We carried out a review of the data available to us about Living Ambitions Limited - Staffordshire on 6 July 2023. We have not found evidence that we need to carry out an inspection or reassess our rating at this stage.
This could change at any time if we receive new information. We will continue to monitor data about this service.
If you have concerns about Living Ambitions Limited - Staffordshire, you can give feedback on this service.
Living Ambitions Limited - Staffordshire is a supported living service. There were a range of types of accommodations such as independent apartments and bungalows. There were 12 properties. It varied per property how many people lived there. The service supported 42 people at the time of the inspection.
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.
People’s experience of using this service and what we found
Risks were generally assessed and planned for and staff knew people well. We have made a recommendation about ensuring all aspects of people’s health and wellbeing are robustly assessed and planned for. Medicines were generally managed safely, however we found omissions at one property. We did have some mixed feedback regarding staffing levels. However, overall people were supported by enough safely recruited staff. People were protected from the risk of abuse. People told us they felt safe and relatives confirmed this. People were kept safe and infection control measures were in place and being followed by staff. Lessons were learned when things went wrong.
Quality assurance systems were in place which were largely effective, however they had failed to identify all the omissions we identified such as some missing documentation. Some further work was needed to ensure everyone was supported with their protected characteristics. There was a clear sense of duty of candour and learning from incidents. People and relatives felt positive about the management of the service and people were empowered to make their own choices. The service worked in partnership with other organisations and professionals.
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.
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 16 January 2020).
Why we inspected
The inspection was prompted in part due to an increased number of concerns we received about the service and about how staff supported people. A decision was made for us to inspect and examine those risks. Whilst we found areas for improvement relating to quality assurance and ensuring all risks were assessed and planned for, we did not find ongoing concerns about staff approach with people.
We received concerns in relation to staff approach with people. As a result, we undertook a focused inspection to review the key questions of safe and well-led only. We reviewed the information we held about the service. No areas of concern were identified in the other key questions. We therefore did not inspect them. Ratings from previous comprehensive inspections for those key questions were used in calculating the overall rating at this inspection.
The overall rating for the service has remained good, however well-led has deteriorated to requires improvement. This is based on the findings at this inspection. We found some improvements were needed. The registered manager took action to respond to our feedback.
You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Living Ambitions Limited - Staffordshire on our website at www.cqc.org.uk.
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.
Living Ambitions Limited - Staffordshire are registered to provide personal care and support to people either living in the community in their own homes or to people who lived in shared accommodation under tenancy agreements, self-contained bungalows or apartments within the community. At the time of the inspection the service was supporting personal care to people across 14 sites and was supporting 88 people aged 18 and over.
The service has been developed and designed in line with the principles and values that underpin
Registering the Right Support and other best practice guidance. This ensures that people who use the
service can live as full a life as possible and achieve the best possible outcomes. The principles reflect the
need for people with learning disabilities and/or autism to live meaningful lives that include control, choice, and independence. People using the service receive planned and co-ordinated person-centred support that is appropriate and inclusive for them.
People’s experience of using this service and what we found
We have made a recommendation about End of Life care planning.
People were empowered to lead their care and had the maximum choice and control over the way in which they were supported. People’s care was personalised which met their needs, and their preferences were consistently considered.
People were supported to live independently, for some this was the first time in their lives. They were given opportunities to visit services to familiarise with the surroundings before committing to a permanent move.
People's care plans reflected their needs and preferences and were reviewed when things changed. People's diversity was recognised and promoted by the staff and systems were in place to meet people's
communication needs. There was a strong emphasis on supporting people to take part in activities,
including groups within the local community.
People told us they liked living at the locations and felt supported by the staff teams. People were able to make new friendships with others who received support from Living Ambitions Limited Staffordshire and with other people in the community where they went to socialise.
Staff knew people well and promoted their dignity and independence at all times. There was a kind and
caring, inclusive atmosphere. Staff had good relationships with people and encouraged people to be
independent and to live fulfilled lives.
The registered manager and the management team lead by example. People, staff and relatives felt their views were important in shaping the future for the service and they felt listened to. The service was proactive and continually worked on ways to improve, this involved being open to feedback from people and relatives.
People had their health and wellbeing including their nutritional needs met and were supported and encouraged to live healthier lives. Medicines were managed safely, and people received their prescribed medication when needed. The service worked in partnership with other organisations and professionals to ensure people's care was holistic.
The outcomes for people using the service reflected the principles and values of Registering the Right
Support by promoting choice and control, independence and inclusion. People's support focused on them
having as many opportunities as possible for them to gain new skills and become more independent.
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.
The provider used management systems to identify and effectively manage risks to the quality of the service and drive continuous improvement. People knew how to raise any concerns or complaints and felt
confident they would be acted on. There were systems in place to capture people's views on how the service could be improved and these were acted on.
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 23 May 2017).
Why we inspected
This was a planned inspection based on the previous rating.
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.
The inspection took place on 31 March 2017 and was announced.
There was a registered manager in post. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Registered providers and registered managers 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 actively involved in the day to day running of the service, including staff recruitment and training, as well as quality assurance monitoring. The provider ensured they followed current best practice, with the result being high quality care for people.
People, relatives and health professionals were positive about the service and how it was run.
People's individual safety needs had been assessed and staff knew how to protect people from harm or abuse. People were encouraged to take a role in their own personal safety. People received their medicines, as prescribed.
Staff had the skills and knowledge to meet people's needs, with a particular focus on positive behaviour support. People were supported to maintain their health and wellbeing. Staff understood the legislation underpinning their practice, and its importance and relevance to their daily work.
People enjoyed positive and respectful relationships with staff. People were involved in reviews of their care, and were assisted in achieving their personal goals.
People led active and varied lives and were able to enjoy their hobbies and interests.
People's changing needs were responded to. People's care plans contained information regarding how to tailor staff's approach to each individual, and this was followed.