7 July 2022
During a routine inspection
About the service
Liberty Support (Cheshire East) provides personal care to people living in their own houses and flats, and to people living in a 'supported living' settings, so they can live as independently as possible. People's care and housing are provided under separate contractual arrangements. The CQC does not regulate premises used for supported living; this inspection looked at people's care and support.
Not everyone using the service received a regulated activity; CQC only inspects the service being received by people who are provided with the regulated activity of 'personal care', for example which includes help with tasks such as personal hygiene and eating. Where they do, we also take into account any wider social care provided. At the time of our inspection eight people were in receipt of personal care.
People’s experience of using this service and what we found
The service was able to demonstrate how they were meeting most of the underpinning principles of right support, right care, right culture.
Right Support
Systems were not fully in place to ensure people had maximum choice and control of their lives. Records did not demonstrate people had consented to their care or where they lacked capacity to consent, the provider had complied with the Mental Capacity Act 2005 (MCA). However, care appeared to be provided in people’s best interests and in the least restrictive way possible.
The service aimed to support people with a small and consistent team of staff who knew people well. However, this was not always possible due to recruitment issues. The service was using agency staff to cover gaps in staffing and had taken steps to improve recruitment. Staff were recruited safely.
Staff were being supported to focus on people’s strengths and promote what they could do, so people had a fulfilling and meaningful everyday life. Staff supported people to make their own choices and understood their needs and preferences.
Staff had good awareness, skills and understanding of individual communication needs.
One of the settings required some refurbishment and redecoration, including the bathroom. The provider was not responsible for the accommodation and had escalated these issues to the landlord, but these were still awaiting repair. However, there were also issues with the cleanliness of one setting which was addressed during the inspection. We shared our concerns with the commissioners of the service.
Right Care
The management team had made some changes and were focused on supporting people to be at the centre of their care. They were making improvements to ensure people were supported by staff who had people's individual needs at their focus.
Feedback suggested some people were not consistently supported to engage with activities they were interested in, including appropriate sensory stimulation. Managers had already identified this and begun to review people’s support plans to consider more individualised and creative options. In some cases, we saw people were supported to take part in various activities within the community.
Staff and people cooperated to assess risks people might face. Where appropriate, staff encouraged and enabled people to take positive risks. Staff liaise with other professionals to promote people’s well-being.
People received kind and compassionate care. Staff protected and respected people’s privacy and dignity. They understood and responded to their individual needs.
Right Culture
Feedback from people and their relatives confirmed overall they were happy with the support and felt safe. The manager had taken steps to promote a positive culture. The training, supervision, monitoring and mentoring of staff was a focus.
Staff knew and understood people well and were responsive. People's support plans reflected their range of needs and this promoted their wellbeing, however some support plans needed to be updated and did not always fully reflect people's goals or aspirations.
The service employed a dedicated Positive Behaviour Support (PBS) coordinator and specialist nurse to support staff training and development, as well as approaches to peoples’ support needs. We saw examples where improved outcomes had been achieved for people receiving support.
Governance processes were being reviewed and new systems embedded. The manager was working on an action plan to help make improvements to the service. The provider sought feedback from people and those important to them and used the feedback to develop the service. However, further consideration was being given to gather this feedback more effectively.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection
This service was registered with us on 9 September 2021 and this is the first inspection.
Why we inspected
This inspection was prompted by a review of the information we held about this service. We undertook this inspection to assess that the service is applying the principles of right support, right care, right culture.
Enforcement
We have identified one breach of regulation in relation to consent at this inspection.
Please see the action we have told the provider to take at the end of this report.
Follow up
We will request an action plan from the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.