Life Path Trust limited is a domiciliary care agency that supports 139 people in their own homes with personal care. The service support older and younger adults with a range of needs including people with learning disabilities or autistic spectrum disorder, mental health needs and people who have physical disabilities. We visited the office of Life Path Trust on 07 June 2017.

We last inspected this service on 14 April 2015 and rated the service as Good. At this inspection we found the service remained Good overall.

There was a registered manager in post who was also the provider. 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 described care workers as being very kind. People had developed meaningful relationships with the care workers who provided their support. Care workers understood the importance of respecting people's dignity and supported them to make decisions about how they wished to live their life. The registered manager and care staff demonstrated their commitment to providing support to people to maintain and develop new relationships.

Pre-employment checks were completed for all new staff to check that they were suitable to work with people who used the service. There were enough staff employed to meet people's needs and to attend each call.

People were kept safe by care workers who had received training on how to recognise and report any suspected abuse. Risks related to people's care were identified and procedures were put in place to minimise the risks. Procedures were in place to support people safely when they took their medicines.

Care workers received training to support people effectively. The registered manager understood the principles of the Mental Capacity Act 2005 and care workers understood the need to gain people's consent before providing care. Referrals were made to health and social care professionals when needed to make sure people received the support they needed.

People worked in partnership with the staff to plan their care and this was continually reviewed to meet their needs. Care workers had good knowledge of people's preferences and offered people choices.

People knew how to raise concerns and felt confident to do so. Two complaints had been received by the service in the 12 months prior to our visit which the registered manager had followed up appropriately.

Care workers received support from the registered manager to deliver high quality care.

People had opportunities to give their feedback about the service they received. The feedback was analysed to make sure the service continued to meet people's needs. The registered manager completed regular quality assurance checks to continually monitor the service people received.

This inspection took place on 14 April 2015. The inspection was announced. The provider was given four days’ notice of our inspection. This was to ensure the registered manager was available when we visited the service’s office, and staff were available to talk with us.

At the last inspection on 23 July 2014 we found there was a breach in the legal requirements and regulations associated with the Health and Social Care Act 2008. We issued compliance actions to the provider under Regulation 18, consent to care and treatment. We asked the provider to send us an action plan to demonstrate how they would meet the legal requirements of the regulations. The provider returned the action plan in the allocated timeframe telling us about the improvements they intended to make. At this inspection we found improvements had been made and the provider was acting in accordance with the regulations.

Life Path is a domiciliary care service which provides care for people with learning disabilities in their own homes. The service is a registered charity which supports people to live as independently as possible. On the day of our inspection the service was providing support to 116 people.

A requirement of the provider’s registration is that they have 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 requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run. At the time of our inspection there was a registered manager at the service.

People felt safe using the service. Staff understood how to protect people they supported from abuse. Staff were responsive to people’s needs.

The management carried out regular checks on care staff to observe their working practices and ensure records were completed accurately. There was an out of hours on call system which ensured management support and advice was always available for staff.

Staff were well trained and were supported to meet the complex needs of people they cared for.

Management and staff understood the principles of the Mental Capacity Act 2005 (MCA), and supported people in line with these principles. Where people had been assessed as not having capacity, best interest decisions had been taken on their behalf.

People knew how to make a complaint if they needed to. People were confident the manager would listen to them, and they were sure their complaint would be fully investigated and action taken if necessary.

The management of the service was open and transparent and identified concerns were acted on quickly. The vision and values of the service was to encourage opportunity and inclusion, independence, rights and choice.

There were procedures in place to check the quality of care people received, and where systems required change the provider acted to make improvements.

At the time of this inspection, Life Path Trust were providing a service to 119 people. An adult social care inspector carried out this inspection. As part of this inspection we spoke with the provider's service auditor and three care managers. We also reviewed records relating to the care given to people, which included 12 care plans. We spoke with four people who used the service. We also spoke with the relatives of 12 people who used the service.

Below is a summary of what we found. The summary describes what people using the service, their relatives and the staff told us, what we observed and the records we looked at.

Is the service safe?

There were effective recruitment and selection procedures in place at the service. Staff records showed that all staff were trained in the needs of people who used the service.

Accidents and incidents were investigated and reported appropriately.

Written consent to care was not seen in any of the plans of care we looked at. We found that the service had not complied with the Mental Capacity Act 2005 in relation to obtaining the agreement to people's plan of care and support where people lacked the capacity to make decisions for themselves. We saw no evidence that people were deprived of their liberty, meaning that Deprivation of Liberty Safeguards were not breached.

Is the service effective?

Care plans were regularly reviewed. We saw that care plans were based on each person's needs. They were comprehensive and well written. Many care plans included evidence-based management plans for specific medical conditions. However, there was little evidence of consent being recorded for care given. We spoke with twelve relatives of people who used the service. All of these people thought that their relatives were not capable of giving consent for care. They also said that they were not involved in consent for their relatives. One person we spoke with said, "They (Life Path Trust) seem to have taken over that area (consent)." Another said, "They never ask for consent." Another relative said, "I ring them, but I never get a phone call from them (Life Path Care). They don't ask me for consent."

Is the service caring?

People were supported by caring staff. All plans of care were written to reflect each person's needs. We spoke with four people who used the service and they all said they were happy with the service given. One relative said, "(Relative) likes going there, they look after her well." However, other relatives of people said that they were not kept informed by Life Path Trust about significant events. One said, "The hospital rang me when (relative) was admitted, but Life Path hadn't told me. "Another said, "I only hear from them on their annual review."

Is the service responsive?

People’s needs had been assessed before care started. Complaints were dealt with well and people knew how to make complaints. The provider regularly used surveys to obtain the views of people who used the service and their relatives. The provider also audited many aspects of the service and used these audits to improve care.

Is the service well-led?

The service had a system in place to obtain the views of people using the service. There was a system for recording formal and informal complaints. There were effective and safe recruitment procedures in place.

You can see our judgements on the front page of this report.

On the day of our visit we met the manager of the service. We were told that the previous registered manager, listed on this report, had recently left the service and another manager had been appointed. The new manager was in the process of becoming registered as the registered manager.

During our visit we looked at four case files of people who used the service. We saw care plans were tailored to meet individual needs as people who used the service required different levels of support.

We spoke with three people who used the service. They told us they were happy with the care they received. One person said, "I like my staff and where I live."

We spoke with four members of staff and the manager of the service during our inspection. Staff we spoke with told us they had received induction and training to assist them to meet people's specific needs safely and effectively.

Staff told us and records showed that all staff had received training in safeguarding vulnerable adults and whistleblowing. We saw training was updated regularly. Staff we spoke with told us how they would report any abuse they witnessed or suspected and how this would be investigated.

We saw processes were in place to monitor people's views about the service. We saw survey results from a recent stakeholder survey, a staff survey, and a customer satisfaction survey. We saw that a high percentage of people were happy with the service provided.

The agency is run as a charitable organisation with a board of trustees. The agency offers a range of support to adults of all ages with learning disabilities in their own home.

During our visit we looked at five case files of people who used the service. We also spoke with five people who had used the agency. We asked people if they were treated with consideration and respect. People told us they were treated with consideration and respect. One person told us “I can choose my activities and the meals that I want.”

We asked people about their experience of the care provided, and if they were happy with the care they had received. People we spoke with told us they were happy with the care they received. One person told us “Life path are good, you can choose who you have to care for you.”

We saw care plans were tailored to meet individual needs. Assessments were drawn up using a person centred approach to involve the individual in planning their own care.

We saw the agency had good auditing procedures in place. Evidence was available to show that checks were regularly made on records and care plans to monitor the quality of care being provided.