Limitless Care Group

Updated 28 January 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.

As part of this inspection we looked at the infection prevention and control measures in place. This was conducted so we can understand the preparedness of the service in preventing or managing an infection outbreak, and to identify good practice we can share with other services.

Inspection team

The inspection was carried out by an inspector.

Service and service type

This service is a domiciliary care agency. It provides personal care to people living in their own houses and flats and while out in the community, for example while at a day centre or out shopping.

The residential respite service is a ‘care home’. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

The service had a manager registered with the Care Quality Commission. The registered manager was also the nominated individual for the service. The nominated individual is responsible for supervising the management of the service on behalf of the provider. The registered manager and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.

Notice of inspection

This inspection was announced. We gave the service a short period of notice to ensure that the registered manager would be available to support the inspection and to arrange a visit to the respite accommodation at a time when someone would be staying there.

What we did before the inspection

We reviewed information we had received about the service since their registration. We sought feedback from the local authority and Healthwatch. Healthwatch is an independent consumer champion that gathers and represents the views of the public about health and social care services in England. We used this information to plan our inspection. The provider was not asked to complete a provider information return prior to this inspection. This is information we ask providers to send to us to give us key information about the service, what the service does well and improvements they plan to make. We took this into account when we inspected the service and made the judgements in this report.

During the inspection

We spoke with the registered manager, human resources manager and two care co-ordinators at the office. We reviewed a range of records, including two people’s care records and a selection of medicines records. We looked at two staff recruitment files and staff supervision records. We visited the respite accommodation. We looked around to check that the environment was safe and suitable for people's needs and observed two support workers supporting a person.

After the inspection

We spoke with ten relatives on the telephone to gain their views about the service. It was not possible to gain feedback from anyone supported by the service due to their complex needs. We also contacted three community health and social care professionals for their feedback and received email feedback from two of the service’s support workers. We reviewed a variety of records related to the management of the service, including policies and audits.

Updated 28 January 2022

About the service

Limitless Community Hub is a care agency which provides personal care and support to children aged four to 17, younger adults, people with a learning disability and autistic people, both at home and in the community. The service also provides short term residential respite support in a house which can accommodate up to two people. At the time of the inspection 18 people were receiving support with personal care and one person was staying at the respite accommodation. Eleven people were accessing the respite accommodation regularly.

Not everyone who used the service received 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.

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

Relatives told us staff provided people with safe care and managed any risks to their health or wellbeing effectively. Staff knew how to protect people from the risk of abuse and avoidable harm. The registered manager recruited staff safely. Most people were happy with the service’s staffing arrangements, but some told us they had experienced missed or late visits. The registered manager told us this was due to staff sickness and difficulties recruiting additional staff. We have made a recommendation about maintaining sufficient staffing levels. People’s medicines were managed safely, with some minor improvements needed to ensure compliance with national guidance. Staff followed safe infection prevention and control practices and adhered to Government guidance relating to COVID-19. The safety of the home environment was checked regularly.

Staff provided people with support which reflected their needs and risks. 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. Staff received the induction and training they needed to support people well. Staff were aware of people’s dietary and healthcare needs and risks and provided appropriate support. The respite accommodation environment was suitable for people’s needs and risks.

Relatives told us people liked the staff who supported them. Relatives found staff kind, caring and respectful and were happy with how they supported their family members. Staff respected people’s privacy and dignity. They encouraged people to be independent and make decisions about their care when they were able to. People’s right to confidentiality was respected.

Staff treated people as individuals and supported them in a way which reflected their needs and preferences. Staff knew people they cared for well, including their likes, dislikes and what was important to them. They encouraged people to make decisions about their support when they could. People were supported to follow their interests, try new things and develop new skills. Staff reviewed people's care needs regularly. Concerns and complaints were managed appropriately.

The registered manager and staff were clear about their responsibilities. They prioritised providing people with personalised, good quality care which met their needs. Relatives’ views about the service were sought and listened to. Staff told us management were approachable and supportive. The registered manager and senior staff completed regular checks to ensure appropriate standards of quality and safety were being maintained at the service. They worked in partnership with community professionals to ensure people received the support they needed.

We expect health and social care providers to guarantee autistic people and people with a learning disability the choices, dignity, independence and good access to local communities that most people take for granted. Right support, right care, right culture is the statutory guidance which supports CQC to make assessments and judgements about services providing support to people with a learning disability and/or autistic people.

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

Right support: The support provided by staff focused on ensuring people had choice, control and were encouraged to be as independent as possible.

Right care: People were treated as individuals and the support provided by staff promoted their privacy, dignity and human rights.

Right culture: The registered manager, care co-ordinators and support staff, all displayed values which prioritised supporting people to live confident, inclusive and empowered lives.

For more details, please see the full report which is on the Care Quality Commission (CQC) website at www.cqc.org.uk

Rating at last inspection and update

This service was registered with us on 1 June 2020 and this is the first inspection.

Why we inspected

This was a planned inspection based on the service’s date of registration.

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. This included checking that the provider was meeting COVID-19 vaccination requirements.

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.