About the service:

Liberty House is a residential care home that was providing personal care to six people who had a learning disability and/or autism at the time of the inspection.

People’s experience of using this service:

Staff understood their responsibilities to protect people from abuse and discrimination. They knew to report any concerns and ensure action was taken. The registered manager worked with the local authority safeguarding adults team to protect people.

Staff were supported in their roles and received an effective level of training. They told us they were happy with the level of training and support they received and we observed them supporting people in a competent and caring manner.

People were protected from harm by the provider having effective systems in place to monitor medicine management, staffing, infection control and upkeep of the premises.

Staff promoted people’s dignity and privacy. Staff provided person-centred support by listening to people and engaging them at every opportunity. Staff were caring and understanding towards people. People using the service appeared comfortable in the presence of staff working in the service.

The premises provided suitable accommodation for people with communal areas and bedrooms which were personalised to peoples individual interests.

Support plans were detailed and reviewed with the person and their relatives when possible. Staff worked with and took advice from health care professionals. People’s health care needs were met.

People had a variety of internal activities and external activities, which they enjoyed on a regular basis. These activities were evidenced by the items and photos displayed around the home. displayed on the notice board, were achievements of fund raising by some of the people at Liberty House. They displayed their craft works to the wider community, via the Adults Education Centre and raised £120.00 for Children in Need.

One person showed a distinct interest in sewing and tapestry. As well as being supported with developing a hobby, staff also supported them to enrol on a local Adult Educational class to further their skill. They attend this weekly with support of staff. This person has thrived, and their work has been displayed by the college as an example of the high quality of completed pieces. Another person living in the home, has shown remarkable improvement in their concentration levels and behavioural issues, thanks to the support undertaking activities within gardening.

The registered manager ran a well organised service. Relatives’ views were sought, and opportunities taken to improve the service. Formal supervision meetings were carried out and staff were also supervised informally. They told us they were supported and clear about what was expected of them. Audits and checks were carried out, so any problem could be identified and rectified.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice.

The care service supported people in line with the values that underpin the Registering the Right Support and other best practice guidelines. These values include choice, promotion of independence and inclusion. People with learning disabilities and autism using the service can live as ordinary a life as any citizen.

Rating at last inspection:

The service was rated as Good at the last inspection. The inspection report for the last inspection was published on 01 November 2016.

Why we inspected:

This was a scheduled inspection based on the previous rating.

Follow up:

We will continue to carry out ongoing monitoring and will inspect the service in line with its rating.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

This inspection took place on 23 September 2016 and was unannounced. At our last inspection on 5 August 2014, the provider was meeting all the regulations that we assessed.

Liberty House provides personal care and accommodation for up to six adults with learning disabilities. There were six people living at the home at the time of our inspection.

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.

The process for making a best interest decision, for treatment, on behalf of a person who lacked the mental capacity to make that decision, was not always effective.

Relatives believed their family members were kept safe. Risks to people had been assessed appropriately. Staff understood the different types of abuse and knew what action they would take if they thought a person was at risk of harm. The provider had processes and systems in place that kept people safe and protected them from the risk of harm.

There were enough suitably recruited staff that had received appropriate training to support people to meet their individual needs.

People's rights were protected because staff understood the legal principles to ensure that people were not unlawfully restricted.

People safely received their medicines as prescribed by the GP.

People were supported to have food that they enjoyed and meal times were flexible to meet people’s needs.

People were supported to stay healthy and accessed health care professionals as required.

People were treated with kindness and compassion. Care was inclusive and people benefitted from positive interactions with staff. People’s right to privacy was promoted and people’s independence was encouraged where possible.

People received care from staff that knew them well and benefitted from opportunities to take part in hobbies and activities they enjoyed and what was important to them.

Staff were aware of the signs that would indicate that a person was unhappy, so that they could take appropriate action. Information was available around the home in easy read formats for people to make use of.

The provider had management systems in place to audit, assess and monitor the quality of the service provided.

No one knew we would be inspecting that day as our inspection was unannounced.

Six people lived at Liberty House at the time of our inspection. However, only five people were available for us to meet and speak with as one person was staying at their parent’s house for the weekend.

