About the service Liberty Support (West Midlands) provides personal care in supported living settings. At the time of the inspection they were supporting 42 people with a learning disability, autism or living with mental ill health. People lived in shared houses, flats and bungalows across different areas within the West Midlands.
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 using this service and what we found
People using the service were not always safe. Staff knew when and how to report any concerns of abuse. However, there were occasions where people using the service were not always safe due to safe staffing levels.
People were not always supported by staff who understood their roles and did not always receive effective training.
People were not asked for their views of the service. There were not effective systems in place to monitor the service.
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.
We expect health and social care providers to guarantee autistic people and people with a learning disability the choices, dignity, independence and good access to local communities that most people take for granted. Right support, right care, right culture is the statutory guidance which supports CQC to make assessments and judgements about services providing support to people with a learning disability and/or autistic people.
The service was not able to demonstrate how they were meeting some of the underpinning principles of right support, right care, right culture.
Right support
People were supported to have choice, staff supported people in the least restrictive way possible.
The provider supported people to make choices, and have control over their own lives, such as what time they got up and went to bed.
Right care
We saw that staff were caring and promoted the people they were supporting dignity.
Right culture
Staff had training on how to recognise and report abuse and they knew how to apply it. Staff had training on how to recognise and report abuse and they knew how to apply it. Staff told us how they would recognise pain, distress and discomfort in people who could not verbally communicate.
Why we inspected
We received concerns in relation to the safety of people and concerns about the numbers of staff available to support people.. As a result, we undertook a focused inspection to review the key questions of safe, effective and well-led only. Whilst undertaking this inspection we assessed whether the service was applying the principles of right support, right care and right culture.
For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating.
The overall rating for the service has changed from good to requires improvement based on the findings of this inspection.
We have found evidence that the provider needs to make improvements. Please see the safe, effective and well led sections of this full report.
You can see what action we have asked the provider to take at the end of this full report.
The provider has an action plan in place to address the concerns raised by the local authority as well as an action plan for across the region to improve the quality of care for people using the service. The action plan was in the early stages, so not enough time had passed to see the change.
Enforcement and Recommendations
We are mindful of the impact of the COVID-19 pandemic on our regulatory function. This meant we took account of the exceptional circumstances arising as a result of the COVID-19 pandemic when considering what enforcement action was necessary and proportionate to keep people safe as a result of this inspection. We will continue to monitor the service and will take further action if needed.
We have identified breaches in relation to regulation 12 of safe care and treatment and regulation 17 of good governance at this inspection.
Please see the action we have told the provider to take at the end of this report.
Full information about CQC’s regulatory response to the more serious concerns found during inspections is added to reports after any representations and appeals have been concluded.
Follow up
The provider has an action plan in place, and they understand what they need to do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
The last rating for this service was good (published on the 11 January 2020).