We carried out an announced inspection of Liberty Centre on 16 January 2018. This service provides care and support to people living in a supported living setting, so that they can live as independently as possible. People’s care and housing are provided under separate contractual agreements. CQC does not regulate premises used for supported living; this inspection looked at people’s personal care and support. At the time of the inspection, seven people lived in the supporting living setting who received personal care. The service also provided a domiciliary service and supported two people with personal care in their own homes.

At the last inspection on 15 September 2015 the service was rated ‘Good’. At this inspection we found the service remained ‘Good’.

The service had a registered manager. 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 legal requirements in the Health and Social Care Act 2008 and the associated regulations on how the service is run.

During our last inspection, we found that the support plans were not always easy to follow, it was not clear when goals were set and reviews did not always capture changes in people’s needs. During this inspection, we found that improvements had been made in this area. Care plans were person centred and included clear information on how to support people. Goals had been set and this had been reviewed regularly and changes in people's needs had been reflected in people's care plans.

Risks had been identified and assessed, which provided information to staff on how to reduce these risks to keep people safe. Medicines were being managed safely. There were sufficient staffing levels to support people. Staff had been trained in safeguarding vulnerable adults and knew how to keep people safe. There was safe recruitment process in place to ensure staff were suitable to support people.

Staff had the knowledge, training and skills to care for people effectively. Staff received regular supervision and support to carry out their roles. People had choices during meal times and were supported with meals when required. Assessments had been carried out on people’s ability to make certain decisions. People had access to healthcare services. People’s needs and choices were being assessed regularly through review meetings to achieve effective outcomes.

People and relatives were aware of how to make complaints if they wanted to and staff knew how to manage complaints. People and relatives told us that staff were friendly and caring. People were treated in a respectful and dignified manner by staff who understood the need to protect people's human rights. People had been involved with making decisions about their care.

Staff felt well supported by the management team. Relatives were complimentary about the management of the service. Quality assurance and monitoring systems were in place to make continuous improvements.

This inspection took place on 15 and 17 September 2015 and was announced. We gave the provider 48 hours’ notice that we would be visiting the service. This was because the service provides domiciliary care and we wanted to make sure staff would be available.

At the last inspection in January 2014 we found breaches of legal requirements. This was because support plans and risk assessments did not meet people’s needs, medicines were not managed safely, the service was not complying with the Mental Capacity Act 2005 and the Deprivation of Liberty Safeguards, the service was not notifying CQC of significant incidents as required by law and the service was not following safe recruitment processes. In addition, there were not effective systems in place to monitor the quality of service, and staff did not have adequate or up to date training required to support people. At this inspection we found improvements had been made and the service now met the required standards.

Liberty Centre Limited is a domiciliary care agency and supported living provider registered to provide personal care to people living in their own homes. The service currently provides care and support to five people. 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. 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 were kept safe from avoidable harm and abuse and were supported by staff that had been recruited safely. There were support and risk management plans in place and where risks had been identified there were plans in place to minimise the risks. Plans were sometimes difficult to follow and needed to be simplified.

There were sufficient numbers of staff available to support people with their needs. Safe recruitment practices had been followed. There were systems in place to ensure that people received their medicines as prescribed from trained staff although the medicines policy needed to be amended to ensure it covered all aspects of the service.

People were supported by staff that had the knowledge and skills to carry out their roles and responsibilities. People’s consent to their care was sought in line with current guidance. Staff supported people with eating and drinking and to have their healthcare needs met as required.

Positive relationships had been developed between people, their relatives and staff. Staff ensured that people were offered choices and promoted their privacy and dignity.

People received care that was appropriate to meet their needs. Information on how to raise complaints was made available but not in a format that was accessible to people who used the service.

There was a culture at the service which demonstrated openness and a commitment to the independence of people who used the service. There were quality assurance systems in place to obtain feedback and monitor performance.

Relatives we spoke with voiced positive opinions about the service. They said people were treated with dignity and respect, and that they could makes choices over their daily lives. A relative said “they do respect X, we are very involved.” Another commented “staff really take the time to understand my (person who used the service).” We saw that staff treated people who used the service with respect and dignity. People’s needs were assessed and care and treatment was planned and delivered in line with their individual care plan. People were not able to tell us about their experience of the service due to their communication needs. However, one person nodded and smiled when asked if they were happy with the centre and the support provided. We found that care plans were in place which set out how people’s needs would be met. Records showed that people were supported to access health care professionals.

We found that the service had adequate systems to prevent and control the spread of infection and that staff had an awareness of their responsibilities in relation to this. Staff had to provide references, complete an application form and undertake an interview before they began working at the service. We found that the registered manager regularly asked relatives about the care and support people received. A relative said "we have a monthly meeting, but I can call them whenever I want and they do respond.”

People who use the service told us that they were treated with respect and the family members we spoke with were positive in their comments about the service. Family members told us that they had been given sufficient information and that they felt their own input was "valued". People also told us that they attended regular meetings with the staff and related professionals and that this was useful to them. We found that people were generally very happy with the service and were aware of the complaints process should they require it at any stage.

This inspection took place on 19 and 20 January 2015. We gave the provider 48 hours' notice to make sure there would be someone in. We found the service was compliant with the regulations we inspected against when we last inspected in October 2013.

Liberty Centre is a service specialising in supporting people with autism and learning disabilities. It provided domiciliary care for one person and supported living for four people. The service has a registered manager in place. 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 were not always protected from abuse and harm. We saw there had been a number of incidents of violent behaviour that had resulted in injury. These had not been reported or effectively followed up.

Medicines were not always managed safely. We saw that there were mistakes in the recording of people's medicines, there were stocks of medicines that could not be accounted for and some medicines were not being stored in accordance with their instructions.

Staff were not always following the Mental Capacity Act 2005 for people who lacked capacity to make a decision. For example, the provider had not made an application with the local authority to the court of protection, even though people's liberty may have been restricted.

The provider had not followed safe recruitment processes. Staff had been employed before their criminal records checks had been returned and the gaps in people's employment history had not been explored.

People's backgrounds were respected. We saw that people were provided with food that related to their cultural background and personal preferences, and they were supported to access religious services in the community.

Care did not meet people's individual needs. The provider did not keep accurate records about the needs of each person, with risk assessments and care plans not relating to the person's current needs.

People using the service and their families were encouraged to give their feedback about the service. We saw that family members were involved in people's care and had been consulted about decisions made about people's care.

The provider did not have effective systems for monitoring and auditing the quality of the service.

CQC registration requirements, including the submission of notifications in relation to safeguarding and applications to the court of protection and their outcomes had not been met.

At this inspection we found breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2010 in relation to care and welfare of service users; assessing and monitoring the quality of service provision; safeguarding service users from abuse; management of medicines; consent to care and treatment; records; requirements relating to workers; and, supporting workers. You can see what action we told the provider to take at the back of the full version of this report.