Best Outcomes is a supported living service for people with a learning disability or mental health diagnosis located in Rochdale, Greater Manchester. Best Outcomes is registered to provide personal care for people in their own home. At the time of the inspection the service was supporting two people living in one property.

This inspection took place on 5 and 6 September 2018 and was announced. The service was last inspected on October 2015 and received an overall rating of good. At this inspection we found that evidence continued to support the rating of ‘good’ and there was no evidence or information from our inspection and ongoing monitoring that demonstrated serious risks or concerns. This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection.

The care service has been developed and designed in line with the values that underpin the Registering the Right Support and other best practice guidance. These values include choice, promotion of independence and inclusion.

We were assisted throughout the inspection by a registered manager. 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 were aware of their responsibilities to safeguard people from abuse. Safe recruitment practices were in place and the service followed national and local safeguarding guidance. There were sufficient staff to care for people. Risks to people's safety were assessed and medicines were administered safely.

People received care from staff who were appropriately trained to effectively carry out their job roles. People were supported to have maximum choice and control of their lives. The service acted in accordance with the Mental Capacity Act (2005). People were supported to maintain good health and receive ongoing healthcare support.

Staff spoke about people with genuine empathy and compassion and demonstrated a commitment to providing good care. We saw that staff knew people’s needs well and people who used the service told us the care was not rushed and they were actively supported to become more independent where possible.

The service was proactive at promoting activities and access to the wider community and both residents had regular activities including holidays and access to education.

The staff were committed to their roles and spoke in a caring and compassionate way about the people who used the service and the service had internal quality assurance systems in place to monitor performance and to drive improvement.

This was an announced inspection that took place on the 19 January 2016.

Best Outcomes is a supportive living service for people with a learning disability or mental health diagnosis. Best Outcomes is registered to provide personal care for people in their own home. At the time of the inspection Best Outcomes were supporting three people living in one property.

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 registered manager was at the property five mornings each week. They were contactable by telephone at other times and an on call service was available outside of office hours.

Relatives of people who used the service told us they thought their relative was safely supported by Best Outcomes. Staff had received training in safeguarding vulnerable adults and knew the correct action to take to protect people from abuse. All staff and relatives said that the registered manager would listen to any concerns raised and take any appropriate action required.

A robust system for staff recruitment, induction and training was in place. Rotas showed that there were enough staff on duty to meet people’s needs. This enabled the staff to support people effectively and safely.

Systems were in place to administer and store medication safely. Guidance was provided for staff as to when to administer any ‘as required’ medicines. People were supported to access health care professionals when required.

Plans were in place in case of an emergency that would affect the running of the service; such as a utility failure.

We saw that the home was clean throughout, with weekly cleaning schedules in place. Policies and procedures were in place for infection control and regular checks were carried out to ensure a high standard of cleanliness was maintained.

The manager and staff demonstrated a good understanding of the Mental Capacity Act 2005 (MCA). Best interest meetings had taken place where a person who used the service did not have the capacity to make a particular decision.

We saw that individual menus were planned for each person who used the service. We were shown adapted plates with ‘lips’ on to support people to eat their meals independently and ‘non spill’ cups that one person used. The systems in place should help ensure that people’s nutritional needs were met.

Records we saw showed that people’s health needs were clearly documented. Staff members supported people to health appointments due their communication needs.

The people who used the service and their relatives spoke positively about the kindness and caring nature of the staff. Staff demonstrated a clear understanding of people’s needs. Throughout the inspection we observed warm and respectful interactions between the people who used the service and staff. The atmosphere at the service was friendly and relaxed.

Person centred care plans and risk assessments were in place. These contained clear information and guidance for staff to support people with the activities they wanted to do and any behavioural support that may be required. The plans were regularly updated to ensure that the information reflected people’s current needs.

Care records showed evidence of staff reducing their support for people as they were able to complete more of a task for themselves. We saw that one person had started to access their local community independently.

The service has systems in place to gather feedback about the service. Staff told us that they enjoyed working in the service and the registered manager was approachable and supportive. Regular supervisions and staff meetings were held. Staff were encouraged to contribute to discussions so that con

On the day of our inspection Best Outcomes was only providing care and support to one person. An assessment of the person’s needs had been carried out prior to them starting to use the service. We saw care plans were in place that gave information about exactly what care and support was required. Care workers had a good understanding of the Mental Capacity Act 2005 and we saw that consent had been appropriately obtained for various aspects of the care and support provided.

A small team of staff provided care and support so that the person had continuity. However, the provider had other staff available at short notice if required.

We saw that the provider had included the person and their family in a review of their needs. They had also been asked to complete a satisfaction survey.