During our inspection we spoke with two people who lived there, three staff, and the manager, who was also the owner of the home. All staff we spoke with told us that the people were well looked after and were safe. One staff member said, “I think that people are very well looked after”. Another staff member said, “People are safe here”.

We spoke with two of the people who lived there. They told us positive things about the service they received. One person told us, “I have lived here for a long time. I like it here it is good. I would not like to have to live anywhere else”. A second person said, “I do like it here”.

Other people who lived there had communication and other needs and were not able to tell us about the experiences of the care and support that they received. To address that during our inspection we used different methods to help us to understand people’s experiences, including observation. We observed interactions between staff and people who used the service. We saw that people were smiling and were confident to approach staff when they wanted something.

We determined that people were shown respect and their dignity was maintained. Staff supported people wherever possible to be independent and to make choices. People's needs had been assessed to ensure that their health, personal care, and safety needs were monitored and met. We found that there was ample opportunity for people to participate and engage in meaningful and interesting hobbies, activities and outings.

People had been provided with varied food and drink options that prevented malnutrition and dehydration and met their preferred needs.

We found that processes were in place to safeguard people from the risk of abuse.

We saw that the premises were adequately maintained, clean, comfortable and safe.

Although initially we had some concerns about staffing levels, we determined that generally staffing levels were adequate to ensure that people’s needs were met in the way that they preferred and that they were safe.

We saw that complaints processes were in place for people or their relatives to use if they were not happy with the service provided.

The people living there have a learning disability and not everyone was able to tell us about their experiences. Therefore, we spent time observing what was going on and how staff interacted with people. Some people were able to tell us about their experiences and we spoke with three people and three members of staff. We looked at the records of two of the people living there. All this helped us to understand what it was like to live there.

We saw staff spending time with people and supporting them in the way they wanted to be supported. There was a good, happy atmosphere in the home. People told us and we saw that they were able to do the things they wanted to. One person told us, "I enjoy living here, it's just so great, we do great activities. It's been a fantastic thing for me to come here and staff have done great things for me, they have supported me all the way. I love staff to bits." We saw that staff helped people to be as independent as possible, so increasing their skills and promoting their self esteem.

We saw that staff supported people to have regular health checks. Staff noticed when people were unwell and needed support from health professionals.

People told us that they felt safe living there. We saw that staff had training in how to safeguard people from harm.

Staff said they were well supported in their role. We saw that they had the training they needed so they knew how to support the people living there.

People told us that they knew how to complain if they were unhappy but they said they had not needed to do this.

We saw that the house was well maintained and clean. The manager planned to ensure that redecoration was done regularly to make sure the home was comfortable and safe for people to live in.

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, and to pilot a new inspection process being introduced by CQC which looks at the overall quality of the service.

Liberty House was last inspected in November 2013. At that time the provider met all the regulations we checked. This current inspection was unannounced which meant that staff did not know we were visiting.

Liberty House is a care home for six adults who have a learning disability. The home does not provide nursing care. The home is a large converted house and accommodation is on two floors.

The home had a registered manager. A registered manager is a person who has registered with the Care Quality Commission to manage the service and has the legal responsibility for meeting the requirements of the law; as does the provider.

We spoke with all six people who lived at the home. Some people were unable to give us detailed information about their care. We spent periods observing people being supported by staff. Our observations and discussions with family members showed that there were positive caring relationships between staff and the people that used the service. We saw that people were treated with respect. All the relatives we spoke with told us that they were very pleased with the care that their relative received.

Staff were aware of the provisions of the Mental Capacity Act (2005) and people were supported to make decisions about their life. Where people lacked the capacity to make decisions these were made in their best interest. Following discussions with the provider during the inspection they commenced the process of making the appropriate applications for people who used the service who may have had their liberty restricted so that their rights were protected.       

Risks to people were identified and plans were in place to make sure people were kept safe and their rights promoted. Care plans were in place and these were personalised and included people’s individual wishes and preferences. People were supported to access health care services.

People were supported to take part in activities of their choice. These took place both in the home and in the local community. Some people attended day centres and college and all people were supported to take part in activities in their local community.

We saw that systems were in place to monitor and check the quality of care and to make sure a safe environment was provided for people to live in.