Livingstone Health Care Services

Updated 20 April 2024

Background

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 Health and Social Care Act 2008.

Inspection team

The inspection team consisted of 3 inspectors and an Expert by Experience. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service.

Service and service type

This service is a domiciliary care agency. It provides personal care to people living in their own houses and flats.

Registered Manager

This provider is required to have a registered manager to oversee the delivery of regulated activities at this location. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Registered managers and providers are legally responsible for how the service is run, for the quality and safety of the care provided and compliance with regulations.

At the time of our inspection there was a registered manager in post.

Notice of inspection

The inspection was announced. We gave the service 24 hours’ notice of the inspection. This was because we needed to be sure that the provider or registered manager would be in the office to support the inspection and to enable the service to securely share information with us electronically prior to the inspection.

Inspection activity started on 29 November 2023 and ended on 22 March 2024. We visited the location’s office on 29 November 2023 and 19 December 2023.

What we did before the inspection

We reviewed the information we had about the service. We used the information the provider sent us in the provider information return (PIR). This is information providers are required to send us annually with key information about their service, what they do well, and improvements they plan to make. We sought feedback from the local authority. We used all this information to plan our inspection.

During the inspection

We spoke with the nominated individual, registered manager and the head of information technology and quality assurance. The nominated individual is responsible for supervising the management of the service on behalf of the provider.

We spoke with and emailed a total of 15 care staff. We spoke with 10 relatives and 5 people who used the service. We looked at a range of management records including quality audits, policies, staff supervision and training. We reviewed 14 people’s care records including risk assessments and 12 staff recruitment records. After the office visit, the registered manager sent us documentation we asked for and clarified any queries we had.

Updated 20 April 2024

We expect health and social care providers to guarantee people with a learning disability and autistic people respect, equality, dignity, choices and independence and good access to local communities that most people take for granted. ‘Right support, right care, right culture’ is the guidance CQC follows to make assessments and judgements about services supporting people with a learning disability and autistic people and providers must have regard to it.

About the service

Livingstone Health Care Service is a domiciliary care agency that provides personal care to people in their own homes. At the time of our inspection there were 141 people receiving personal care from the service.

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 the service and what we found:

Right Support

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. People were encouraged to make choices and decisions in relation to the care they received.

Care plans and risk assessments were regularly reviewed and involved relatives as appropriate. People’s medicines were managed safely and they were protected from the risks associated with the spread of infection.

Right Care

People’s needs were assessed before they began to use the service to ensure the provider could meet those needs. People had personalised care and support plans which included physical and mental health needs. Care plans documented people’s communication, cultural and spiritual needs. Where appropriate, people were supported with activities of their choice.

Relatives confirmed they were included, where appropriate, in decision making about their relative’s care. People were supported to eat and drink enough to maintain a balanced diet. Staff supported people to maintain their health where appropriate and worked jointly with healthcare professionals to improve outcomes for people.

Right Culture

People, relatives and staff felt the service was well managed. There had been improvements in communication and the provider sought feedback from people and relatives to identify areas for improvement.

Staff were recruited safely and there were enough staff employed to meet people’s needs. People were protected from abuse and poor care. The provider supported staff with training, supervision and appraisal. Training included learning disability so care could be provided effectively.

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

Rating at last inspection and update

The last rating for this service was requires improvement (published 16 July 2022). and there was a breach of the regulations. The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection we found improvements had been made and the provider was no longer in breach of regulations.

At our last inspection we made recommendations about the handling of complaints and communication. At this inspection we found improvements had been made and people now felt listened to as the provider responded to their concerns.

Why we inspected

This inspection was prompted by a review of the information we held about this service.

Follow Up

We will continue to monitor information we receive about the service, which will help inform when we next inspect.