providers to send us at least once annually to give some key information about the service, what the service does well and improvements they plan to make.

We visited the office location on 8 February where we spoke with one person who used the service, the registered manger, nominated individual, three staff including a care coordinator. We reviewed five care records, four staff training and recruitment records and other records used for the management of the service including policies and procedures, audits, surveys and minutes of meetings.

On 13 February 2018 we spoke on the telephone with three people and two care staff to seek their views about the care they received or the care they provided. We also contacted the local authority that commission services from the provider to obtain their views about the service.

Updated 27 March 2018

This inspection took place on 8 February 2018 and was announced. Independent Living Centre is a domiciliary care agency. It provides personal care to people living in their own houses and flats in the community. It provides a service to older adults and younger disabled adults. At the time of this inspection, seven people were using the service.

At our comprehensive inspection on 30 November and 02 December 2016 we found breaches of legal requirements as risks to people had not always been identified, assessed adequately, or steps taken to mitigate them. Recruitment checks were not always robust and did not always demonstrate that staff were of good character. Records relating to people’s medicines were not always properly completed and staff had not always taken action in good time to ensure people had sufficient stocks of their prescribed medicines at home. Staff had not always completed training or refresher training in line with the provider’s requirements and staff had not received supervision in line with the provider’s policy. The provider’s systems to assess and monitor the quality of the service provided were not always effective. Records relating to people’s care records were not always accurate and up to date and the provider had not always sought feedback from people using the service to help drive improvements.

The provider wrote to tell us the actions they would take to address these concerns by 28 February 2017. We undertook an announced focussed inspection on 25 April 2017 in relation to the warning notices we served on Regulations 12 and 17 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. We found that action had been taken and improvements made but the systems and processes that had been implemented had not been operational for a significant amount of time for us to be sure of consistent and sustained good practice.

There was a registered manager in post. 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.

At this inspection, we found that the issues we had identified had been addressed, in line with the provider’s action plan. Risks to people had been assessed, identified and with appropriate management plans in areas such as moving and handling, medicines management, eating and drinking and falls. Appropriate recruitment checks took place before staff started working with the provider to and were vetted to be of good character and suitable for the role they had applied for in social care. People were supported with their medicines safely and staff ensured there was sufficient stock of medicines for people and records relating to people’s medicines were completed properly.

The provider had training courses that were mandatory and all staff training were up to date. Staff had also completed training relevant to people’s needs and had completed an induction when they first started working with the service. Staff were supported with regular supervision and appraisals in line with the provider’s requirement.

Appropriate systems had been put in place to assess and monitor the quality of the service. People’s care records were up to date and reflective of their care needs. People’s views were sought through telephone monitoring calls, home visits and annual satisfaction surveys and staff views were sought through regular team meetings.

People told us that adequate numbers of staff were deployed to support them; however we had mixed feedback on staff punctuality. Staff said the current staffing numbers in place were appropriate to support the number of people using the service. The provider had safeguarding policies and procedures in place and staff knew of their responsibility to report and records any concerns of abuse to their manager. People were protected from the risk of infection because staff were aware of the provider’s infection control practices.

Before people started using the service their needs were assessed to ensure the service would be suitable and their needs met. People were supported to eat sufficient amounts for their well-being. The provider worked well within and across organisations such as the local authority to plan and deliver an effective service. People said they made their own arrangements for healthcare appointments but where required, staff supported them to access healthcare services. Staff were aware of the need to seek consent from people and work in line with the requirement of the Mental Capacity Act 2005 (MCA).

People were involved in planning their care and support needs. Staff demonstrated a good understanding on supporting people under the Equality Act. People’s privacy and dignity was respected and their independence promoted. Staff demonstrated a good knowledge of the people they supported including their support needs and preferences.

Each person using the service had a care plan which was reviewed regularly to ensure their needs were met. People were supported to be engaged in activities that interest them. The provider had a complaints policy and procedure in place which provided guidance on how to raise a complaint. People were provided information about the service so they know the level of support to expect. The provider had arrangements in place to support people with end of life care; however, no one using the service at the time of this inspection required such support.

People told us the service was well-led and staff said their manager was open and addressed issues quickly. Staff teams were aware of the provider’s values and visions. The provider worked in partnership with key organisations to drive improvement. The provider kept records of accidents and incidents and continuously learned to improve on the quality of the service.