Chesham Supported Living provides personal care for up to 21 adults with learning disabilities. The service consists of fourteen individual flats. These have a communal lounge where people can gather together for events or to meet up informally. Seven people can be supported in Hawthorn House, which is a shared property. Eighteen people were receiving support at the time of our inspection. Each person had a tenancy agreement with the landlords.

We previously inspected the service on 11 and 13 February 2015. The service was meeting the requirements of the regulations at that time and was rated good. The service remained good at this inspection.

Why the service is rated good:

We received positive feedback about the service. A relative told us “It ticked all the list of things we wanted as a family and more.” They added “It feels like we’ve landed in paradise.” They said there were “Lots of smiles and giggles now” from their family member; “They weren’t doing that before.” Another relative said “It’s wonderful, they really care, like a family.” A person who used the service told us “This is the best place I’ve ever been. They try and make us happy and ask you what you want to do.” Another person said they were very happy at the service and added “We do have a laugh.”

People were protected from the risk of harm. The service used robust recruitment procedures to make sure people were supported by staff with the right skills and attributes. Staff understood their responsibilities to safeguard people from abuse. People’s medicines were handled safely.

There were enough staff to meet people’s needs. This included one to one support to help people access the community and try different things.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice.

We found there were sufficient staff to meet people’s needs. They were recruited using robust procedures and staff received appropriate support through induction, supervision and training.

Care plans had been written, to document people’s needs and their preferences for how they wished to be supported. The service listened to people’s views, such as when recruiting staff. People were supported to take part in a wide range of social activities. Staff supported people to attend healthcare appointments to keep healthy and well.

People knew how to raise any concerns and were relaxed when speaking with staff and the registered manager.

The service was managed well. There were good monitoring systems to assess standards of care. Records were well kept.

Further information is in the detailed findings below.

When we visited the service on 22 April 2013, we had concerns about how this standard was being managed. This was because support plans did not consistently contain all the necessary information to ensure people’s needs could be met. There were also insufficient risk assessments to reduce the likelihood of injury or harm to people. We set a compliance action for the provider to improve practice.

We returned to the service on 16 July 2013 to check whether improvements had been made. We looked at four people’s support plans. We noted improvements had been made to these to ensure people’s needs could be met. Risk assessments had also improved, to help ensure people could safely be as independent as possible.

We were satisfied the provider had taken sufficient action to become compliant with this standard.

We spoke with three staff, the manager and divisional manager as part of this inspection. We talked with a relative and six people using the service and observed practice in Hawthorn House.

People we spoke with were pleased with the support they received. One person told us, ''I'm very happy here. It's like Butlin's.'' People told us staff were available to support them when they needed assistance. They said they had a key worker to help ensure continuity of their care.

We found there was good regard for people's privacy and dignity. Staff were respectful towards people and supported them in accessing the community and being independent.

Support plans were in place to identity people's care needs. In two of the three support plans we read, some further work was needed to ensure people's needs could be met. We found there were insufficient risk assessments to reduce the likelihood of injury or harm to people.

There were appropriate measures to safeguard people from abuse. Staff undertook safeguarding training and there were procedures to follow in the event of any suspicions or allegations of abuse. The manager referred any concerns to the local authority, in line with multi agency guidance.

We found there were robust recruitment practices. New staff received a structured induction to equip them with the skills and knowledge to meet people's needs. There were systems to supervise and appraise staff. Staff had access to good training opportunities.

Chesham Supported Living provides support for up to 21 adults with learning disabilities. Fourteen people have their own flats. Seven people live in Hawthorn House, which is a shared house. Twenty people were using the service at the time of our visit. The service had a registered manager in post. 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.

This inspection took place on 11 and 13 February 2015. It was an announced visit to the service. We previously inspected the service on 16 July 2013. The service was meeting the requirements of the regulations at that time.

We received positive feedback about the service. Comments from people who used the service included “I feel safe”, “I love having my own front door,” “I’ve plenty of choice,” and “You’ve got independence here and there are staff to help you with the things you can’t do.” A social care professional said it was a “Great service, people living there are really empowered to live their lives.” A healthcare professional told us they were happy with the level of care and that the service was caring and well-led. A relative told us “We have found the staff to be caring and compassionate at all times…they include us as partners in any important decisions to be made. We are tremendously grateful for all that they do and the manner in which they do it.”

Staff had undertaken training to provide them with the skills and knowledge to recognise and respond to safeguarding concerns. There were procedures for them to follow in the event of any concerns and these were used appropriately.

People were supported to be as independent as possible and any risks had been assessed to reduce the likelihood of harm. People took part in social activities. Several people had personal assistants who regularly supported them to access the community.

People received their medicines safely. Regular audits were undertaken of medicines practice to check staff followed correct procedures.

Staff were recruited using robust procedures to make sure people were supported by workers with the right skills and attributes. Staff received support through a structured induction, supervision, team meetings and annual appraisals. People told us there were enough staff to support them and they all had a keyworker. This is a member of staff assigned to them who helped to co-ordinate their care, liaise with family members and ensure care plans were accurate and up to date.

Each person had a care plan which outlined their needs and preferences. People were supported with their healthcare needs and a record was kept of the outcome of medical appointments and any treatment that was required.

The service had received several compliments over the past year. There were no complaints during the same period.

The service was managed well. The provider regularly checked quality of care at the service through visits and audits. The registered manager had kept their training up to date and was undertaking an adult social care qualification to enhance their skills and knowledge. Records were well maintained at the service and kept secure.