23 January 2024
During a routine inspection
Living Glory Social Care is a domiciliary care agency providing personal care to people living in their own homes, including children, younger adults, older people, and people with learning disabilities. At the time of our inspection 228 people were in receipt of personal care, 44 of these were children. The provider told us at the time of inspection they were not supporting any people in supported living settings.
People’s experience of the service and what we found:
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. We considered this guidance as there were people using the service who have a learning disability and or who are autistic.
Right Culture
People were not consistently supported to have maximum choice and control of their lives and staff did not always support them in the least restrictive way possible and in their best interests; the policies and systems in the service did not support this practice.
The provider did not have robust systems in place to monitor the quality and safety within the service. This meant the provider had failed to identify some of the issues we found. This included concerns about the lack of care plans and risk assessments for people’s known health conditions, lack of guidance for staff to follow in relation to prescribed medicines and lack of monitoring for people for whom methods of restraint had been approved. Where the provider's systems had highlighted concerns, the systems in place to action and follow up on these were not robust and did not evidence appropriate actions had been taken.
The registered manager told us how they had communicated with staff and people using the service to ensure the culture within the service was open and inclusive.
Right Support
Risks to people were not always well managed which meant risk of harm to people had not always been considered. There was no evidence that people had been harmed. There was little evidence to demonstrate people had been supported with things which were important to them such as their interests. However, staff knew people well. Medicines were not always well managed, including a lack of robust guidance for staff to follow in relation to ‘as required’ medicines.
People were supported to live in their own homes. Although there were adequate numbers of staff to support people, calls did not always take place at the time people wanted and for some, they were often shorter than commissioned.
Right Care
People's care plans and risk assessments did not always provide robust guidance for staff to follow in relation to people’s known health needs. This included how to support people who expressed emotional distress to minimise the risks to themselves and staff. This meant people could be placed at risk as staff may not have information in relation to how known health conditions impact on people’s needs, wishes and abilities. However, there was no evidence to demonstrate people had been harmed. People were not always supported and encouraged, to promote their independence.
We found overall there was a stable team of staff who knew people's needs.
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 02 September 2019).
Why we inspected
The inspection was prompted in part due to concerns received about staffing, poor care practices, missed, short or late call times, and poor medicines management. A decision was made for us to inspect and examine those risks.
Enforcement
We have identified new breaches in relation to Person centred care, Need for consent, Safe care and treatment, Safeguarding service users from abuse and improper treatment, Receiving and acting on complaints, Good governance, Staffing and Fit and proper persons employed.
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. Once the report has been published, we will arrange a meeting with the provider to discuss how they will make changes to ensure they improve their rating to at least good. We will work with the local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.
Special Measures
The overall rating for this service is ‘Inadequate’ and the service is therefore in ‘special measures. This means we will keep the service under review and, if we do not propose to cancel the provider’s registration, we will re-inspect within 6 months to check for significant improvements.
If the provider has not made enough improvement within this timeframe and there is still a rating of inadequate for any key question or overall rating, we will take action in line with our enforcement procedures. This will mean we will begin the process of preventing the provider from operating this service. This will usually lead to cancellation of their registration or to varying the conditions the registration.
For adult social care services, the maximum time for being in special measures will usually be no more than 12 months. If the service has demonstrated improvements when we inspect it, and it is no longer rated as inadequate for any of the five key questions it will no longer be in special measures.