Archived: Living Ambitions Limited (Salford)

Updated 9 August 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 was 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 4 and 7 July 2017. We gave the provider 48 hours’ notice as we needed to be sure that a manager would be available to participate in the inspection. The inspection was carried out by two adult social care inspectors. At the time of our inspection there were 40 people receiving care at the service.

Before the inspection the provider completed a Provider Information Return (PIR). This is a form that asks the provider to give some key information about the service, what the service does well and improvements the plan to make.

Prior to the inspection we reviewed information we held about the service, including statutory notifications. A statutory notification is information about important events which the provider is required to send us by law. We also reviewed the information we held, including complaints, safeguarding information and previous inspection reports. In addition to this we contacted the local authority contract monitoring team who provided us with any relevant information they held about the service.

During the inspection we visited three people’s houses and spoke with eight people who used the service. We spoke with eight staff members, including the manager, locality manager and regional quality manager. We looked at the care records of nine people who used the service and other associated documents such as policies and procedures, safety and quality audits and quality assurance surveys. We also looked at six staff personnel and training files, service agreements, staff rotas, minutes of staff meetings, complaints records and comments and compliments records.

Updated 9 August 2017

This inspection took place at Living Ambitions on the 4 and 7 July 2017. The first day was unannounced and was carried out at the service offices by one adult social care inspector. The second inspection day was announced and carried out by two adult care inspectors, one at the service offices and the second visiting people’s homes to speak with them and staff. The service was newly registered in June 2016 and this was the first time it had been inspected.

Living Ambitions is a domiciliary care agency. The agency's office is located in Salford, and the service provides flexible personalised care and support for people living with a learning disability who require additional support to live independently within the community.

At the time of the inspection there was a manager at the service who had applied to be registered with the Care Quality Commission. 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.

We received positive feedback from people using the service, their families and staff members. People using the service and their families felt staff had the correct skills and a clear understanding of their daily needs and support requirements. Family members also said they felt their loved ones were safe in the care of Living Ambitions staff. Staff gave suitable examples around how to keep people safe and promote positive risk taking. They also knew how to respond to any concerns or safeguarding events.

Staff displayed a sound knowledge in relation to the varying needs and requirements of the people they supported and understood the importance of ensuring person centred and safe care was delivered. Staff received training appropriate to their positions and were confident that if additional training was needed this would be arranged without delay.

The provider ensured processes were in place to provide a suitable environment for all people using its service, their visitors and staff. Environmental risk assessments were evident and further risk was identified in relation to areas such as water temperature, use of stairs, food hygiene, substances hazardous to health (COSHH), electrical and gas appliances.

Staffing levels were sufficient to enable safe and personalised care and support to be provided to people using the service. Comments from people using the service, their relatives and staff supported this.

Recruitment procedures were in place to ensure appropriate steps had been taken to verify new employee's character and fitness to work. New employee induction processes ensured staff had the correct amount of support and training prior to commencing the role unsupervised. People and their relatives told us staff were knowledgeable about their individual support requirements. Staff demonstrated a good understanding of their role and how to support people based on individual need and in a person centred way.

Medicines were administered in line with best practice guidance from the National Institute for Health and Care Excellence. Staff were adequately trained in the administration of medicines and spoke confidently about the correct process to follow when administering medicines. All medicines were stored securely and safely.

Each person had their own individual care file containing support plans, risk assessments and other relevant documentation. These records gave clear information about people's needs, wishes, feelings and health conditions. Changes to people’s needs and requirements were communicated effectively by means of liaising with families, regular support plan and risk assessment reviews and use of a staff communication book.

Staff were aware of the principles of the Mental Capacity Act 2005 (MCA) and the Deprivation of Liberty Safeguards (DoLS). These provided legal safeguards for people who may be unable to make their own decisions. The management team also demonstrated their knowledge about what process they needed to follow should it be necessary to place any restrictions on a person who used the service in their best interests.

All people we spoke with along with their relatives and staff, informed us the management structure was adequate and there was always a senior person at each service. Staff said they could contact any manager throughout the day or night for further advice if needed. This meant staff and people were able to seek appropriate advice and support when necessary. Each person informed us they were happy to approach management with any concerns or questions. People felt the registered manager and assistant managers were very supportive and would act on any issues they may have.

We found the ethos of the service was very much about providing a place where people could live as independently as possible, whilst feeling safe and being supported to develop daily living skills. The staff and management team were very much a part of enabling this to happen.