We inspected this service on 13 January 2017. This was an announced inspection. Our last inspection visit took place in February 2016 and at that time we found the service was rated as Good overall, although our question ‘Is this service effective?’ was rated as Requires Improvement. This was because assessments had not been completed to ensure decisions were only being made in people’s best interests when they lacked capacity. On this inspection we found that improvements had been made.

The service was registered to provide personal care for people. Three people with a learning disability were supported by the provider in their own shared home. People referred to the staff members as personal assistants.

There was a registered manager in the service. 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 made decisions about their care and their personal assistants helped them to understand the information they needed to make informed decisions. The personal assistants sought people’s consent before they provided care and they were helped to make decisions which were in their best interests.

People were protected from the risks of abuse because the personal assistants understood where harm may be caused and knew what action to take. The personal assistants supported people to understand any risks to prevent avoidable harm. Where people were concerned about their safety they knew who to speak with.

People kept their medicines in the bedroom and were helped to understand what their medicines were for and to take responsibility for them. The personal assistants knew why people needed medicines and when these should be taken.

People received support from their personal assistant at the times that suited them to enable them to be involved with activities and do the things they enjoyed. People chose to work, continue with their education and be involved with activities they enjoyed. People’s health and wellbeing needs were monitored and they were supported to organise and attend health appointments as required.

People were treated with kindness, compassion and respect and the personal assistants promoted their independence. People liked their personal assistants who supported them and they had developed good relationships. People maintained relationships with their families and friends.

The personal assistants listened to people’s views about their care and people were able to influence the development of the service. People knew how to complain and concerns were responded to.

The registered manager assessed and monitored the quality of care to ensure standards were met and maintained. They understood the requirements of their registration with us and informed us of information that we needed to know.

We inspected this service on 12 and 13 February 2016. This was an announced inspection and we telephoned the provider two days before our inspection to ensure we had an opportunity to speak with people who used the service. This was the first inspection of this service.

The service was registered to provide personal care for people. Three people with a learning disability were supported by the provider in their own shared home.

The service had 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.

People chose how to spend their time and staff sought people’s consent before they provided care and support. Some people did not have capacity to make certain important decisions. It was not clear whether people should make the decision for themselves or whether some decisions should be made in their best interests. We have asked the provider to make improvements.

People were supported by staff when out and they told us they were able to take responsible risks but felt safe and well supported. The staff knew how to reduce avoidable risk to prevent harm and understood how to recognise and report any abuse. People told us they were supported to develop their independence and were provided with opportunities to develop their interests and join in social activities. Staffing levels were sufficient and flexible to support people to do the activities they wanted to do.

People were supported to be responsible for their medicines and they knew why they needed their medicines to keep well. People accessed health care where needed and when they were unwell or had concerns.

Staff knew people well and were trained and competent to meet people’s needs. Staff were supported and supervised in their roles by the manager. People had chosen the staff they wanted to work with them and staff had developed good relationships with people. The staff were kind and caring in their approach and people’s privacy and dignity were respected.

People were involved in the planning and review of their care and support and family members continued to play an important role. Where people had any concerns they were able to make a complaint and this was responded to.

People were able to choose who to develop and maintain relationships with and visited their families and friends. People were treated with kindness and respect and staff promoted people’s independence and right to privacy. People were helped to prepare and cook their own meals and people were responsible for shopping and planning their meals. People could choose their own food and drink and were supported to eat healthily.

Systems were in place to assess and monitor the quality of the service. People and staff were encouraged to raise any views about the service to review how improvements could be made. The manager promoted an open culture which put people at the heart of the service.

You can see what action we told the provider to take at the back of the full version of the report.