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Living Ambitions (Chester) Good

Inspection Summary

Overall summary & rating


Updated 8 September 2018

This inspection took place on 8 August 2018 and was announced.

Living Ambitions is a domiciliary care agency. This service provides care and support to people living in their own homes and supports them to live as independently as possible. Living Ambitions provides a service to young and older adults. At the time of the inspection the registered provider was providing support to five people.

A registered manager was in post at the time of the inspection. A registered manager is a person who has registered with the Care Quality Commission (CQC) 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. This was the first inspection since the registered provider had registered with CQC in March 2017.

The registered provider had a variety of different systems and processes in place to assess and monitor the quality and safety of the care people received. This meant that people were receiving safe, effective, compassionate and high-quality care. Such systems included regular care plan and medication audits, care plan reviews, medication competency assessments and quality questionnaires.

Care files contained individual care plans and risk assessments. Information we checked was up to date, relevant and regularly reviewed. Staff were familiar with the individual needs and risks of the people they support. We received positive feedback about the level of safe care people received.

Medication management systems were safely and effectively managed. Each person had robust medication records in place. Records contained the level of support each person required and the level of risk that needed to be monitored. Staff received the relevant medication training and regularly had their competency assessed to ensure they were complying with safe administration policies and processes.

We found that the area of ‘recruitment’ was safely managed. This meant that all staff who were working for the registered provider had sufficient references and disclosure and barring system checks (DBS) in place. DBS checks ensure that staff who are employed are suitable to work within a health and social care setting. This enabled the registered manager to assess level of suitability for working with vulnerable adults.

All accidents and incidents were appropriately recorded and analysed on a monthly basis. The registered manager explained that there was very little activity in relation to accident/incidents but staff were aware of the reporting procedures.

People were protected from avoidable harm and risk of abuse. Staff were familiar wit safeguarding procedures and knew what ‘whistleblowing’ meant. Staff had completed the necessary safeguarding training and there were up to date safeguarding and whistleblowing policies in place.

The registered provider had suitable infection prevention control procedures in place. Staff were provided with the relevant personal protective equipment (PPE) and were encouraged to comply with infection control procedures. There was an infection control policy in place for people to consult if they needed further guidance and support.

We checked if the registered provider was complying with the principles of the Mental Capacity Act, 2005. People’s capacity had been assessed and where appropriate the relevant deprivation of liberty safeguards (DoLS) had been authorised. ‘Consent’ to care had been obtained by people who has the capacity to make decisions and records indicated that people and relatives (where legally able to do so) were involved in relevant decisions which needed to be made.

Staff were supported with training, learning and development opportunities. Staff told us that they were fully supported by the registered provider and had developed the correct skills and competencies to provide the level of support that was

Inspection areas



Updated 8 September 2018

The service was safe.

Care plans and risk assessment were well-maintained, contained the relevant information and were regularly reviewed.

Medication management procedures were safely in place. People were administered medication by trained, competent staff.

Accidents and incidents were routinely recorded and analysed on a monthly basis in order to identify and establishing trends.

Safe recruitment practices were in place. Staff who were employed by the registered provider were deemed �fit and proper� to work with vulnerable adults.



Updated 8 September 2018

The service was effective.

Principles of the Mental Capacity Act, 2005 were effectively followed.

Staff were supported with training, learning and development opportunities and received regular supervisions and annual appraisals.

People were supported with nutrition and hydration support needs. The relevant referrals were made to healthcare professionals; people received a holistic level of support.



Updated 8 September 2018

The service was caring.

The staff provided kind, compassionate and caring support.

People were treated with dignity and respect.

Confidential and sensitive information was protected in line with General Data Protection Regulation.



Updated 8 September 2018

The service was responsive.

Care records contained person-centred information; people received tailored support centred around their needs.

People were supported to engage and participate in their hobbies and interests.

There was a formal complaints process in place. People and relatives were familiar with the complaints procedure and how complaints would be responded to.



Updated 8 September 2018

The service was well-led.

There was a registered manager in post at the time of the inspection.

Effective quality assurance systems were in place. Routine audits and checks were completed, these helped to assess, monitor and identify areas of development and improvement.

There were systems in place to gather feedback in relation to the quality and safety of care provided.

Staff were familiar with a variety of different policies the register provider had in place.