Background to this inspection
Updated
12 May 2017
We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.
This inspection took place on 3, 4, 8, 10, 11 and 12 April 2017 and was announced.
The provider was given 48 hours’ notice because the location provides a domiciliary care service and we needed to be sure that the registered manager was available.
The inspection team consisted of two adult social care inspectors and an 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. The expert-by-experience used on this occasion had experience of learning disabilities.
Before the inspection we gathered and reviewed information about the service, including notifications received from the service and information from the local authority safeguarding and contracts teams. We also had asked the provider to complete a Provider Information Return (PIR). This is a form which gives information about the service, what it does well and improvements planned. The service returned this in a timely manner and we took this into account when making our judgements.
During the inspection we used various methods to help us understand the experiences of people who used the service. Before our visit to the service offices we spoke with six people who used the service and eight relatives on 3, 4 and 8 April 2017.
We visited the service offices on 10 April 2017 and looked at elements of four people's care records, medicines administration records (MARs) and other records which related to the management of the service including quality assurance processes and policies and procedures. We also spoke with the registered manager, an operations manager and the quality officer.
On 10 April 2017 we also visited three supported living services where we spoke with three people and three relatives of people living at the services, three staff members, a service manager, a team leader and a deputy manager. On 11 April 2017 we spoke on the telephone with a further five staff members and on 12 April 2017 we reviewed further information the service had sent to us including three staff records and other records relating to the management of the service including training records, and records of staff and relative meetings.
Updated
12 May 2017
Our inspection of Lifeworks took place between 3 and 12 April 2017 and was announced to ensure the registered manager was available. This was our first inspection of the service.
Lifeworks is part of the Yorkshire Housing group and provides a domiciliary care and supported living service to younger and older adults who have a learning disability or autism spectrum disorder. At the time of our inspection there were 30 people receiving the regulated activity of personal care within eight supported living sites. Yorkshire Housing is currently working with the local authority to transition the Lifeworks services to other providers.
The service had a registered manager in post. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they 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 told us they felt safe. Safeguarding policies and procedures were in place and staff had received safeguarding training, although some training required renewing. Staff we spoke with were able to identify types of abuse and what to do if they had safeguarding concerns.
Risks to people were assessed and appropriate measures put in place to positively manage and review these. Incidents and accidents were reported with outcomes and actions taken as a result.
Medicines were safely managed with some people assessed as able to manage their own medicines to promote independence.
We saw staff were recruited safely to ensure their suitability to work with vulnerable adults. Sufficient staff were deployed to meet the care and support needs of people living at the service. Staff were suitably trained and supported with regular supervision and annual appraisals.
People's health care needs were usually met. One of the services where some missed appointments had occurred had commenced a new shift system to mitigate the risk of this happening in the future.
People were supported to consume a healthy diet and encouraged to be as independent as possible with meal preparation.
People told us they liked living at the service and staff were kind and caring. Staff we spoke with knew people well including what they liked to do and their care and support needs. We saw staff interacted with people with respect and supported their independence where possible.
Plans of care were clear and person centred with clear emphasis on independence and achievement of goals. Regular reviews and meetings were held where any changes were discussed with people and/or their relatives. Best interest meetings and evidence of consent were documented.
Activities were planned on an individual basis and according to people's choice.
Systems were in place to log, investigate and respond to complaints. Complaints were responded to appropriately and people we spoke with understood how to make a complaint. However, no central log was kept of complaints within the service to analyse for trends and help drive service improvements.
We received inconsistent feedback about the management and quality of the service. Although people living at the service told us they were happy, some relatives were concerned about communication, management and the use of agency staff. Some staff also expressed concerns about communication, poor morale and staff divisions at one of the service houses.
A range of audits and checks were in place to monitor and improve the service.
The management team were enthusiastic about the work they had carried out so far and plans for future improvements. Regular meetings were held with people living at the service, relatives and staff to discuss concerns, activities and improvements within the service.