Background to this inspection
Updated
6 July 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 Health and Social Care Act 2008.
Inspection team
Five inspectors carried out the inspection. An expert by experience made calls to the people who used the service and their families for feedback on the service. 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
The service had a manager registered with the Care Quality Commission. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.
This service provides care and support to people living in their own homes, so that they can live as independently as possible. People’s care and housing are provided under separate contractual agreements. CQC does not regulate premises used for supported living; this inspection looked at people’s personal care and support.
Notice of inspection
This inspection was announced. We gave a short period of notice of the inspection because some of the people using it could not consent to a home visit from an inspector. This meant that we had to arrange for a ‘best interests’ decision about this. We also needed to be sure the registered manager would be in the office to support the inspection.
Inspection activity started on 16 May 2022 and ended on 7 June 2022. We visited the office location on 18 May 2022. Inspectors visited people in their homes in the week following the office visit.
What we did before inspection
We reviewed information we had received about the service. We sought feedback from the local authority and professionals who work with the service. The provider was not asked to complete a Provider Information Return (PIR) prior to this inspection. A PIR is information providers send us to give some key information about the service, what the service does well and improvements they plan to make.
This information helps support our inspections. We used all of this information to plan our inspection.
During the inspection
We visited eight addresses and met with 18 people who used the service to get their feedback about the care provided. Where people were unable to talk with us, we used observation to help us understand their experience of using the service. We also met with 16 care staff and senior care staff who supported them.
We had phone contact with four family members and three people for feedback about the service. We emailed all care staff and had replies from 11 staff.
During the office visit we met with the registered manager, regional quality manager and other office staff.
We reviewed a range of records. This included seven people’s care records and multiple medication records. We looked at four staff files in relation to recruitment and staff supervision. A variety of records relating to the management of the service, including policies and procedures were reviewed.
After the inspection
We continued to seek clarification from the provider to validate evidence found. We looked at training data and quality assurance records. We spoke with two professionals who had contact with the service.
Updated
6 July 2022
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
Living Ambitions Limited - Essex is a supported living service providing personal care to approximately 64 people in 23 addresses. Support is primarily provided to people with learning disabilities and autistic people. People live in individual flats and shared houses.
People’s experience of using this service and what we found
The service was able to demonstrate how they were meeting the underpinning principles of Right support, right care, right culture.
Right Support
Although some people were supported by staff to pursue their interests, not everyone was enabled to achieve their individual aspirations and goals. The registered manager was working effectively to improve this and ensure people received consistently personalised support.
There was a new registered manager since our last inspection who had made changes in the service to ensure people received safer care.
Staff supported people to have the maximum possible choice, control and independence and have control over their own lives. People had the support they needed to make decisions following best practice in decision-making.
People accessed specialist health and social care support in the community. Staff supported people to play an active role in maintaining their own health and wellbeing.
Staff supported people with their medicines in a way that promoted their independence and achieved the best possible health outcome.
Right Care
Staff spoke respectfully about people and treated them with compassion. Staff respected people’s privacy and dignity. They understood and responded to people’s individual needs.
The service had improved how it worked with other agencies to protect people from the risk of abuse. There were improved systems to ensure effective investigations took place and actions were taken, where required. Staff understood how to protect people from poor care and abuse. Staff had training on how to recognise and report abuse and they knew how to apply it.
There had been a turnover of staff as the registered manager was focusing on building a stronger and more caring staff team. The service had enough appropriately skilled staff to meet people’s needs and keep them safe.
People could communicate with staff and understand information given to them because staff supported them consistently and understood their individual communication needs.
People’s care and support plans reflected their range of needs and this promoted their wellbeing. There was an ongoing programme to improve care plans to ensure they gave guidance to staff about how to continually enhance people’s lives. People and those important to them, were involved in planning their care.
Staff and people cooperated to assess risks people might face. Where appropriate, staff encouraged and enabled people to take positive risks.
Right culture
The registered manager had restructured the management team. As part of the changes, local managers were more visible. This helped reduce the risks of closed cultures. The management team were passionate about creating a culture where people’s wishes, needs and rights were at the heart of the service.
The leadership of the service had worked hard to create a learning culture where the whole organisation had a role in improving the support people received. People’s quality of life was enhanced by the service’s culture of improvement and inclusivity.
Staff evaluated the quality of support provided to people, involving the person, their families and other professionals as appropriate. The registered manager had introduced improved checks on safety and the quality of care. There were new systems to ensure the registered manager and provider had better oversight of the service.
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 30 April 2020).
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.
Why we inspected
We undertook this inspection to assess that the service is applying the principles of Right support, right care, right culture and to follow up on action we told the provider to take at the last inspection.
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.