We inspected the service on 8 September 2016 and the visit was announced. We gave notice of our inspection because we needed to be sure somebody would be available at the office.

Choice East Midlands (Supported Living) provides personal care and support for people with learning disabilities in their own homes. There were 37 people using the service when we inspected.

At the time of our inspection there was a registered manager in place. It is a requirement that the service has 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 felt safe with the support offered. Staff could describe and understood their responsibilities to support people to protect them from abuse and avoidable harm. The provider had systems in place to manage and deal with accidents and incidents appropriately. Risks to people’s well-being were assessed. For example, where people could have shown behaviour that challenged, staff had guidance available to them.

People’s homes and equipment were regularly checked and the provider had plans to keep people safe during significant incidents, such as a fire.

People were satisfied with the availability of staff to provide their support. Staff were checked for their suitability before starting work for the provider so that people received support from those appropriate to work within the caring profession.

Where people required support to take their prescribed medicines, this was undertaken in a safe way by staff who had received regular guidance. Staff knew what to do should a mistake occur when handling medicines.

People received support from staff who had suitable skills and knowledge. Staff received an induction when they started working for the service and regular training and guidance. This included meeting regularly with their supervisor to discuss their working practices and to receive feedback to enable them to provide effective support to people.

People received support in line with the Mental Capacity Act 2005 (MCA). The provider had undertaken mental capacity assessments where there were concerns about people’s ability to make specific decisions. Staff understood their responsibilities under the Act and appropriate support had been sought where they were seeking to lawfully deprive a person of their liberty.

People chose their own food and drink and were supported to maintain a balanced diet where this was required. They had access to healthcare services to promote their well-being and were involved in decisions about their health.

People received support from staff who showed kindness and compassion. Their dignity and privacy was protected including the safe handling of their sensitive and private information. Staff knew people’s communication requirements and the provider had made information easier to read to aid people’s understanding. For example, the provider’s complaints procedure was written using pictures.

People were supported to be as independent as they wanted to be. For example, by washing their own clothes. Staff knew people’s preferences and had involved people in planning their own support. Where people required additional support, advocacy information was available to them.

People had contributed to the planning and review of their support. The recording of this within people’s care records had not always taken place. The registered manager told us they would make improvements. People had support plans that were person-centred and staff knew how to support each person based on their individual preferences. People took part in interests and hobbies they enjoyed including paid and voluntary work.

People knew how to make a complaint. The provider had a complaints po