Archived: Independent Lifestyles Support Agency

Independent Lifestyles Support Agency provides personal care and support to people in their own homes. Personal care and support is provided for people living with a learning disability or autism. At the time of the inspection personal care was provided to one person in their own home. Personal care and support was also provided to 17 people across five supported living services, which are houses privately rented by people. The supported living services are staffed over a 24-hour period and people are supported with social care needs such as, activities and occupation, as well as their personal care. The Care Quality Commission inspects the care and support people receive in supported living homes, but does not inspect the accommodation people live in.

At our last inspection we rated the service Good. At this inspection we found the evidence continued to support the rating of Good and there was no evidence or information from our inspection and ongoing monitoring that demonstrated serious risks or concerns. At this inspection we found the service remained Good.

The care service has been developed and designed in line with the values that underpin the Registering the Right Support and other best practice guidance. These values include choice, promotion of independence and inclusion. People with learning disabilities and autism using the service can live as ordinary a life as any citizen.

Staff had a good awareness of the of the importance of protecting people and what to do if they considered people were not being treated appropriately. Risks were assessed and there were procedures for care staff to follow to ensure people were safely supported. Medicines were safely managed. Sufficient numbers of staff were provided to meet people’s needs. Checks were made on the suitability of new staff to work in a care setting. Staff were trained in infection control and had access to protective clothing to help prevent the spread of infection. Reviews of accidents and incidents took place.

Care staff were supported well and had access to a range of training courses including nationally recognised qualifications in care.

People’s nutritional needs were assessed and people were supported with food and drinks. Health care needs were assessed and the provider made referrals to health services where this was needed.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice. The provider had a good knowledge of the Mental Capacity Act 2005 and made appropriate referrals to the local authority when people did not have capacity and whose freedom was restricted for their own safety. There was, however, a lack of clarity in care records regarding consent to care and treatment and when best interests decisions were made on behalf of one person whose liberty was restricted for their own safety. This was clarified by the provider following the inspection.

Care staff treated people with dignity and respect. People were supported to make decisions about their care and support, which promoted their independence. Care staff had a good understanding of the need to ensure people’s privacy was upheld.

People’s needs were comprehensively assessed. Each person had care plans which reflected their needs, preferences and choices. Relatives told us the staff were responsive to people’s care needs and ensured person centred care was provided. People’s communication needs were assessed and communication tools were used to involve people in decision making.

Relatives said they had a good dialogue with the care staff and management team. They told us they felt able to raise any concerns and issues were always responded to.

The service was well - led and was responsive to the challenges it faced. The provider had systems to assess and monitor the quality of the service, as well as plans to develop and improve. This included seeking the views of people, their relatives and staff about the quality of the service. Staff were supported to develop their skills and knowledge.

Further information is in the detailed findings below.

Independent Lifestyles Support Agency provides personal care and support to people living in their own home. Personal care and support is provided for people with a learning disability, acquired brain injury and autism. The agency also provides day care services to people who use their services and staffing twenty four hours a day to houses that are rented privately by people who require supported living. The Care Quality Commission inspects the care and support the service provides, but does not inspect the accommodation people live in or the day care service.

The service had a registered manager. 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 experiences of people were positive. People told us they felt safe, that staff were kind and the care they received was good. One person told us “Yes, I always feel safe with the staff”.

Assessments of risk had been undertaken and there were instructions for staff on what action to take in order to mitigate them. Staff knew how to recognise the potential signs of abuse and what action to take to keep people safe. The registered manager made sure there was enough staff at all times to meet people’s needs. When the provider employed new staff at the service they followed safe recruitment practices.

The provider had arrangements in place for the safe administration of medicines. People were supported to receive their medicine when they needed it. People were supported to maintain good health and supported to access health care services if required.

The service considered peoples capacity using the Mental Capacity Act 2005 (MCA) as guidance. People’s capacity to make decisions had been assessed. Staff observed the key principles in their day to day work checking with people that they were happy for them to undertake care tasks before they proceeded.

People were supported at mealtimes to access and prepare food and drink of their choice and were supported to undertake activities away from their home. One person told us “I like cooking and [member of staff name] helps me, we have fun”.

Staff felt fully supported by management to undertake their roles. They were given training updates, supervision and development opportunities. For example staff were offered to undertake additional training and development courses to increase their understanding of the needs of people using the service. One member of staff told us “We talk about all the people I see and any concerns then decide on my training needs”. All staff had a personal TNA (Training Needs Analysis) for the coming year.

The management team monitored the quality of the service by the use of regular checks and internal quality audits to drive improvements. Feedback was sought by the registered manager through surveys which were sent to people and their relatives. Survey results were positive and any issues identified acted upon. People and relatives we spoke with were aware of how to make a complaint and felt they would have no problem raising any issues. Complaints were responded to in a timely manner with details of any action taken.

People told us that they received the care and support they required to meet their needs. They said that they were aware of what care was to be provided and were in agreement to it being provided. People told us that their care and support needs had been discussed with them and the care they received reflected this.

They also told us that the care they received met their individual needs. One person said, "I'm very happy with the care and support I get.' A relative commented, "The carers are very nice and kind and do what is needed." However one relative raised concerns about the lack of confidentiality and inconsistency of care workers.

We looked at the systems and processes the service had in place to protect people from abuse. Staff knew what constituted abuse and what to do if it was suspected.

We reviewed the recruitment procedures that were in place and found that processes were thorough and well documented. Staff received regular training and supervision and felt valued and supported.

The service had effective systems in place to deal with people's comments and complaints.

We found that the provider had robust processes in place to ensure that the care and support provided for people had been appropriately assessed, delivered and reviewed.

We reviewed the provider's documentation and found policies in place which underpinned the process of the delivery of care and support to people. We found that the provider had appropriate processes in place to safeguard the people the service supported.

We also reviewed the files of four people who used the service. We found that care and support had been delivered in line with the provider's policies.

One person told us "I am happy with my care and support. They cook for me. They are very good". One member of staff said "It's brilliant working here. I enjoy teaching arts and crafts and cooking with people".