We undertook an announced inspection on 22 October 2015. We gave the registered manager 48 hours’ notice of our intention to undertake an inspection. This was because the organisation provides a domiciliary care service to people in their homes and or the family home we needed to be sure that someone would be available at the office.

The provider registered this service with us to provide personal care and support for people with learning disabilities who live in their own homes. At the time of our inspection 11 people received care and support services.

There was a registered manager in post. On the day of our inspection they were not at work but the director was overseeing the registered manager’s responsibilities until they returned to work. 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.

People were supported to make safe choices in relation to taking risks in their day to day lives. Staff had been trained and understood how to support people in a way that protected them from harm and abuse. This included using technology and aids to enable people to be safe whilst remaining in their own homes.

There were sufficient staff to safely support people who used the service. The management team monitored staffing levels and made sure extra staff were available when needed. The management team had completed checks on staff prior to them starting to work to make sure they were suitable to work with people in their homes.

People were involved in saying what their preferences were for receiving their medicines and what support they wanted from staff. Where people received their medicines staff were trained to administer these and made sure people had their medicines safely and when they needed it.

Staff were very positive about working for the organisation and understood and practised its values around providing a service to people in their homes. Staff felt confident in their roles because they were well trained and told us the management team were always available for support and advice both day and night. People who used the service and staff had adopted the five key questions used by the Care Quality Commission to judge whether people were receiving safe, effective, caring, responsive care that was well led.

The management team ensured staff had many varied training opportunities and were recognised by awards relevant to providing care to people with learning disabilities in their homes. Staff were motivated and passionate about using the knowledge and skills gained from training to ensure the best possible outcomes for people. Staff had used their knowledge in practice on many occasions to support people in gaining health diagnosis’s and treatment which had a significant impact on enhancing how well people felt.

People were supported to make their own choices and decisions about aspects of the services they received at home. This included staff making every effort to enable people to consent to the way they received their care to meet their needs by using pictures and symbols. When people were unable to consent to their care best interest discussions took place so that decisions were made by those who knew people well and had the authority to do this.

Where people needed support in their homes to assist them in eating and drinking to meet their needs staff did this in the most appropriate way for each person.

Staff were kind and encouraged people to remain living in their homes as independently as possible. Staff knew people well and were able to understand people’s unique ways of communicating. People led their own care reviews and were supported to review their care regularly with staff, to ensure it met their individual preferences and needs. Staff recognised people’s diversity and supported them as individuals and on many occasions staff went above and beyond their roles to help people to live the lifestyles they chose. There were many opportunities for people to voice their opinions about the services they received at home and participate within the community they lived in.

The management team and staff shared common values about the aims and objectives of the services people received in their homes. These were based around people being supported to live the lives they chose. Regular quality audits and checks were completed so that improvements were continually recognised and there was effective follow up action which made sure people received a high quality service. People who used the service and all staff were actively encouraged to contribute to the evaluation of the services provided and the recommendations for improvement. The management team and staff worked together as a team with a passion to learn about and aim for best practice with people very much at the heart of the services they received in their homes.

The focus of the inspection was to answer five key questions; is the service safe, effective, caring, responsive and well-led?

Prior to our visit we reviewed all the information we had received from the provider. We visited the organisations office base which was used as a day service and meeting centre and one supported living service. During the inspection we spoke with a total of five people who used the service and two relatives and asked them for their views. We also spoke with two care workers, one senior care worker, one office based member of staff, the registered manager. and the provider. We looked at some of the records held at the office including the care files for two people. We also observed the support people who used the service received from staff.

At the time of the inspection Amber Support services provided care and support to 11 people living in four supported living services, eight people who used outreach services either in their own home or local communities and a number of people who used their day service.

The summary below describes what people using the service, their relatives and the staff told us, what we observed and the records we looked at.

If you want to see the evidence that supports our summary please read the full report.

This is a summary of what we found:

Is the service safe?

People's needs had been assessed and individual care plans drawn up to meet people's needs. These assessments and plans included consideration of risks to the person and how these could be managed to keep the person safe. There were arrangements in place

to deal with foreseeable emergencies.

People were protected from the risk of abuse because the provider had ensured that safeguarding policies and procedures were in place and available to staff. Staff had been trained in safeguarding and knew what to do in the event of abuse being suspected, witnessed or alleged.

