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This inspection took place on 30 May 2017 and was announced. The service had previously been inspected on 18 January 2016 and had breaches of legal requirements in relation to consent and good governance. We found improvements had been made to meet the relevant requirements.

The service is registered to provide personal care for people with a range of varying needs including dementia and learning disabilities who live in their own homes, or within supported living schemes. Supported living schemes help people to live independently in the community. People are responsible for their own tenancies, and receive an agreed level of caring and housing related support to meet their needs.

The service supported 68 people at the time of our inspection with 25 people received support with personal care.

There was a registered manager in post during our inspection who had been registered since February 2016. 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.

Staff had received training in how to keep people safe. All the staff we spoke with demonstrated they understood how to ensure people were safeguarded against abuse and they knew the procedure to follow to report any incidents.

Risks were managed at the service and there were systems and processes in place to ensure environmental risks were minimised. The service used a positive risk approach which balanced the necessary levels of protection with preserving reasonable levels of choice and control for the person.

Recruitment checks were in place. These checks were carried out to make sure staff were suitable to work with vulnerable people and to ensure staff were recruited with the right experience and behaviours for their role. Staff received regular training to ensure they developed skills and knowledge to perform in their role. Staff had regular supervision and appraisals to support their development.

Staff had been trained and had their competencies checked where they supported people to manage their medicines. Six people using the service required support with their medicines and required a prompt or check to ensure they had taken them. We found gaps in their records where staff had not provided this support, with no reason for the omissions. We have therefore made a recommendation about the management of some medicines.

The registered manager understood their responsibilities under the Mental Capacity Act 2005. Staff had an understanding of the principles of the Act and how to support people if they lacked capacity.

Staff enabled and maximised people’s independence to live fulfilled lives. People using the service confirmed this approach in encouraging independence.

Support plans were detailed and person centred and people were supported by staff who had been chosen for their compatibility with the people they supported. This enabled staff to enhance people’s well-being and life skills. People were involved in their support planning and reviews to identify goals and staff worked with people to achieve their desired outcomes.

Complaints were handled appropriately and the service had a complaints policy in place. The service kept a record of compliments received and used these to motivate and encourage staff.

The service was well-led with a positive culture within the service. There were clear values and a vision to develop the service. Staff spoke highly of the registered manager and the management team and the support they provided. Quality audits had been undertaken and there were good systems in place to monitor the effectiveness of the service provided apart from the medication audit which although it was a small part of the service provision, required a more rigorous approach.

The inspection took place on 18 January 2016 and was announced.

The service had previously been inspected in February 2014 and was fully compliant at that time.

The service provides domiciliary care services to people in their own homes. The people who use the service have a wide range of needs, some of which are complex, including older people, people who have a learning disability, a physical disability or an acquired brain injury and are all adults. All of the people who use the service require support to allow them to remain independent in their own homes. At the time of our inspection there were 75 people receiving support in the local area surrounding their offices in Dewsbury from the registered provider.

The service did not have a registered manager at the time of our inspection, although there was a manager who going through the process of registration. 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 we spoke with told us they felt safe with their care workers, both in their own homes and when they were supported to go out.

We saw the service had identified their care plans were not personalised and needed to be improved. We found in the care files we reviewed whilst some of the care plans which had been re-written; were very personalised and detailed and would allow care staff to meet the person’s needs, there were others which were not detailed enough and care staff would not have all the information needed to meet the person’s needs fully. The risk assessments in place had recently been changed and were improved; however we did see one example where the risks which had been identified did not have measures in place to reduce those risks.

We looked at the daily care records for the service. We found these were recorded in standard hard back books which were in a poor state of repair. There were large gaps between some of the entries which meant records could be tampered with.

We spoke to staff who told us there had been a high turnover of staff and that it was sometimes difficult for them to safely meet the needs of the people who used the service. We saw from staff files that staff training was up to date and they had undertaken all mandatory training, there was also the opportunity to access more specialised training.

Staff understood and were able to explain the signs and types of abuse they would look for and they were clear who they would report their concerns to and what action they would take if they did not feel their concerns had been acted upon.

The service had safe recruitment processes in place and we saw that these were being followed to ensure the staff were of good character and suited to the roles they were appointed to.

We found whilst some people had signed their care plans, there was no clear agreement in the documents which stated they were giving their consent to the care which was carried out, and some care plans were not signed by or on behalf of the people who used the service.

Staff were enthusiastic and passionate about delivering good quality care when we spoke with them, and they told us that whilst there had been a lot of changes of management they felt the current management team was the best there had been.

Staff told us they had regular supervision with their line managers which they found useful and supportive, although records showed not all staff received supervision as regularly as the manager told us they should. Some staff told us the office team didn’t always make time to listen to them.

We found incidents and accidents were recorded and there were records of the actions which had been taken when investigating matters, however we did not see the outcomes of the investi

We found that the service sought consent from people before carrying out any support in both written and verbal format. We spoke with people who used the service about the ways in which they were supported by staff. One person told us “They listen to me. They help me with things when I ask them”. People we spoke with were happy with the support they received. One person told us “They make me feel safe. There are no improvements needed”. We found support plans to be detailed and individualised.

The provider communicated well with other organisations and people involved in a person’s support. Records of these communications and discussions were robust. There was evidence of joint decision making and collaborative working.

Appropriate checks were undertaken before people started work and staff underwent a detailed induction process which prepared them for the role. There were comprehensive quality assurance systems in place and people felt able to speak up about the support they were receiving and development of the organisation.

The Avalon Group – West Yorkshire Supported Living Service is run from a central office location and provided support to people in their own homes. We visited the office, met with several members of staff and looked at records and other documentation to gather evidence of people's experiences of the service. We spoke by telephone with support workers and people (or their representative where they were unable to communicate themselves) who use the service, to gain their views about their experience of the service provided. All the people who use the service we spoke with gave favourable comments about the service such as:

“[My support worker] listens and helps, that’s what they are here for.”

“All staff are friendly.”

“I like the independence we get.”

“Nothing’s a problem to them.”

All of the people who use the service we spoke with felt they were treated with dignity and respect and had their privacy maintained by all the staff. We saw evidence of people being actively involved in the assessment of their individual need and choices to promote independence. All staff spoken with were able to described clearly what action they would take in the event of a safeguarding issue coming to their attention and they could describe the different types of abuse, so they were fully aware of potential risks to people's safety. They also said they felt supported by the provider and received enough training to equip them with the right skills to do their job well.