Luton Council Respite and Shared Lives Service

Updated 21 November 2023

The inspection

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Health and Social Care Act 2008.

As part of this inspection, we looked at the infection control and prevention measures in place. This was conducted so we can understand the preparedness of the service in preventing or managing an infection outbreak, and to identify good practice we can share with other services.

Inspection team

This inspection was carried out by 1 Inspector.

Service and service type

Luton Council Respite and Shared Lives Service is a ‘care home’ and a shared lives scheme. People in care homes receive accommodation and nursing and/or personal care as a single package under one contractual agreement dependent on their registration with us. Luton Council Respite and Shared Lives Service is a care home without nursing care. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

Luton Council Respite and Shared Lives Service is also a shared lives scheme, they recruit, train and support self-employed shared lives carers (SLC) who offer accommodation and support arrangements for vulnerable adults within their own family homes in the community.

Registered Manager

This provider is required to have a registered manager to oversee the delivery of regulated activities at this location. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Registered managers and providers are legally responsible for how the service is run, for the quality and safety of the care provided and compliance with regulations.

At the time of our inspection there was a registered manager in post.

Notice of inspection

We gave a short period notice of the inspection. This was because we needed to be sure that the provider or registered manager would be at the location to support the inspection.

Inspection activity started on 22 September 2023 and ended on 29 September 2023. We visited the location’s office on 22 and 25 September 2023.

What we did before the inspection

We reviewed information we had received about the service since the last inspection. We sought feedback from the local authority who work with the service. We used the information the provider sent us in the provider information return (PIR). This is information providers are required to send us annually with key information about their service, what they do well, and improvements they plan to make. We used all this information to plan our inspection.

During the inspection

We spoke with 2 people who used the service and 6 people’s relatives about their experience of the care provided. We spoke with 5 members of staff including support workers, a team leader and the registered manager. We also spoke with 3 shared lives carers. We reviewed a range of records. This included 5 people's care records and a variety of medicines records. We looked at 3 staff files in relation to recruitment. A variety of records relating to the management of the service, including audits were reviewed.

Updated 21 November 2023

About the service

Luton Council Respite and Shared Lives Service provides care and support for people with a learning disability or autistic spectrum disorder. It consists of 2 services; a care home that provides respite care and a shared lives service. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. The Care Quality Commission (CQC) regulates both the premises and the care provided, and both were looked at during this inspection.

The care home accommodates up to 9 people and the respite service supports 65 people on a rotational basis. At the time of the inspection, 6 people were being supported by the service.

The shared lives scheme provides people with long-term placements, short breaks and respite care, within shared lives carers (SLC) own homes. 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. At the time of our inspection, the service was supporting 6 people with personal care. Some of the people who were supported by the shared lives scheme, also accessed the respite service.

People’s experience of using this service and what we found

We expect health and social care providers to guarantee people with a learning disability and autistic people respect, equality, dignity, choices and independence and good access to local communities that most people take for granted. ‘Right support, right care, right culture’ is the guidance CQC follows to make assessments and judgements about services supporting people with a learning disability and autistic people and providers must have regard to it.

Right Support: People were at risk of harm because risks were not always fully assessed, and care plans contained inconsistent information. Risks in relation to people’s behaviour needs, health and nutrition needs, equipment and medicines were not always managed safely. 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; however, the policies and systems in the service did not always support this practice.

Right Care: The provider did not always ensure staffing deployment for the respite service was planned effectively. Staff understood how to protect people from poor care and abuse. We observed positive interactions between people and staff and people told us they felt safe. The provider worked in partnership with other professionals.

Right Culture: Audits and checks were not always effective to ensure the quality of care plans and risk assessments. Feedback was gathered through surveys and meetings; however enough action was not always taken in response to staff feedback.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection

The last rating for this service was good (published 11 October 2018).

Why we inspected

This inspection was prompted by a review of the information we held about this service.

We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.

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. This is based on the findings at this inspection.

You can read the report from our last comprehensive inspection, by selecting the 'all reports' link for Luton Council Respite and Shared Lives Service on our website at www.cqc.org.uk.

Enforcement and recommendations

We have identified breaches in relation to risk management, medicines and governance systems at this inspection. Please see the action we have told the provider to take at the end of this report.

We have made recommendations about recording consent and people’s involvement in care planning and ensuring people’s needs are thoroughly assessed and accurately recorded.

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 continue to monitor information we receive about the service, which will help inform when we next inspect.