Liberty Care
Contract Monitoring Report
- Name of Provider: Liberty Care
- Date of Visit: 26 January 2023
- Visiting Officers: Ceri Williams - Contract Monitoring Officer CCBC
- Present: Gary Lewis (Head of Operations) Kim Williams (Registered Manager)
Background
Liberty Care is a domiciliary care provider based in Blackwood. They are currently registered with Caerphilly County Borough Council to provide a supported living service in various properties throughout the county borough.
The monitoring visit was undertaken at the head office of Liberty Care and involved viewing a range of documentation and policies and procedures, discussions with the Responsible Individual and Registered Manager, and also visits to a number of properties and speaking to tenants who live there.
Dependant on findings within the report, corrective and developmental actions will be given to the provider to complete. Corrective actions are those which must be completed (as governed by legislation), and developmental actions are good practice recommendations.
Findings
Documentation
Personal Plans were viewed on individual’s files when visiting properties. Personal Plans were detailed and person centred, the majority of the plans viewed contained all of the identified needs from the care and support plan prepared by the local authority.
Personal Plans focus on what can be achieved independently and, provide clear instructions for staff, to support the elements of care and support individuals need assistance with. They also included the individuals likes, dislikes, strengths, wants and needs, and gave a good overall picture of each individual.
Appropriate risk assessments were on file. They were detailed and included measures to be taken to reduce and also how to react to risks that had been identified while providing care and support.
Staff are required to read and sign all care planning documentation to evidence they are familiar with individuals care and support needs and how to achieve them.
Some of the personal plans viewed were signed by the individuals receiving care and support but others were not signed by the individual or a representative.
Reviews of personal plans are carried out three monthly which is within the frequency set out in regulations. The review document was a detailed, comprehensive document covering the last three months. The document included physical health, mental health, leading a healthy and active lifestyle, medical appointments, medication, and promoting independence. An outcome scoring mechanism is used to measure each outcome with a summary on outcomes the individual wishes to achieve in the next period.
Review documents viewed were signed by individuals and staff members.
Daily delivery of care and support is captured on a daily monitoring record sheet. The document provides prompts for staff to record the delivery of care accurately which include, personal care, finance, daily living skills, community activities, goals, appointments and meals. Comments / concerns are also recorded by staff.
Evidence was available on file that the individuals are referred to outside agencies when required. Individuals are referred to NHS services, social services and any advice received or changes to care are updated in personal plans in a timely manner.
Staff use a communication book at each property to ensure all staff are aware of any relevant information following shift changes. This is also confirmed in a verbal staff handover at the start of each shift.
All files viewed at properties were stored securely in locked filing cabinets. Files were well organised and easy to navigate.
Staffing
Two staff files were viewed during the monitoring visit. Both files contained the necessary documentation including 2 references with at least 1 from a previous employer, detailed application form, interview record with scoring, proof of identity and signed contract of employment.
Tenants are also involved in the recruitment process and are included on the interview panel, at induction at the office and property.
Liberty Care review staff recruitment and retention quarterly and produce a report with the findings. The report evidenced good recruitment and retention of staff in relation to the properties contracted by CCBC.
Agency staff have only been required at one property contracted by CCBC.
Management and other senior staff are on call at all times to offer support to staff at the properties. The house managers for each property are also supported through supervision and regular telephone contact. An on-call system is operated during evenings and weekends covered by managers on a rotational basis.
Supervision & Appraisal
A supervision matrix was provided which evidenced that staff receive regular supervision with a senior within timeframes set out in regulations.
The supervision meetings are 1:1 meetings with the member of staff and the supervisor. The supervision template encourages a two way conversation between supervisor and supervisee. Staff are given opportunity to discuss any workplace issues, personal development or personal issues that they may need support with.
From supervisions viewed on staff files it was evident that staff feel supported in their role by team leaders and senior management and know that they can raise issues and feel comfortable doing so with senior management.
