Archived: Livability South East

Updated 8 February 2017

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

Livability Lifestyle Choices Southeast is registered to provide personal care. Support is provided both to individuals living in their own home and to people living in small group settings. At the time of our inspection there were 18 people using the service. Two people lived in Brighton, 14 lived within a cluster of two to three bedded houses in Eastbourne, and another two people lived with their families.

We spent the first day of our inspection at Newhaven where the registered office is located. The second day of our inspection was in Eastbourne, where we met with people and staff. Although people received support in a range of areas we only inspected the personal care element of their care package.

Before our inspection we reviewed the information we held about the service, including previous inspection reports. We considered information which had been shared with us by the local authority and other people, looked at safeguarding alerts which had been made and notifications which had been submitted. A notification is information about important events which the provider is required to tell us about by law.

We also asked the provider to complete a 'Provider Information Record' (PIR). This is a form that asks the provider to give us some key information about the service, what the service does well and improvements they plan to make and this helps to inform some of the areas we look at during the inspection. This was provided before our inspection.

This inspection took place on 2 and 6 December 2016 and was announced. When planning the inspection we took account of the size of the service. As a result, this inspection was carried out by one inspector without an expert by experience or specialist advisor. Experts by experience are people who have direct experience of using health and social care services. We contacted the service two days before our visit to let them know we would be coming. We did this because staff were sometimes out of the office and we needed to be sure that there would be someone available.

As part of the inspection, with their permission, we spoke with two people who lived at two of the

supported houses. During the inspection we met with the registered manager and deputy manager at the Newhaven office. In Eastbourne we met with a team leader and three care staff. Following the inspection we spoke by telephone with the relatives of three people. We also received feedback from two visiting health professionals.

During the inspection we reviewed the records of the service. This included staff recruitment, training and supervision records, medicines records, complaint records, accidents and incidents, quality audits and policies and procedures. We also looked at three people’s support plans and risk assessments along with other relevant documentation.

Updated 8 February 2017

Lifestyle Choices South East provides personal care and support for people living in their own homes. The service is provided in East Sussex and Brighton and Hove to adults with physical and learning disabilities. The support hours varied from a few hours daily to one to one support throughout the waking day. This was dependant on people's individual needs. The service was staffed 24 hours a day.

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. The registered manager is also registered to manage a care home and they told us that their time was split evenly between both services. They were registered two months before this inspection.

This comprehensive announced inspection was carried out on 2 and 6 December 2016.

There were a range of systems in place to assess the quality of the care and support provided to people. However, the last full analysis was carried out in March 2016 and although shortfalls identified at that time had been monitored to ensure they were completed, no further full assessment had been carried out. A range of shortfalls identified through our inspection would have been identified through effective and regular monitoring.

When people’s needs changed there was a delay in either introducing risk assessment documentation or in reviewing the risk assessment documentation already in place to ensure the risks of accident and/or incidents had been minimised and this left people at risk of harm.

DoLS applications had been made in respect of some people. (A DoLS is used when it is assessed as necessary to deprive a person of their liberty in their best interests and the methods used should be as least restrictive as possible). Some staff knew which people had restrictions in place but others were unsure. Documentation related to restrictions were not detailed in care plans.

Whilst staff felt supported by their line manager and attended regular supervision meetings, they did not feel supported by the management of the service. They felt the distance between the service and the office was too great to be effective. The registered manager had only met with people once since taking on their role as manager. However, six weekly staff meetings were held and detailed minutes were kept that demonstrated that staff were encouraged to share their views and that they were kept up to date with changes within the service.

Although there were staff vacancies, with the use of overtime, bank and agency staff there were enough staff to meet the needs of people. Staff understood what they needed to do to protect people from the risk of abuse and if there were concerns appropriate documentation was completed and sent to the local authority for investigation.

The service was committed to enabling people to gain and maintain daily living skills and improve their independence. Relatives spoke positively of this and recognised that independence often required risk and that this was done in a planned way to safeguard against accident and incidents.

People knew who to speak with if they had any concerns or worries. There was a detailed complaints procedure along with an easy read format. There were also additional measures in place to support anyone who might not be able to understand the easy read format so that anyone wanting to raise a concern could do so.

There were good systems to carry out environmental risk assessments and as part of this to ensure that all equipment in use was in working order. The business contingency plan had been used good effect following a recent electricity power cut and as a result learning from the experience had been added to the plan.

All staff completed basic training and more specialist training was provided for staff who supported people with specific needs. There was a thorough induction to the service and staff felt confident to meet people’s needs before they worked independently with them.

We found one breach of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see what action we told the provider to take at the back of the full version of this report.