Date of assessment 22 October to 26 November 2025. This assessment was in response to concerns raised with the Care Quality Commission in relation to another of the providers locations. Living ambitions Limited-Essex provides personal care for people living in their own homes. In supported living people’s care and housing are provided under separate contractual agreements. The service provides support to those with learning disabilities and autistic people for up to 78 adults. Not everyone who used the service received personal care. CQC only inspects where people receive personal care. This is help with tasks relating to personal hygiene and eating. Where they do, we also consider any wider social care provided. At the time of our visit the service was providing a regulated activity to 51 people. We assessed the service against ‘Right support, right care, right culture’ guidance to make judgements about whether the provider guaranteed people with a learning disability and autistic people respect, equality, dignity, choices, independence and good access to local communities most people take for granted. As we visited 8 of the providers locations, we did identify some inconsistencies in the provision of care between the locations. However, the registered manager was responsive to our feedback and aware of the locations where extra support was needed. Overall people's care needs had been assessed with risks identified and actions taken to reduce these. People received safe care and the provider checked to ensure staff were suitable to work at the service. Medicines were managed safely; however, some minor improvements were needed. The registered manager had oversight of staffing and was aware of the 1 location where staffing during our visit impacted on the people who were supported there. All other locations had enough staff to meet people’s needs safely. People were supported by staff who knew them very well and provided kind, caring person-centred care and support. People were treated with dignity and respect that valued them individually. Feedback from people, relatives and staff was overall positive. Support plans were electronic, however there were various documents that remained paper based. Some paper documents we viewed required updating, and this was completed by staff at the time of our assessment. Overall people were supported by staff to take part in a variety of activities, hobbies and interests they enjoyed and that maintained their independence. In 1 of the locations the staff available during our assessment impacted on people’s ability to access the community. The provider had a number of quality assurance and audit checks to monitor the care being provided. Additional learning was needed to ensure standards in all locations were consistent.
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Living Ambitions Limited - Essex improved from Requires Improvement to Good overall, with a new registered manager driving safer care, better governance, and resolution of previous breaches of Regulations 12, 13, 17 and 18. Responsive remained Requires Improvement due to limited person-centred activities, entrenched routines and care plans not always tailored to individual goals.
Concerns (5)
moderatePerson-centred care: “Not all people were encouraged to be active and develop new interests, in line with their needs and preferences.”
moderateCare planning: “There were not always clear pathways to future goals and aspirations, including developing new skills, in people's support plans.”
moderateStaffing levels: “Relatives told us the high turnover of staff affected how much people went out.”
minorEnd-of-life care: “The provider had carried out internal audits, which found there was a need to improve the planning of end of life care across the service.”
minorRecord keeping: “We found gaps in some people's records about these appointments which had taken place, however this was being addressed and was already improving.”
Strengths
· New registered manager had introduced effective systems to manage safeguarding and incident investigations, leading to no longer being in breach of Regulations 12, 13, 17 and 18
· Staff supported people with medicines safely, applying STOMP principles to avoid over-medication
· Improved staff training systems and induction, including for agency staff
· Caring, respectful staff who knew people well and supported communication using Makaton and personalised methods
· Strong leadership driving cultural change, improved oversight, and partnership working with local authority and CQC
Quality-Statement breakdown (22)
safe: Systems and processes to safeguard people from the risk of abuseNot rated
safe: Assessing risk, safety monitoring and management; Learning lessons when things go wrongNot rated
safe: Staffing and recruitmentNot rated
safe: Using medicines safelyNot rated
safe: Preventing and controlling infectionNot rated
effective: Assessing people's needs and choices; delivering care in line with standards, guidance and the lawNot rated
effective: Staff support: induction, training, skills and experienceNot rated
effective: Supporting people to eat and drink enough to maintain a balanced diet