Evidence was also available on staff files of annual appraisals completed with staff. These appraisals give staff an opportunity to reflect on their achievements over the last year, to discuss their role, identify any training or support needs they may have.
Training
Liberty Care use a mixture of on-line and face to face training for staff. Some training is delivered by in-house trainers whilst also utilising training from CCBC Workforce Development Team.
A training matrix showed that staff were mostly up to date with all mandatory training, with those staff who required refresher training already booked on courses in the near future.
Staff also attend a wide range of non-mandatory training courses in order to support the individuals they work with.
Most staff had achieved, or were working towards an NVQ/QCF qualification appropriate to their role, and some staff were working towards a higher level QCF in order to help them further their careers.
Service User & Stakeholder Feedback
Liberty Care have various quality assurance systems, audits and monitoring in place which all feed into the 6 monthly quality of care review as required by regulations.
Evidence was provided of Responsible Individual visits to supported living services which included all the necessary requirements as set out in regulations such as, discussions with individuals receiving care and support, general observations, reviewing of documentation and discussions with staff. These reports also contained actions to be completed following the visit.
Service user feedback is also captured by tenant meetings at each property and quality assurance questionnaires.
The quality of care review was a comprehensive report, with areas of what Liberty Care do well and areas for improvement or development.
Medication
Medication policies and procedures are robust. Evidence was seen whilst visiting the properties of policies and procedures being followed correctly and medication stored securely.
Daily medication counts are completed on MAR charts, weekly medication audits are carried out by staff and monthly medication audits are carried out by team leaders.
Individual files reviewed at the properties contained necessary care planning and risk assessments if the individual required assistance with medication, which were also reviewed quarterly.
If a medication error does occur this is reported and investigated to identify any actions to reduce the risk of the error reoccurring.
Liberty Care produce medication root cause analysis reports to analyse medication errors quarterly. These reports evidence that there are minimal errors compared to the amount of medication administered across services.
Approach to Care and Accommodation
Liberty Care have a comprehensive Statement of Purpose which clearly sets out the services provided, how they are provided and there is a clear focus on how to support individuals to achieve their personal outcomes.
The company has the necessary policies and procedures in place to achieve the aims of the statement of purpose.
The R.I. and senior management team are actively involved in the day to day provision of care and opportunities for the individuals they support.
The company also benefit from an in-house clinical team comprising of psychologists, clinical behavioural specialists and occupational therapists, providing support to individuals and staff to achieve outcomes.
Referrals for support/accommodation are received from local authority’s, health boards and individuals or their representatives. Liberty Care then have robust process in place for assessing and offering a tenancy.
Individuals are given choice of vacancies, offered visits to the property to meet staff and other individuals and compatibility assessments are also completed with the current tenants kept informed and involved as much as possible.
Appropriate tenancy agreements were viewed on individual files whilst visiting properties. Whilst Liberty Care are the landlord and care provider tenants are not obliged to receive support from Liberty Care in order to keep their tenancy, and can choose another care provider, however no one has requested this arrangement to date.
Tenants are given the opportunity to discuss any issues regarding their care and support or tenancy issues during regular tenancy meetings, care plan reviews and key worker meetings.
Liberty Care employ an in-house maintenance team who respond to any maintenance issues reported by team leaders of the properties.
Actions
Corrective Actions
There were no corrective action identified at this monitoring visit.
Developmental Actions
There were no developmental actions identified at this monitoring visit.
Conclusion
The monitoring visits to the office, and particularly the properties and talking to individuals, was positive. It is clear that Liberty Care have an ethos of supporting both individuals and staff to achieve their goals. There is a clear focus on person-centred planning and achieving outcomes independently as much as possible. Individuals are supported and safeguarded by well-trained staff who are in turn supported by a visible and pro-active senior management team.
The monitoring officer would like to thank tenants and staff for their time and hospitality during the monitoring visits.
- Author: Ceri Williams
- Designation: Contract Monitoring Officer
- Date: 24 April 2023