Staff personnel records showed the provider had carried out checks before staff started work to ensure they were fit to work in health and social care. We found there were enough staff to meet people's needs. One person who used the service told us, "The staff are really good, they do their job properly and look after us". One relative told us, "The staff care and do a good job".

The Care Quality Commission (CQC) monitors the operation of the Deprivation of Liberty Safeguards which applies to care homes. While no applications have needed to be submitted, proper policies and procedures were in place. Relevant staff had been trained to understand when an application should be made, and how to submit one.

Is the service effective?

People told us they were happy with the care they received and felt their needs had been met. It was clear from what we saw and from speaking with staff that they understood people's care and support needs and that they knew them well. We saw people being cared for and supported in accordance with their plans. We found the provider reviewed people's care plans and made changes if required.

We found the provider considered people's immediate and long term needs and wishes. For example, holiday arrangements and work aspirations were planned for along with daily care and support arrangements. One relative told us, "They plan for people to live their lives".

Staff had received training to meet the needs of the people using the service. We found the provider had provided additional training to meet people's needs as a result of this being suggested.

Is the service caring?

People were supported by kind and attentive staff. We saw staff talking with people in a kind, calm and respectful manner. Staff we spoke with were knowledgeable about the individual needs of people.

One person supported told us, "The staff are really good, they do their job properly and look after us". Family representatives told us they were happy with the way their relative was cared for and supported. One relative told us, "The staff care and do a good job". An office based member of staff told us, "The dedication and interest from staff is incredible".

Is the service responsive?

We found that each person's needs were regularly reviewed with care plans updated if needed. Records showed that people were supported in line with these plans.

People had access to activities that were important to them and had been supported to maintain relationships with their friends and relatives.

The provider had responded to representations and complaints and made changes as a result. We saw the provider had put in place a system to ensure that people's views were sought and ensured these were brought to the attention of senior staff.

Is the service well-led?

We found that quality assurance processes were in place. People's views had been obtained by the provider along with the views of family representatives and staff. Relatives told us they were able to contact the provider and give their views. One family member told us, "They have dealt with problems and put them right" and, "They encourage you to give their views". We were told by staff that they are encouraged to raise any concerns they have with the provider.

The provider investigated accidents and accidents and carried out checks to ensure the health, safety and welfare of people supported, staff and others.

We found that staff received training and the provider was able to provide evidence that most of the staff held vocational qualifications relevant to their role. Staff told us that that training was provided to assist in their professional development. One staff member told us, "They're very good at helping us get qualifications".

You can see our judgements on the front page of this report.

When we carried out our inspection the agency was providing personal care for 11 adults. Some people lived in their own home while others lived in supported living accommodation. During this inspection we spoke with the registered manager and the training and human resources manager. Following our inspection at the office we spoke with two people who used the service on the telephone. We also spoke with five relatives of people who used the service. In addition we spoke with six members of staff who visited people to provide care either at the office or on the telephone.

Most people we spoke with were complimentary about the care and support they or their relative had received provided. We were told that people were involved in their support plan and that consent was gained prior to the provision of care. One person told us: “I am involved in everything. I am my own boss”. Another person told us that they were: “All right” and: “Like the people” who cared for them.

Staff had been recruited in an appropriate way and checks had been undertaken to make sure that they were suitable to care for people in their own homes.

Staff received training and support to make sure they were able to provide appropriate care.

The provider had systems in place to enable them to monitor the quality of the service provided. This was to make sure people received appropriate care. The registered manager was aware of where improvements in the service were needed.

At the time of our inspection we were informed that 10 people were using the service. People were living at 4 separate dwellings under supported living arrangements. Amber Support staff were providing all or part of the care provided at these addresses.

We spoke with two people who used the service and three relatives. We spoke with six members of staff including the registered manager.

We found that people were able to express their views and had been involved in making decisions about their care and support. People were complimentary about the care they or their relative had received. Comments included, “Staff support me”, “Excellent” and “Everyone very caring”.

We found that care workers had a good understanding of the needs of people they supported and cared for.

Staff who worked at the agency knew about safeguarding procedures and the actions they would take to make sure other agencies were made aware of any incidents that had occurred.

Systems were in place to assess and monitor the quality of care provided and as a means to identify any improvements needed.