We undertook an announced focused inspection on 29 March 2018. We gave the service 48 hours’ notice as we needed to be sure they would be available for the inspection. Liral Veget Training and Recruitment Ltd provides personal care to people living in supported living accommodation across four local authorities. At the time of our inspection seven people were using the service. Most of the people using the service were younger adults with a learning disability. The supported living accommodation was provided by another service which the manager for Liral Veget was also responsible for.

At the last inspection on 15 August 2017, we found one breach of regulation relating to concerns about the provider’s staff recruitment practices. We rated the service Requires Improvement. At this inspection we found improvements had been made in relation to recruitment practices and care workers were recruited safely. No risks, concerns or significant improvement were identified in the remaining Key Questions through our ongoing monitoring or during our inspection activity so we did not inspect them. The ratings from the previous comprehensive inspection for these Key Questions were included in calculating the overall rating in this 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 provider conducted appropriate checks of candidates prior to employing them to help ensure they were safe to work with people using the service.

The registered manager visited people in their homes to monitor service provision. The provider carried out an annual survey to ascertain people’s views in relation to the care being provided. Where issues were identified, action plans were put in place to rectify these and improve the service.

The provider conducted safe medicines management. There were appropriate procedures in place for administering and recording the medicines given and care workers were given appropriate training. Records indicated that procedures were adhered to as stipulated within the policy.

Risk assessments were conducted to safely manage known risks. These included risk management plans with clear advice for care workers about how to mitigate risks.

Care workers were aware of their responsibilities to safeguarding people from abuse. They had received appropriate training and were aware of the procedures to follow if they suspected someone was being abused.

Liral Veget Training and Recruitment Ltd provides personal care to people living in supported living accommodation across four local authorities. At the time of our inspection seven people were using the service. Most of the people using the service were younger adults with a learning disability. The supported living accommodation was provided by another service which the manager for Liral Veget was also responsible for.

We undertook an announced comprehensive inspection on 15 August 2017. We gave the service 48 hours’ notice as we needed to be sure they would be available for the inspection. At our previous inspection of the service on 8 July 2015, the service was rated Good.

At our inspection of 15 August 2017, we found one breach of regulation of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 relating to concerns with the provider’s recruitment practices. We rated the service Requires Improvement.

There was no registered manager in post. The manager was in the process of completing their application with CQC to become the 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.

The service did not carry out appropriate and robust checks to make sure that only staff suitable were allowed to work with vulnerable people. We found a number of inconsistencies and irregularities in the provider’s recruitment practices.

The manager carried out visits to people’s homes to monitor service provision. The opinions of people, their relatives, staff and professionals were surveyed and were used to drive improvements at the service. However, the systems for checking quality and compliance had not picked up the issues we found with recruitment practices.

Records showed medicines were managed safely. Staff had received training on medicine management. There was a medicine policy and procedure in place for staff to follow. Medicine administration records were clearly completed.

Risk assessments were in place and detailed actions for staff to take to manage identified risks and keep people safe. These were reviewed regularly to reflect people’s current needs and any associated risks. Staff understood how to recognise signs of abuse and how to protect people from the risk of abuse. They also knew how to escalate concerns to external authorities if needed. Staff told us staffing levels were sufficient to meet people’s needs. They also confirmed the time allocated to them to support people was enough and enabled them to support people safely.

Staff were supported through effective induction, supervision, appraisal and training. We saw evidence that people or their relatives consented, where appropriate, to their care before it was delivered, and were involved in making decisions about their support. We noted however that staff were not knowledgeable about the Mental Capacity Act 2005. We have made a recommendation about this.

The service worked with health and social care professionals. People were supported to arrange appointments to ensure their health needs were met. Relevant professionals were involved to ensure people received appropriate support and care that met their needs. People were supported to prepare their meals and eat and drink where required.

Relatives told us staff treated people with kindness, consideration and respect. Staff provided support to people in the way they wanted to be cared for. People’s dignity and privacy was promoted.

People received care and support customised to meet their individual needs. People and their relatives were involved in planning their care. Care plans were reviewed and updated regularly to reflect people’s changing needs.

Relatives knew how to complai

Liral Veget Training and Recruitment Ltd supports people with their personal care needs in their own homes. At the time of our inspection eight people were receiving the service. The majority of people using the service were younger adults with a learning disability. All eight people lived in supported living accommodation. The supported living locations were across South London and Kent. The supported living accommodation was provided by another service which Liral Veget had a close working relationship with.

We undertook an announced inspection of this service on 8 July 2015. At our previous inspection of the service on 18 December 2013 the service was meeting the regulations inspected.

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 requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

People were supported in line with their identified needs. Staff encouraged people to maintain their independence and to undertake tasks themselves when able. Staff involved people in decisions about the support they received. This included the level of support they required and their preferences about how it was to be delivered. Many of the people had limited verbal communication. Staff understood people’s communication needs and received training in non-verbal communication which ensured people’s wishes and choices were heard and respected.

Staff provided support in a way that maintained people’s privacy and dignity. Staff enabled people to make choices about day to day decisions, and offered advice to people to ensure their needs were met. For example, staff supported people to choose clothes appropriate to the weather conditions.

Staff were aware of risks to people’s welfare and safety, and supported them to manage those risks. For example, staff had information about risks to people’s health, and ensured people got the support they needed with any on-going health conditions. Staff supported people as required with any meals or medicines.

Staff had received training to ensure they had the knowledge and skills to undertake their roles. They received regular supervision from their manager and had the opportunity to speak with their manager if they needed any further advice or guidance. There was open communication within the staff team and staff were encouraged to express their opinion about service delivery.

The registered manager undertook checks on the quality of the service, and took any necessary action to address any concerns. The registered manager obtained the views of people, their relatives, and other health and social care professionals on the quality of the service.

An assessment of need was undertaken by the service and information from this was used to develop the care package. The person using the service and their next of kin were involved in this process.

The individually tailored care plan gave detailed information about how the person was to be supported. It contained information about what aspects of personal care they were able to do for themselves. Staff encouraged the person to do as much as they could to maintain their independence.

There were appropriate recruitment and selection processes in place. Staff were skilled, experienced and knowledgeable. They all had previous experience of working a care setting and assisting people with their personal care. There were enough staff to meet the needs of the person using the service.

There were processes in place to check the quality of the service provided. The manager undertook unannounced spot checks. There were processes in place to obtain the views and feedback of people using the service and their relatives.

At our inspection on 14 January 2013 there were no people using the service. We were assured that Liral Veget Training and Recruitment Ltd had the processes and systems in place to be compliant as and when they begin to provide a service.