Background to this inspection
Updated
10 May 2022
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 Care Act 2014.
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 one inspector.
Service and service type
Livability York House Shrewsbury is registered as a ‘care home’ and a supported living service. People in care homes receive accommodation and personal care as a single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection. CQC only regulates the provision of personal care in supported living services.
Registered Manager
This service is required to have a registered manager. A registered manager is a person who has registered with the Care Quality Commission to manage the service. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.
At the time of our inspection there was not a registered manager in post. The manager was in the process of applying to be registered.
Notice of inspection
This inspection was unannounced.
What we did before inspection
We reviewed intelligence we had already gathered on the service. This included contact with the supported living services and feedback from people, their families and staff. We also reviewed governance documentation and incident reports. We contacted the local authorities who commission the service for their feedback.
The provider was not asked to complete a Provider Information Return (PIR) prior to this inspection. A PIR is information providers send us to give some key information about the service, what the service does well and improvements they plan to make.
During the inspection
During the inspection we observed the care people received at the care home and asked people their views on the home. We used verbal conversation and some sign language to support communication. We spoke with five members of staff including the manager, care staff and agency staff.
We reviewed a range of records. This included two people’s care records and three people’s medication records. We looked at four staff files in relation to recruitment and staff supervision. A variety of records relating to the management of the service, including policies and procedures were reviewed.
Updated
10 May 2022
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.
About the service
Livability York House Shrewsbury, is registered as both a care home and a supported living service providing personal care to eight people at the time of the inspection. The service currently supports five people in the care home and three people in the community. We reviewed both aspects of the service as part of this inspection.
People’s experience of using this service and what we found
Right Support
People received a service which supported them with their faith. People maintained an active relationship with their church and were involved in activities in the community.
Staff completed care records, but we found some gaps in people’s documentation and areas where action was required. For example, there were gaps in fluid records which meant we could not be sure if people were getting the right amount of fluid for their individual needs.
The building was being refurbished but more work was required to ensure all areas could be effectively cleaned.
People received their medicine from trained staff and action was taken to ensure there was clearer instruction for medicine given on an ‘as required’ basis.
The provider produced action plans outlining improvements they were going to make to the service, but more detail was required for the progress to be successfully monitored.
Right Care
Staff completed incident reports when something happened, but they did not always refer to the incident in the daily records of everyone involved. People impacted by the behaviour of others needed to have their wellbeing monitored.
New staff and agency workers were given an induction and time to read people’s care plans to ensure they understood each person’s individual needs.
The manager of the service worked with people and the staff team in a kind and considered way. People responded well to this approach.
Right culture
People were supported by a growing team of permanent staff. Agency staff were well supported in the service and, all staff working in the community received increased monitoring and support throughout the day.
The provider had not always ensured information was handed over in a timely manner and care plans were updated when information was reviewed.
Families told us there had been reduced communication due to changes within the staff team. The provider was addressing this and actions taken included newsletters showing activities people had been involved in and plans for the future.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at the last last inspection.
The last rating for the service was good (published 15 August 2018). At this inspection we found the provider was in breach of regulation.
You can see what action we have asked the provider to take at the end of the full report.
Why we inspected
This inspection was prompted in part due to concerns about agency staff use. Also, in response to a serious incident involving an agency worker. The incident is subject to criminal investigation and as a result we did not examine the circumstances of the incident. The information CQC received about the incident indicated concerns about the management of agency staff. This inspection examined those risks and the subsequent actions taken by the provider.
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.
Follow up
We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.