This inspection took place over two days on 20 and 27 July 2017. This inspection was announced to ensure that key staff would be available to talk with us.

Independent Living (Chorley, Leyland, Parbold & Standish) were previously registered with the Care Quality Commission as a franchise of the Right at Home brand. Since our previous inspection in September and October 2015 the service had bought the Right at Home franchise and were now operating independently as Independent Living (Chorley, Leyland, Parbold & Standish). The services were however operating from the same office location and the owner and registered manager remained the same, as did many of the staff and people receiving care from the service.

We therefore ensured that the issues highlighted within the previous inspection were reviewed even though the services registration had changed. At our previous inspection, as part of the Right at Home franchise, we found the service was not meeting four of the regulations that we assessed and we asked the provider to take action to make improvements. The four breaches of regulation were in relation to gaining valid consent from people prior to their care and support being delivered; the lack of established systems and processes in place to effectively assess and monitor service delivery; staff not receiving appropriate support via robust training, supervision and appraisals and the lack of an effective recruitment procedure for staff.

We issued four requirement notices and asked the registered provider to tell us how they were going to make the improvements required. At this inspection we found that the registered provider and registered manager had made the changes and improvements needed to meet all the requirement notices issued from the previous inspection.

Independent Living (Chorley, Leyland, Parbold & Standish) is a domiciliary care service based near Chorley town centre. The agency supplies staff to work across Chorley, Leyland, Parbold and Standish. The service provides support to people living in their homes and is regulated to provide people with support with their personal care needs. The service offers other support such as help with domestic tasks, shopping and also provide end of life support. At the time of our inspection the service was providing support to 60 people permanently and 13 other people via respite and ad hoc care packages. This totalled approximately 450 hours of care per week.

People told us that they felt safe when receiving care and support from staff employed by Independent Living. Staff knew how to recognise and report potential safeguarding issues and they received appropriate training in this area. However one person who received help with their finances did so in contradiction of the agency's own policies and procedures. We have made a recommendation about this.

People we spoke with had no concerns with how staff helped them to take their medication. An up to date medication policy was in place that staff were aware of. Staff knew their responsibilities in this area and were trained to administer people’s medicines.

Staff received an induction when they first started work at the service. We saw evidence to show that staff were trained, supervised and received an annual appraisal of their performance. Staff told us they felt supported in their role and were given the appropriate training and guidance to carry out their duties effectively.

The service was broadly working to the principles of the Mental Capacity Act (2005). However we found some areas that required improvement, namely how people’s consent was gained and recorded as in some instances people’s care plans were contradictory in this regard. We have made a recommendation about this and saw that action had been taken when we returned to the service to give formal feedback.

People we spoke with told us they were happy with the care and support they received and that staff were caring and considerate. Nobody we spo

This inspection took place over three days on 23 and 28 September and 1 October 2015 and was unannounced. We last inspected Right at Home (Chorley & West Lancashire) on the 12 and 16 September 2014 and the service was judged to be fully compliant with the previous regulatory standards.

Right at Home (Chorley & West Lancashire) is a domiciliary care agency based near Chorley town centre. The agency supplies staff to work across Chorley, Leyland, Parbold and Standish areas. The service provides support to people living in their own homes. The service is regulated to provide people with support for their personal care needs.

There was a registered manager in place at the time of our inspection. 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 had procedures in place for dealing with allegations of abuse. Staff were able to describe to us what constituted abuse and the action they would take to escalate concerns. Staff members spoken with said they would not hesitate to report any concerns they had about care practices. We saw that the service had an up to date safeguarding policy and procedure and staff told us they were familiar with it and knew how to access it.

We found a number of issues relating to recruitment practices. Gaps in employment histories were not always accounted for, suitable references were not always in place and there was no record of a criminal record checks on one person’s file, who provided care for people.

We noted that several people’s care plans contained review dates that had been missed by several months with regards to their medication care plans and risk assessments. We discussed these issues with the proprietor of the service, who told us that there was a need to review people’s care plans and that this had been highlighted within a recent internal audit.

We asked staff if they received appropriate support in the form of supervision, appraisal and training. We received a mixed response from staff in terms of the formal support they received. However they all told us that informal support was good and that members of the management team were always available to speak to if they had any issues.

There was little evidence within staff files to show that people had received a comprehensive induction before starting work. The proprietor and registered manager accepted this and had begun to put systems in place to ensure all new staff received an induction

We discussed consent issues with staff. All were very knowledgeable about how to ensure consent was gained from people before assisting with personal care, prompting medication and helping with day to day tasks. People we spoke with and their relatives spoke positively about how staff communicated with them.

People we spoke with told us the staff that supported them were kind and compassionate and when possible enabled them to make a range of decisions about how their care and support was delivered.

We spoke with staff on issues such as privacy and dignity and how they ensured that people retained as much independence as possible whilst being supported. Staff were knowledgeable in all areas and were able to talk through practical examples with us.

People we spoke with and their relatives told us they knew how to raise issues or make a complaint and that communication with the service was good. They also told us they felt confident that any issues raised would be listened to and addressed.

We looked in detail at six people’s care plans. Care plans did have some good information within them and they were laid out appropriately, so it was clear for staff to follow the instructions and information within them. However, care plans generally lacked detail about the individual person and how to care for them and much of the information within care plans was task orientated and not personalised to the individual. We also saw that some information was generic across all the care plans we looked at.

The care plans we looked at lacked detail around people’s past life history and their likes and dislikes. There was some basic information in some people’s care plans however this was limited. By gaining a better understanding of people’s histories and preferences carers would be able to provide a more personalised service to individuals.

We saw evidence that some audits had taken place however these were infrequent and did not form part of a scheduled quality improvement process and there was little evidence to show that audits were fed back to staff or caused changes or improvements to people’s care or informed care planning.

People we spoke with talked positively about the service they or their loved ones received. People spoke positively about the management of the service and the communication within the service. We spoke with six members of staff, all of whom spoke positively about their employer. Staff had a good understanding of their roles and responsibilities. Staff we spoke with praised the management team.

We saw a wide range of policies and procedures in place which provided staff with clear information about current legislation and good practice guidelines. All policies and procedures were version dated and included a review date. This meant staff had clear information to guide them on good practice in relation to people’s care.

We found several breaches of the Health and Social Care Act (2008) (Regulated Activities) Regulations. These breaches amount to breaches of the Health and Social Care Act (2008) (Regulated Activities) Regulations 2014. These related to staffing, fit and proper persons employed, person-centred care and good governance.