LIBERTAS

LIBERTAS is a domiciliary care agency providing personal care to people living in their own homes. The service supports older and younger people and people with mental health needs and various other health conditions. The service also provides care and support to people living in two extra care' settings where people's care and housing are provided under separate contractual agreements.

Not everyone who uses the service might receive personal care. CQC only inspects where people receive personal care. This is help with tasks related to personal hygiene and eating. Where they do, we also consider any wider social care provided. At the time of the inspection the service was providing support to 194 people.

People’s experience of using this service and what we found

People told us timings of care visits were inconsistent, late or cut short. Some people found this impacted their ability to plan their day which they found frustrating.

People’s medicines were mostly managed safely, although sometimes inconsistent care visit times meant medicines were administered later than scheduled, which increased risks to people’s health from conditions such as diabetes.

We have made a recommendation to the provider about reviewing care visit times to ensure safe administration of medicines.

Staff received training in safe administration of medicines and had their competency checked by senior staff. Staff worked with local pharmacies and GPs to make sure people had the correct medicine.

Staff had received training in safeguarding and understood how to recognise and report any concerns. Most people told us they felt safe due to knowing the staff and staff treated them with kindness. However, not all people felt this way. Some people had concerns about new staff and agency staff who they felt did not know them or understand how to meet their needs.

People felt confident to speak up where they had concerns but did not always feel their concerns were listened to by the management team.

People’s care was regularly reviewed and updated where changes were required. The registered manager conducted various audits to review what was working and what needed to be improved. These were not always effective in identifying the full extent of concerns in relation to care visit times.

Risks to people’s health and wellbeing were assessed and staff understood what they were doing and how to identify and report any concerns.

The registered manager ensured all staff had recruitment checks prior to employment to make sure they were suitable for their role and people would be safe.

Staff received full training and induction and took time shadowing other staff. This was so they could get to know people well and how they liked things to be done before providing their care.

People were supported by staff who used effective control measures to reduce the risks of infection and COVID-19. This included washing their hands regularly and followed the latest government guidance.

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.

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 (16 April 2018).

Why we inspected

This inspection was prompted by a review of the information we held about this service. We undertook a focused inspection to review the key questions of safe and well-led only. For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating. We have found evidence that the provider needs to make improvements. Please see the safe and well-led sections of this full report.

The overall rating for the service has changed from good to requires improvement based on the findings of this inspection. You can read the report from our last comprehensive inspection by selecting the ‘all reports’ link for LIBERTAS on our website at www.cqc.org.uk.

Enforcement and Recommendations

We have identified breaches in relation to person centred approaches, quality assurance measures and staff support at this inspection. Please see the action we have told the provider to take at the end of this report.

Follow up

We will request an action plan from the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.

Not everyone using LIBERTAS receives the regulated activity ‘personal care’. CQC only inspects the service provided to people receiving personal care such as help with tasks related to personal hygiene and eating. For people receiving personal care, we also take into account any wider social care provided.

We inspected the service on 6 and 7 February 2018. The inspection was announced. At the time of our inspection 305 people were receiving a personal care service.

The service had a registered manager. A registered manager is a person who has registered with CQC to manage the service. Like registered providers (the ‘provider’) 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 our last inspection in January 2015 we rated the service as Good. At this inspection we found the evidence continued to support the rating of Good and there was no evidence or information from our inspection and ongoing monitoring that demonstrated serious risks or concerns. This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection.

People told us that they were satisfied with every aspect of the service they received. In particular, the provider’s careful approach to managing staffing resources which meant staff were rarely late for the start of their care calls.

Staff had established warm, friendly relationships with people and went out of their way to help them in any way they could. Staff worked together in a supportive way and participated in a varied programme of training appropriate to their needs. They were proud to work for the provider and felt listened to by the registered manager and other senior staff. The registered manager had an open and responsive leadership style which set the cultural tone for the service

People were involved in agreeing the type and amount of care they received and their needs and wishes were understood and followed by staff. Staff treated people with dignity and respect and encouraged them to maintain their independence. Staff had the knowledge and skills required to meet people’s individual needs effectively and supported them to prepare food and drink of their choice.

People received any support they required to take their medicines and staff worked closely with local healthcare services to ensure people had access to specialist support when needed. The provider assessed any potential risks to people’s safety and welfare and put preventive measures in place where required. Staff knew how to recognise and report any concerns to keep people safe from harm.

The provider sought people’s opinions through regular customer surveys and people were satisfied that any complaints were handled effectively.

The provider was committed to the continuous improvement of the service and maintained a range of systems to monitor service quality. Action was required to improve the auditing of medicines management. Action was also required to ensure CQC was always notified of any significant incidents or events.

CQC is required by law to monitor how a provider applies the Mental Capacity Act 2005 (MCA) and to report on what we find. Staff understood the principles of the MCA and how to support, in the least restrictive way possible, people who lacked capacity to make some decisions for themselves.