We carried out a review of the data available to us about Livability Horizons on 6 July 2023. We have not found evidence that we need to carry out an inspection or reassess our rating at this stage.
This could change at any time if we receive new information. We will continue to monitor data about this service.
If you have concerns about Livability Horizons, you can give feedback on this service.
Livability Horizons is a purpose-built residential care home providing personal care, and support to 11 people at the time of the inspection. Livability Horizons is situated in Poole, Dorset. The home can accommodate and support up to 13 people.
People’s experience of using this service and what we found
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.
Right Support
Livability Horizons was a safe place to be, feedback we received confirmed this and people were supported by staff who knew them well. Recruitment processes were in place but had not always been followed, the registered manager sought to rectify this during inspection. We have made a recommendation about governance processes to ensure they are robust, as they had not identified this shortfall. Risks people faced in their lives were identified, assessed and steps put in place to mitigate them. This meant people were supported to lead the fullest lives possible in a safe way. 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.
Right Care
People received their medicines as prescribed and there were robust, safe processes in place. Detailed assessments and instructions meant people were protected from avoidable harm. Staff knew how to recognise and raise concerns, confident they would be dealt with promptly. Staff had received training in keeping people safe. Fire safety and equipment checks were in place to ensure the environment was safe. Infection control procedures were in place.
Right Culture
We observed many kind interactions between people and staff, they were both natural and encouraging. The home actively sought feedback on the service it provided and used the information to drive improvement and learn lessons. The registered manager understood their regulatory responsibilities and had made all necessary notifications and referrals as required by law. Staff felt appreciated and were extremely proud to work at the home. We received positive feedback about the management of the home. The home worked well with external professionals.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection
The last rating for this service was good (published 15 June 2018).
Why we inspected
We had not inspected and visited this service since 2018. As a result, we undertook a focused inspection to review the key questions of safe and well-led only.
We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.
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 good based on the findings of this inspection.
Follow up
We will continue to monitor information we receive about the service, which will help inform when we next inspect.
This unannounced comprehensive inspection took place on 2 and 3 May 2018.
Horizons are registered to provide accommodation and personal care for up to 13 people. At the time of the inspection nine people were living at the home.
The home had 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.’
People told us they felt safe with the staff and living at the home. There were clear systems in place to safeguard people from the risk of harm. Staff had completed training in safeguarding people and spoke knowledgeably about how to raise concerns if they suspected people were being abused. The registered manager had raised safeguarding concerns to the relevant authorities when necessary.
People’s needs were assessed and planned for. People were provided with care and support that took into account their personal wishes and preferences. People had good access to healthcare and staff referred people appropriately to health care professionals. Health professionals supplied positive written feedback on the service people received at horizons.
The provider had an established system for ensuring people were recruited to work in the service safely. Recruitment systems were robust and staff were trained to ensure they could care and support people safely and consistently. There were enough appropriately trained staff available on each shift to ensure people were cared for safely. Staff received appropriate training which was refreshed at regular intervals. Staff told us they felt well supported by the management team.
People’s medicines were managed safely and administered as prescribed.
People’s rights were protected because staff acted in accordance with the Mental Capacity Act 2005 (MCA). Staff ensured decisions were made in people’s best interests and followed any conditions placed on their Deprivation of Liberty Safeguards.
People told us they enjoyed living at Horizons and said the staff were friendly, caring and treated them with kindness and patience. Relatives were very happy with the care and service provided by the home. Staff knew people very well and cared for them in the way they preferred. Staff knew what was important to people and supported them as individuals.
People were supported to take part in a range of activities and hobbies they enjoyed. People said they really enjoyed taking part in their voluntary work and attending their college courses. People were supported to remain as independent as possible to ensure their health and well being was maintained or improved.
People were provided with a choice of healthy home cooked food and drink that ensured their nutritional needs were met. People told us they enjoyed the food and they could choose what they wanted to eat if they wanted something different to the menu. People enjoyed observing the staff preparing and cooking the meals and taking in the atmosphere of the kitchen.
People told us they knew how to make a complaint and said staff listened to them and took action if they needed to raise concerns or queries. Records showed complaints were investigated in accordance with the provider’s complaint policy.
People, relatives and staff told us they felt the service was well led, with a clear management structure in place. There were governance systems in place to assess and improve the quality and safety of the service and to ensure people were supported in a safe, effective and caring way.
People told us they felt safe living at the home. Staff spoke knowledgably on how to prevent, identify and report abuse and the provider had a system in place to protect people from the risk of harm. There was one occasion where the manager had not notified the commission of a safeguarding alert they had made to the local authority. This was an area of improvement for the home.
People’s needs were assessed and they were involved in planning and reviewing their care needs. Staff supported people in accordance with their wishes, protecting people’s privacy and maintaining their dignity.
People said they had enough to do and didn’t get bored. Staff ensured the environment was suitable and promoted people’s independence by supporting them to decide what they wanted or needed to do, and asking them what they needed help with.
There were robust recruitment systems in place and staff were trained to make sure they understood how best to support or help people. Staff told us they were well supported and found supervision and appraisals helped them to understand their role.
People told us they felt the service was well led and that they were listened to. There were systems in place to monitor and improve the quality of the service provided and staff said they felt people received a high quality of service.
Another person smiled and gave the 'thumbs up' sign when we asked them about the quality of care, staff and activities.
We spoke with six members of staff including the manager. Staff spoke positively about the unit. One told us, 'It's a privilege to work here, the young people are amazing'.
People's views and experiences were taken into account in the way the service was provided and delivered in relation to their care.
People experienced care, treatment and support that met their needs and protected their rights. We observed that staff supported people in an attentive and dignified way.
People's health, safety and welfare was protected when more than one provider was involved in their care and treatment, or when they moved between different services. This was because the provider worked in co-operation with others.
People who use the service were protected from the risk of abuse because the provider had taken reasonable steps to identify the possibility of abuse and prevent abuse from happening.
People were cared for, or supported by, suitably qualified, skilled and experienced staff.
The provider had an effective system in place to monitor the quality of the service and to manage risks to people's health, safety and welfare.