The inspection took place on 06 June 2017 and was announced. We gave the provider 24 hours’ notice. This was because we wanted to ensure that there would be someone in the office to facilitate the inspection and some people who used the service available to speak with us. The service had changed location since the last inspection so had not yet been rated at this location.

The service has an office in Bolton and provides personal and nursing care to people who have complex care needs. The service supports six people living in a supported tenancy house. In addition, care is provided to people living in their own homes via an outreach placement.

The service had a registered manager in place. 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 recruitment system was robust and helped ensure staff were suitable to work with vulnerable people. Staffing levels were sufficient to meet the needs of the people who used the service.

Safeguarding issues were recorded and reported appropriately. Staff undertook regular training in safeguarding and demonstrated a good understanding of how to recognise, record and report any concerns.

Accidents and incidents were recorded appropriately and general and individual risk assessments were in place and reviewed regularly. Health and safety records were complete and up to date and medicines were managed safely at the service.

There was a thorough induction programme and a training programme was on-going to help keep staff skills and knowledge up to date. Staff demonstrated a good understanding of their roles and responsibilities.

Care files included relevant assessments and evidenced good communication between the service and other agencies.

The service were working within the legal requirements of the Mental Capacity Act (2005). Staff had an understanding of the principles of the MCA.

We observed staff at the supported living service and saw that they interacted in a kind and friendly manner. People who received care in the community told us they were treated with the same respect and courtesy.

There was a service user involvement policy and procedure. Many of the documents included in people’s care files were produced in easy read format to make them more accessible to people who used the service.

Care plans were person-centred and included a range of health and personal information. People’s preferences, likes, dislikes and interests, goals and aspirations were documented.

People were supported to access a range of work, college and social activities. The service had an appropriate, up to date complaints policy and complaints were followed up as required.

People told us the management at the service were always approachable and supportive. Staff supervisions and appraisals were undertaken on a regular basis.

There were a number of regular audits undertaken at the service and the results were analysed to help drive continual improvement in care delivery.