This comprehensive inspection took place on 31 October and 1 November 2016 and was announced. The inspection was conducted by an adult social care inspector. At the time of our inspection there were 41 people who were using the service.At the last inspection on 30 August 2013 we found the service to be compliant with all regulations we assessed at that time.The Frances Taylor Foundation is part of the UK charity, the Poor Servants of the Mother of God. Liverpool Adult Services is a supported living service providing community care and support to people with a learning difficulty mainly in the Liverpool area.
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.
Records showed that 100% of staff had completed training in safeguarding adults and people told us they felt safe receiving support from the service. Staff were able to clearly tell us what they would do if they suspected someone was being abused.
Each person who used the service had a ‘working file,’ a ‘medicines file,’ and a ‘financial file.’
We found that the risks to people's safety had been assessed using a variety of risk assessments which were completed before and when people started to use the service and these were updated if their needs changed.
There was an accidents/incidents file in use for recording any accidents or incidents. Audits of accidents and incidents undertaken at each house.
Care staff we spoke with were experienced and knew how to respond in an emergency or when to offer assistance for a person's well-being.
There were sufficient staff to carry out the various roles within the service and each house held copies of the rota for the individual location address.
We looked at five staff personnel files and there was evidence of robust recruitment procedures in place.
Suitable arrangements were in place to ensure that people who used the service were safe. There was an appropriate and up to date medicines administration policy in use.There was a medicines competency check file in place and we saw that staff competence to administer medicines was regularly undertaken each month on a rolling basis.
There was a health and safety policy in place which gave guidance on infection prevention and control at each house we visited. All care staff had received training in infection control which we verified by checking records.
The service had a business continuity plan that detailed the action to be taken in the event of an unforeseen circumstance such as loss of utilities supplies, loss of IT/telephony, pandemic flu, adverse weather, lack of public transport, fire and flood.
People we spoke with confirmed that the care workers and other staff they met were competent. There was a comprehensive staff induction programme in place which was carried out over three days.
Staff we spoke with all told us they received an induction and on-going training in order to ensure they had the necessary skills to meet people's individual needs.
Staff told us they felt they had received sufficient training to undertake their role competently.
Staff received supervision and appraisal from their manager, and the service kept a record of all staff supervisions that had previously taken place.
Staff demonstrated a good understanding of MCA/DoLS and told us about when they felt a DoLS authorisation might be required. All staff had completed training in MCA/DoLS as part of the process of induction and through subsequent training.
Before any care and support was given the service obtained consent from the person who used the service or their representative and each section of people’s care files had been signed accordingly.
Each person who used the service had a comprehensive health assessment and health care plan which was easily accessible within their individual care and support plan.
At each house we visited people’s bedrooms were decorated to their choice and contained a wide variety of personal items that were relevant to each person.
People chose their own food and drink, had nutritional care plans in place and referrals to other professionals such as speech and language therapists (SALT) had been made where required, and information and advice received from these was documented. People’s likes and dislikes were recorded in their care file and this was in pictorial format, which would assist some people with limited verbal and written communication to recognise the foods they liked.
People received support from staff who showed kindness and compassion. Staff knew the different ways that people communicated and people had communication care plans and risk assessments in place. The service had made written information easier to understand for people that required this.
People were treated with dignity and respect. We saw that staff knocked on people's doors and waited to be let in. The service used a ‘matching tool’ which helped to ensure a good match between the person using the service and the staff supporting them.
Involvement of people who used the service was embedded into everyday practice. People's support plans detailed things that people could do for themselves and what they needed support with.
People were involved in developing their care plan and were supported to be independent. Sensitive information was also being handled carefully.
The service did not provide end of life care and no-one was in receipt of this at the time of the inspection.
The service had a service user’s handbook called Liverpool Adult Services Support Guide, which was given to each person who used the service. In addition to this people were also provided with a Statement of Purpose, which is a document that includes a standard required set of information about a service.
People had a weekly planner in their care files and this documented the activities that they enjoyed doing and had taken part in. People also had a ‘care and support grid’ document in their files which identified different tasks that needed to be completed each day.
People’s care plans were reviewed on a monthly basis by their key worker and any updates were recorded correctly in their files. The needs of people were assessed by experienced members of staff before being accepted into the service and thorough pre-admission assessments were completed to ensure the service could meet people’s individual needs.
People who used the service had a care plan that was personal to them. Copies were held at both the person’s own home and in the main office premises. The structure of the care plans was clear and information was easy to access.
People using the service and staff told us that they felt confident talking to the registered manager directly with any concerns or complaints. The service had a complaints policy and procedure and we saw that they followed this consistently.
The staff we spoke with told us they enjoyed working for the service which had an open transparent culture. Staff also felt supported to undertake their roles to the best of their ability.
New developments were discussed within staff meetings, along with policies & procedures. All team managers encouraged the staff they were responsible for to contribute to staff meetings so that all staff felt included.
Staff supervisions records were held in individual staff personnel files which were kept securely, maintaining their confidentiality.
The service worked closely with Liverpool John Moores University (LJMU) in supporting student nurses with placements.
The service was registered with the Workplace Wellbeing Charter which provided advice and guidance to enable the service to continue to strive towards excellence.
The service was also registered with the Dignity in Care Charter and staff members had pledged their commitment to dignity in care.
The service had committed to the Health Charter for Social Care Providers. This charter was developed in partnership with the Voluntary Organisations Disability Group (VODG).
Staff had access to a wide range of policies and procedures. These could be easily accessed and viewed by staff if they ever needed to seek advice or guidance in a particular area.
The registered manager undertook regular audits covering a wide range of areas and records of audits were comprehensive.
The service had a business continuity plan that was recently reviewed in September 2016 and also had a business development plan for the period 2016-2020.