Archived: Livability Devon

Updated 24 July 2018

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

The inspection of Livability Devon took place between the 27 June and 4 July 2018. The inspection was announced 48 hours in advance. This was to ensure someone was available at the office on the 27 May and to enable staff to support people to understand why we were going to visit them. The registered manager also needed time to contact families and staff to seek their consent to talk to us.

Livability Devon had an office in Exeter and two settings were people they support lived in their own homes. This included one in Exeter and one in Torquay.

The inspection was completed by one adult social care inspector.

Prior to the inspection, we reviewed our records and contacted a range of health and social care professionals. This included three GP surgeries and five other professionals with a specialist role relating to the needs of people living at the two settings.

On the 27 June we visited the office of the service to review records held there. On the 29 June we spoke with three staff and one family. On the 4 July we visited people living at the Exeter and Torquay settings. We sent questionnaires to all staff and families and received nine staff and four family responses.

We reviewed the care records of four people in detail to ensure they were receiving the support as planned. We reviewed the administration of all people’s medicines. We checked staff training records and the recruitment of four staff personnel records. We also reviewed the records held by the provider and registered manager to ensure the quality and safety of the service. This included audits of aspects of the service, complaints and feedback about the service.

People had varied ability to communicate; we spoke with people where we could and observed how staff interacted with them. Staff supported us to communicate with people who had certain communication methods or with people who felt more comfortable having a familiar person with them.

We spent time with five people in their homes; two people in Exeter and three people in Torquay. We spoke with one family and three staff. We also spoke with one person individually.

We received feedback from two professionals linked to the service. This included one GP and one health and social care professional.

Updated 24 July 2018

The inspection of Livability Devon took place between the 27 June and 4 July 2018. The inspection was announced 48 hours in advance. This was to ensure someone was available at the office on the 27 June and to enable staff to support people to understand why we were going to visit them. The registered manager also needed time to contact families and staff to seek their consent to talk to us.

This is the first comprehensive inspection of the service since the new provider was registered with us on the 9 June 2017.

This service provides care and support to people living in two ‘supported living’ settings, so that they can live in their own home 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. There were eight people receiving support; five people living in a setting in Exeter and three people living in one in Torquay.

People being supported had a range of needs. They were younger adults that could have a learning disability and/or autism. People could have other needs such as a physical disability and epilepsy.

We checked the service was working in line with ‘Registering the right support’, which makes sure services for people with a learning disability and/or autism receive services are developed in line with national policy - including the national plan, Building the right support - and best practice. For example, how the service ensured care was personalised, discharge if needed, people’s independence and links with their community.

A registered manager was employed to oversee the running of the service. 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.

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. People were assessed in line with the Mental Capacity Act 2005. There was some confusion about how the Deprivation of Liberty Standards applied to supported living settings. People can only be deprived of their liberty so that they can receive care and treatment when this is in their best interests and legally authorised under the MCA. In supported living settings this takes the authorisation of the Court of Protection. We have recommended the provider addresses this to ensure staff were clear.

People and families felt safe in their homes and with the staff who supported them. Staff knew how to keep people safe from harm and ensure they received a personalised approach to identifying if they were unhappy depending on their communication and comprehensive abilities. People’s care plans were detailed and written with people of those relatives who knew them well. People’ medicines were administered safely. We have however, recommended the provider review their medicine policy and practice of recording medicines at one home to ensure they were operating in line with latest guidance.

There were systems and processes in place to minimise risks to people. These included a robust recruitment process and making sure staff knew how to recognise and report abuse. Staff were available to meet people’s needs in a timely manner.

People received effective care from staff who had the skills and knowledge to meet their needs. Staff monitored people’s health and well-being and made sure they had access to other healthcare professionals according to their individual needs. Staff ensured people had choices about how to meet their needs while balancing the need for people to eat well, keep hydrated and stay healthy. Detailed ‘hospital passports’ were in place so important information about people’s needs and communication methods was able to be shared easily with other health care professionals if needed.

People were supported by staff who were kind and caring. Where people found it difficult to express themselves, staff showed patience and understanding. Every effort was made to enable people to express themselves; this include knowing people and well and using assisted technology as relevant.

The service was responsive to people’s needs and they could make choices about their day to day routines. People followed their hobbies and maintained links with the community, which provided them with mental and social stimulation. People were also supported to try new things, volunteer or take up paid work as they desired. Making sure they could follow their faith was important to many people being looked after by Livability Devon and staff made sure this happened for them. People could also choose not to be involved if they wanted.

People and family could make a complaint and were confident action would be taken to address their concerns. The registered manager and provider treated complaints as an opportunity to learn and improve. Staff knew people well and identified if people were unhappy; every effort was then made to find out why this was and put things right for the person.

The home was well led by an experienced registered manager. The provider had systems in place to monitor the quality of the service, seek people’s views and make on-going improvements.

Further information can be found in the full report which can be located on our website at www.cqc.org.uk.