Archived: Livability Lifestyle Choices West

The inspection was announced. Forty-eight hours’ notice of the inspection was given to ensure that the people we needed to speak with were available. The inspection was undertaken by one inspector.

Livability Lifestyle Choices West provide care and support services to people living in their own homes. The service is provided to people who predominately have learning disabilities and may also have associated physical disabilities and dementia care needs. At the time of the inspection they were supporting 23 people.

There was a registered manager in post at the service however they were not available for the inspection because they had been on a period of extended leave. A registered manager is a person who has registered with the Care Quality Commission to manage the service and has the legal responsibility for meeting the requirements of the law; as does the provider. Whilst the registered manager had been away, an interim manager was in place, plus there was also a deputy manager who was familiar with the service.

The care planning and risk assessment processes in place were cumbersome and disorganised. Care records were more appropriate for a residential setting (a care home) and did not clearly identify the care and support the service provided. Risk assessment processes were excessive and some people had 19-20 risk assessments. Some of those assessments were in respect of activities the person participated in without support from the service. Old care documentation was being stored in people’s own homes, was not secure and the service could not be sure all records were retained for the appropriate period of time.

The interim manager, deputy manager and the staff team were knowledgeable about safeguarding issues, knew the appropriate actions to take if concerns were raised and who any concerns should be reported to. All staff received safeguarding adults training. Robust recruitment procedures were followed to ensure only suitable staff were employed. The appropriate steps were in place to protect people from being harmed.

Where people needed support to manage their daily medicines this was identified in their care and support plan. Staff received safe medicines administration training to ensure they were competent to undertake the task and their competency was rechecked.

Staff were provided with training opportunities to enable them to carry out their roles and responsibilities. They completed a programme of essential training, person-specific training and a programme of refresher training. Support workers were expected to complete additional qualifications in health and social care.

Staff understood the principles of the Mental Capacity Act 2005 (MCA). The MCA provides the legal framework to assess people’s capacity to make certain decisions. Where people had been assessed as not having the capacity to make a decision or had no verbal skills, best interest decisions had been made involving others who knew the person well.

People were supported to have sufficient food and drink. Where people needed support with meal preparation this was detailed on their care and support plan. Where required people were provided with support to eat their meals and have drinks. People were supported to see their GP and other healthcare professionals as and when they needed to do so.

The support workers and the managers had good, kind and friendly working relationships with the people they were looking after. Staff ensured people’s privacy and dignity was maintained at all times.

The people looked after by this service had received care and support for many years and the support workers looked after them in the way they knew they preferred. Support workers were able to tell if those without any verbal communication skills were feeling because they knew what other non-verbal actions meant. People were encouraged to express their views and opinions about how they wanted to be looked after.

Although people were satisfied with the service, the staff were looking forward to the return of the registered manager and the recruitment of new staff. All staff endeavoured to provide a high quality care service that was safe, effective and compassionate.

Measures were in place to monitor the quality of the service and action plans were in place where improvements had been identified. Learning took place following any accidents, incidents or complaints to prevent further occurrences.

You can see what action we told the provider to take at the back of the full version of the report.