Affinity Trust - Domiciliary Care Agency – Norfolk is registered to provide personal care to people in their own homes. At the time of this inspection there were 27 people using the service who had a learning disability.

This announced inspection took place on 17 and 22 November and 19 December 2016.

At the time of the inspection there was a registered manager in place. A registered manager is a person who has registered with the Care Quality Commission (CQC) 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. However they were not available during the inspection.

CQC is required by law to monitor the Mental Capacity Act (MCA) 2005, Deprivation of Liberty Safeguards (DoLS) and to report on what we find. The provider was acting in accordance with the requirements of the MCA including the DoLS. The provider was able to demonstrate how they supported people to make decisions about their care. Where people were unable to do so, there were records showing that decisions were being taken in their best interests. This meant that people did not have restrictions placed on them without the correct procedures being followed.

People told us they felt safe. Risk assessments were in place and staff confirmed they followed them. Staff had an understanding of how to protect people from harm and knew what action they should take if they had any concerns.

Staffing levels ensured that people received the support they required at the times they needed it. The recruitment practices were thorough and protected people from being cared for by staff that were unsuitable to work at the service. People using the service were involved in the recruitment procedures, with only the most appropriate staff being selected for a job.

Staff were kind when working with people. They knew people well and were aware of their preferences, likes and dislikes. People’s privacy and dignity were upheld.

People were supported to take their medicines as prescribed. Records showed that medicines were obtained, administered and disposed of safely. People were supported to maintain good health as staff had the knowledge and skills to support them and there was prompt and reliable access to healthcare services when needed. People were provided with a choice of food and drink that they enjoyed.

Support plans were in place detailing how people wished to be supported and had been produced in conjunction with people using the service. People had agreed what care and support they needed and were fully involved in making decisions about their support. People participated in a activities at their home or in the community and received the support they needed to help them to do this. People were able to choose how they spent their time and what activities they participated with.

There was a complaints procedure in place and people felt confident to raise any concerns either with the staff or the registered manager if they needed to. The complaints procedure was available in different formats so that it was accessible for everyone.

People had confidence in the management team and the way the service was run. The provider ensured the service was well supported and there were opportunities for people and staff to provide feedback about any improvements that could be made, and these were listened to and acted on.

This inspection was carried out by a single inspector. As part of our inspection we spoke with four people who were receiving support, the manager, and eight staff working at the service. Thirty five people were using the service at the day of our inspection. A registered manager was in post at this service. We looked at the support plans for four people. We used the evidence collected during our inspection to answer five questions.

Is the service safe?

Risk assessments regarding people's individual activities were carried out and measures were in place to minimise these risks.

Staff had an understanding of their roles and responsibilities in making sure people were protected from the risk of abuse and correct procedures had been followed. People who used the service told us that they felt safe and they felt confident to report any concerns.

People were cared for by suitably qualified, skilled and experienced staff.

Appropriate checks were undertaken before staff began work.

The provider was taking appropriate action to ensure that people’s rights were protected by appropriate consideration and use of the Mental Capacity Act (2005).

Is the service effective?

We saw that members of staff had a thorough knowledge of people's individual health and wellbeing needs. People had a positive relationship with the staff who supported them.

The care and support plans were personal to each individual and were reviewed on a regular basis. Assessments of any potential risks to people had been carried out and measures put in place to reduce risks.

Staff told us they received a very good level of training and felt well equipped to undertake their role at the service.

Is the service caring?

We saw how members of staff supported people and this was done well and in a respectful way. We saw that staff were friendly and encouraged people to be independent and engage in meaningful activities. Staff demonstrated a thorough knowledge and sensitive understanding of the needs of the people they supported.

Staff ensured they gained consent from people before they offered them care and support. One person said, “Staff always ask my consent.”

Is the service responsive?

We saw that people's individual physical, emotional, psychological and social care and support needs were assessed and met. This included people's individual choices and preferences as to how they liked to spend their day.

People's needs and care plans were regularly reviewed by the staff. Support plans included information on people's likes and dislikes and their preferences to ensure that care and support was delivered taking into account their preferences. Staff promoted the independence of people who used the service.

Is the service well led?

The service had a registered manager in place.

Staff told us they felt very well supported by the management of the service. They felt well trained to safely do their job. They told us they enjoyed working for the service provider. One member of staff said, “It’s great, it’s a very good company to work for. I feel very well looked after and I have received lots of good training.”

There was a clear complaints procedure in place. People told us they were confident to raise any concerns or complaints they had with staff and managers.

The provider had effective quality assurance and audit systems in place to monitor the service and ensure improvements were made where necessary.

We read information and care plans that told us that people receiving the service had been previously assessed prior to using the service. We saw that their care needs, potential risks, likes and dislikes were recorded and reviewed regularly. People had a copy of their care support plan that was in a format they could understand. People were involved with the care and support required that met their individual needs. They told us, “I am so happy here. All the staff are brilliant. I am helped to do all the things I enjoy.”

Professionals involved with the individual people cooperated with Affinity Trust staff. This ensured the care and support was appropriate and that people received the correct care and support required.

We looked at records and spoke to staff who told us that the training and support offered to them was suitable. They told us the skills required to meet individual people’s needs would be offered in training and support. This enabled them to do the job required safely and appropriately.

There were comprehensive methods used by this service to ensure quality was monitored. People who required individual support were given methods such as picture formats or translations into another language to ensure they could participate in assessing the quality of the care provided.

People who were unhappy with any aspect of their care and support were listened to and action was taken to address the concerns/complaints.

At the time of our inspection 26 people were receiving support in their own homes from Affinity Trust, Norwich. The level of support they required varied greatly.

We visited one home where two people were living and receiving 24 hour support from staff. They told us that they liked living there and that they could influence how they lived their lives. They said that staff were “kind” and that they got on well with them.

People we spoke with told us that staff looked after them well and that they knew where their records were kept.

We visited the office of the agency and spoke with two people who were being supported by staff.Both people told us they visited the office on a regular basis. One person told us "I work here two days a week, I like to help with the stationary and filing." Both people were very happy with the support they received from the staff who visit them in their own homes and supporting them when they go out.