LIBERTAS

Updated 20 December 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.

Inspection team

This inspection was carried out by 1 inspector and 1 Expert by Experience. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service

Service and service type

This service is a domiciliary care agency. It provides personal care to people living in their own houses and flats. This service also provides care to people living in specialist ‘extra care’ housing. Extra care housing is purpose-built or adapted single household accommodation in a shared site or building. The accommodation is bought or rented and is the occupant’s own home. People’s care and housing are provided under separate contractual agreements. CQC does not regulate premises used for extra care housing; this inspection looked at people’s personal care service.

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 the service 24 hours’ notice of the inspection. This was because we wanted to be sure the registered manager would be available to support the inspection. Inspection activity started on 8 November 2023.

We visited the location’s office on 8 November 2023. We then used remote technology such as email, document sharing, telephone and video calls to speak to people, their relatives, professionals and staff and review various records. We finished the inspection on 29 November 2023, when we met remotely with the registered manager and providers representative to give feedback.

What we did before inspection

We reviewed information we had received about the service since the last inspection. We sought feedback from the local authority, Healthwatch England and professionals who work with the service. Healthwatch is an independent consumer champion that gathers and represents the views of the public about health and social care services in England.

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 17 people who used the service and 3 relatives about their experience of the care provided. We spoke with 10 members of staff including the registered manager, training manager, head of operations and care staff. We spoke with two professionals who regularly work with the service.

We reviewed a range of records. This included 6 people’s care records and 4 people’s medication records. We reviewed the care visit times and related records for 17 people. We looked at 2 staff files and 3 agency staff files in relation to recruitment and staff supervision. We reviewed a variety of records relating to the management of the service, including policies, procedures and audits.

Updated 20 December 2023

About the service

LIBERTAS is a domiciliary care agency providing personal care to people living in their own homes. The service supports older and younger people and people with mental health needs and various other health conditions. The service also provides care and support to people living in two extra care' settings where people's care and housing are provided under separate contractual agreements.

Not everyone who uses the service might receive 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 the inspection the service was providing support to 194 people.

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

People told us timings of care visits were inconsistent, late or cut short. Some people found this impacted their ability to plan their day which they found frustrating.

People’s medicines were mostly managed safely, although sometimes inconsistent care visit times meant medicines were administered later than scheduled, which increased risks to people’s health from conditions such as diabetes.

We have made a recommendation to the provider about reviewing care visit times to ensure safe administration of medicines.

Staff received training in safe administration of medicines and had their competency checked by senior staff. Staff worked with local pharmacies and GPs to make sure people had the correct medicine.

Staff had received training in safeguarding and understood how to recognise and report any concerns. Most people told us they felt safe due to knowing the staff and staff treated them with kindness. However, not all people felt this way. Some people had concerns about new staff and agency staff who they felt did not know them or understand how to meet their needs.

People felt confident to speak up where they had concerns but did not always feel their concerns were listened to by the management team.

People’s care was regularly reviewed and updated where changes were required. The registered manager conducted various audits to review what was working and what needed to be improved. These were not always effective in identifying the full extent of concerns in relation to care visit times.

Risks to people’s health and wellbeing were assessed and staff understood what they were doing and how to identify and report any concerns.

The registered manager ensured all staff had recruitment checks prior to employment to make sure they were suitable for their role and people would be safe.

Staff received full training and induction and took time shadowing other staff. This was so they could get to know people well and how they liked things to be done before providing their care.

People were supported by staff who used effective control measures to reduce the risks of infection and COVID-19. This included washing their hands regularly and followed the latest government guidance.

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.

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 (16 April 2018).

Why we inspected

This inspection was prompted by a review of the information we held about this service. We undertook a focused inspection to review the key questions of safe and well-led only. For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating. We have found evidence that the provider needs to make improvements. Please see the safe and well-led sections of this full report.

The overall rating for the service has changed from good to requires improvement based on the findings of this inspection. You can read the report from our last comprehensive inspection by selecting the ‘all reports’ link for LIBERTAS on our website at www.cqc.org.uk.

Enforcement and Recommendations

We have identified breaches in relation to person centred approaches, quality assurance measures and staff support at this inspection. Please see the action we have told the provider to take at the end of this report.

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.