Archived: Lithos Road Supported Living Service

During our inspection on 7 May 2014, we found that the service was not meeting essential standards relating to consent to care and support, and record-keeping. The provider submitted an action plan detailing what they would do to meet the standards. During this visit, on 12 September 2014, we checked whether the provider had carried out the actions and whether the standards were now being met.

We found that people had appropriately consented to their support in line with the requirements of the Mental Capacity Act 2005, and their consent was appropriately documented. We also found that people's care and support records were now accurate and up-to-date.

Below is a summary of what we found. The summary describes what relatives of people using the service and staff told us, what we observed and the records we looked at.

If you wish to see the evidence on which this summary is based please refer to the full report.

Is the service safe?

People who used the service had support plans and risk assessments which helped to ensure their safety and welfare. We found, however, that people's personal records were not always accurate which meant that their safety was not always ensured if new staff or other professionals were relying on that information to ensure they offered appropriate support.

Staff were properly vetted to ensure they had appropriate skills and knowledge to provide the support required to safely meet people's needs. Staff were trained in the complex needs of the people who used the service, and demonstrated that they knew the people they supported very well.

The service premises and equipment available for staff were in line with guidelines for infection control and food hygiene.

Is the service effective?

People's needs were met through the support provided by the service. A relative of a person who used the service told us "It is obvious my relative is very happy living there, they are always happy to go back after visits". Records showed that people's health needs were attended to in a timely manner, and one staff member told us that a person's epileptic seizures had greatly reduced in frequency in the time they had been living in the service. People were supported to undertake a range of activities of their choice, and one relative we spoke with told us "I am constantly impressed with the professionalism of the staff".

The provider had taken steps to ensure that people with complex communication needs were included and involved as much as possible in their care and support. One person's relative told us "They address all the questions in review meetings to my relative], even when they can't answer. The staff know my relative so well and have such a good rapport with them they understand what they mean even though they don't speak".

Is the service caring?

Feedback from relatives of people who use the service was very positive. One relative told us "They are incredibly kind and supportive. One care worker in particular has such a special bond with [my relative], they treat [my relative] with great respect and need a medal". Another relative said "They do amazing work, so kind and always telling me what's going on".

Is the service responsive?

The provider had a suitable quality assurance system in place, and regularly sought feedback from people who use the service, their relatives and staff. These feedback mechanisms took people's varied communication needs into account to ensure they could have their say.

Is the service well-led?

Staff told us the managers of the service were approachable and responsive when they raised issues. One staff member told us "By and large this is a great place to work".

We found that systems were not in place to ensure that legal requirements were followed when people did not have the capacity to consent to their care and support.

People who used the service appeared relaxed and happy. The provider had taken action to ensure that people's finances and valuable items were well managed. Procedures were in place for two staff to be present for checking and signing when dealing with people's finances and when administering medication. However, medication administration record sheets were not signed by staff on one occasion to confirm people had had their medication. The provider had put in place systems for auditing people's finances and medication on a regular basis.

There were 'lots' of training opportunities for staff. We noted that staff were "happy working" at the service and were well supported by the managers.

People's care plans were detailed and up-to-date. Each person had a key worker who regularly met with people and updated their care plans. Care plans and risk assessments were detailed and staff were aware of how to meet people's needs. People's families, social workers and health professionals were involved in review of care plans. This ensured that people received appropriate support that met their needs.

The service had a safeguarding policy and systems were in place to ensure that people's welfare were upheld. We noted staff had attended training which would enable them to provide care and support that met people's needs. However, we noted that people were at risk of financial abuse. We asked the registered person to make suitable arrangements to ensure that people who used the service are safeguarded against the risk of abuse.