About the service:

Class UK Limited provides care and support to people with a learning disability and autism in a 'supported living' setting so that they can live as independently as possible. People’s care and housing are provided under separate contractual agreements. CQC does not regulate premises used for supported living; this inspection looked at people’s personal care and support. At the time of inspection there were 12 people living in four separate houses receiving personal care and support.

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. People with learning disabilities and autism using the service can live as ordinary a life as any citizen.

People’s experience of using this service:

People told us they felt safe with staff. Individual risks to people had been assessed and these were well managed by knowledgeable staff who knew how to support people safely.

There were sufficient staff employed who had been safely recruited. People had access to one to one support as and when needed which gave them choice and control over their day to day lives.

Medicines were managed safely by staff who had been trained and assessed as competent. Staff had training in food hygiene and infection control and followed good practice to prevent contamination and the spread of infection.

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

People were supported to have enough to eat and drink which met their preferences and any health needs. Staff supported people to be independent, people were assisted to do their own grocery shopping and prepare meals.

Staff received training and ongoing monitoring and support to ensure they were competent in their role. Staff enjoyed working at the company and felt well supported by the management team. Staff worked with healthcare professionals and followed their guidance and advice about how to support people effectively.

Staff were kind and caring and treated people with dignity and respect. People had regular care staff who knew how they liked to be supported. Staff knew how to communicate with people to help people express their views and wishes.

People were supported to access their local community and enjoy activities and interests of their choice. The service supported people to maintain relationships that were important to them.

Information was provided to people in easy read formats to help people’s understanding, including how to make a complaint or raise concerns.

We made a recommendation about recording people's preferences around end of life care.

Systems and processes were in place to monitor safety and quality and drive improvements. People and staff were included in the running of the service and were provided with opportunities to share their ideas and give feedback.

Rating at last inspection: Good. (Last report published October 2016).

Why we inspected: This was a planned inspection based on the previous rating.

Follow up: We will continue to monitor all intelligence received about the service to ensure the next planned inspection is scheduled accordingly.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

This inspection was carried out on 19, 20, 27 July and 02 August 2016. We visited the locations where support is provided on 19 and 20 July and between 27 July and 02 August we spoke with relatives of people who used the service by telephone. This inspection was announced. We gave the provider 48 hours’ notice that we were coming because the service provides a supported living service to people in their own homes and we wanted to make sure that someone would be in. The service provides support to adults who have learning disabilities, autistic spectrum conditions, and/or mental health conditions. At the time of the inspection, seven people were being supported by the service in three different houses.

There were two registered managers 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.

The service had safeguards in place to protect people from the risk of harm. People’s support plans and risk assessments were detailed, person-centred and reflective of their changing needs. Medicines were managed and administered safely and people were supported to manage their own medicines if they wished to and where this was assessed as safe. The provider had recruitment processes in place to ensure people were supported by suitable staff and there were enough staff with the right skills and knowledge to meet people’s needs.

Staff received training which was relevant to their role and received regular supervision and support. Interactions between people and staff were positive and friendly and staff were knowledgeable about the people they supported. Staff had a sufficient understanding of the Mental Capacity Act 2005 (MCA) and associated regulations. Some capacity assessments and best interest decisions had not been appropriately documented.

People had enough to eat and drink. People did their own meal planning, shopping and cooking with support from staff. They were supported by caring staff, who understood their needs, promoted their rights, encouraged their independence and respected their privacy and dignity.

People had opportunities to contribute to their care and support and were included in reviews and meetings. People had plans and aspirations for the future and were supported to work towards these. People also had active social lives and participated in many community activities.

Although the formal, documented quality auditing process was not yet fully developed, the registered managers had strong leadership oversight of the service and took action to address shortfalls that were identified. People and their families had opportunities to share their views and there was a complaints policy which detailed how people could make a complaint if they wished.

At our last inspection on 21 November 2013, we had moderate concerns in relation to the lack of appropriate arrangements in place to deal with the management of medicines and record keeping.

The purpose of this visit was to check if improvements had been made.

During this inspection we spoke with two people these were the provider and one of the registered managers.

We found that the provider had made improvements in all areas. In relation to the management of medicines the provider had developed a robust recording tool and audit programme to monitor training and administration of medicines.

To cover record keeping the provider had re-formatted all care plans and risk assessments to ensure the carers were aware of people’s needs.

We found that staff had a good understanding of people's individual needs. We saw that people were treated respectfully and their individuality and diversity understood. The interaction we saw between staff and people was relaxed, friendly and enabling.

Some of the people using the service had given their consent to be supported with their care and treatment. However improvements were needed to ensure that where people may lack capacity their needs were formally assessed and appropriate actions taken to protect their best interests.

Medication management practice within the home did not protect service users against the risks associated with the unsafe use and management of medicines, by means of the making of appropriate arrangements for the obtaining, recording, handling, using, safe keeping, safe administration and disposal of medicines

Staff we spoke with said they had been properly recruited and trained. Staff told us that they received good support in their roles.

Care records we viewed did not ensure that service users were protected against the risks of unsafe or inappropriate care and treatment arising from a lack of proper information about them by means of the record keeping.