Livability Somerset

Updated 8 September 2022

The inspection

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 Care Act 2014.

This was a focussed inspection to check whether the provider had met the requirements of the Warning Notice in relation to Regulation 17 (Good Governance) of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. We also checked other actions the provider told us they had taken.

Inspection team

Three inspectors carried out the inspection.

Service and service type

This service provides care and support to people living in three ‘supported living’ setting, 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.

Registered Manager

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.

At the time of our inspection there was a registered manager in post.

Notice of inspection

We gave the service 48 hours’ notice of the inspection. This was because it is a small service and we needed to be sure that the registered manager, or a provider representative, would be available to support the inspection. Also, people are often out and we wanted to be sure there would be people at home to speak with us. We also checked that people were happy for us to visit them in their homes.

Inspection activity started on 14 July 2022 and ended on 5 August 2022. We visited the office location on 27 July 2022 and visited the people who use the service at their homes on 14 and 23 July 2022.

What we did before inspection

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.

We reviewed all the information we had received about the service since our last inspection. We used all of this information to plan our inspection.

During the inspection

We met 12 people who used the service at their homes. Eight people chose to speak with us about their service. One person did not use words as their main means of communication, we were able to spend time with them and the staff who supported them. We received feedback from the relatives of three people about their views of the care and support provided. We also received feedback from three professionals who worked with the service.

We spoke with seven members of staff. We also spoke with the registered manager, an intensive support manager who had been supporting the service, a regional manager, and a senior representative from the provider.

We reviewed a range of records. This included seven people’s care records and a sample of medication records. We also looked at variety of records relating to the management of the service, including quality audits, staff training records and staff meeting minutes were reviewed.

Updated 8 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

Livability Somerset is a supported living service. It provides care and support to 20 people who have a learning disability across three locations in Bridgwater, Burnham on Sea and Bath.

People's experience of using this service and what we found.

The service was able to demonstrate how they were meeting the underpinning principles of right support, right care, right culture.

Right Support

People were supported to have maximum possible choice and control of their lives and staff sought to support them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice. There was ongoing work to keep restrictive practices under review.

People were supported by staff to be involved in decisions about their care and support. Staff used individual communication methods to enable people to express themselves. There was work ongoing to ensure ongoing improvement to support with communication. People's families felt involved.

People received personalised care and support which was built around their needs and preferences. Care and support was provided by staff who knew people well.

Staff supported people with their medicines in a way that promoted their independence.

People’s needs were assessed and they were supported by staff who were trained and supported. This supported people to achieve their aspirations. Staff advocated strongly for people to ensure all appropriate agencies played their part in achieving good lives for people.

Staff enabled people to access health and social care support in their community.

Right Care

People received kind and compassionate care. Staff respected people’s privacy and dignity. They understood and responded to their individual needs.

Staff understood how to protect people from poor care and abuse. The service worked well with other agencies to do so. Staff had training on how to recognise and report abuse and they knew how to apply it.

The service faced staffing challenges but had sufficient appropriately skilled staff to meet people’s needs and keep them safe.

People's care and support plans reflected their needs and preferences, and this enhanced their wellbeing and enjoyment of life. Staff understood people's needs.

People could pursue interests of their choice. The service gave people opportunities to try new activities that enhanced and enriched their lives.

Right culture

The culture and practice of the organisation achieved positive outcomes for people. This had resulted in people being more content and a reduction in the times they experienced distress. The governance and oversight systems needed to be further embedded to ensure emerging issues were identified and outcomes continued to be good.

People had increased control over their lives because of the ethos, values, attitudes and behaviours of the management and staff.

People were supported by a management team who worked hard to promote a culture where people were valued and respected as individuals. This culture was reflected in the staff team’s commitment to the values of the organisation.

People and those important to them were involved in planning their care.

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 23 December 2021) 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

This inspection was carried out to follow up on action we told the provider to take at the last inspection.

Follow up

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.