Community Integrated Care, Leeds Regional Office provides a supported living service in 12 small homes, varying from two to five occupants, around Leeds. The service supports people with a learning disability, some of whom have additional disabilities. Each home is situated in a residential area, within walking distance of shops and local amenities and close to a main transport system into the city centre.

This comprehensive inspection took place on 1, 10 and 11 August 2017 and was announced. At the last inspection in June 2016 the service was found to require improvement to be safe, effective, responsive and well-led. At this inspection we found the required improvements had been made.

There was 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.

People received good care and support and they were encouraged to lead lives in line with their own preferences and choices. The emphasis was on supporting people to be as independent as possible. People were involved in making decisions about their care and how the service was run.

Care and support plans contained clear and up to date information about how people wanted their needs met. There were good opportunities for people to discuss any concerns or ideas that they had.

People were supported in having their day to day health needs met. Health services such as dentists, doctors and opticians were used as required and there were close links with other services such as the Leeds Community Learning Disability Team.

Staff were knowledgeable about the needs of each person and how they preferred to live their lives. Staff received the training they needed and were supported through regular supervision meetings with the registered manager. There were safe recruitment practices in place for new staff and there were a sufficient number of staff on duty to meet people’s needs.

There were good systems in place to keep people safe. Staff were confident about their responsibilities in relation to safeguarding and also knew who they could contact regarding any concerns they had about the service. There was a positive approach to risk taking so that people could be as independent as possible. Risks in peoples’ day to day lives had been identified and measures put in place to keep people safe. The focus was on how each person benefited from the activity undertaken.

Supported living homes were suitable for the people who used the service. Checks and tests were carried out regularly to make sure the environment was safe.

The legislative requirements of the Mental Capacity Act 2005 (MCA) and Deprivation of Liberty Safeguards (DoLS) were followed.

Staff told us that the service was well managed and there was good support. The registered manager promoted a culture of respect, involvement and independence. There were good systems in place to make sure that the quality of care was maintained. Areas that required improvement were identified and necessary action taken.

The inspection took place on 31 May 2016 and 01 June 2016 and both were announced. We carried out an inspection in April 2014, where we found the provider was meeting all the regulations we inspected.

Community Integrated Care, Leeds Regional Office provides personal care and support to people living in their own homes. They provide services to people with learning disabilities in a total of 14 supported living locations.

At the time of the inspection, the service had a manager registered with the Care Quality Commission (CQC). However, they were no longer in day to day control of the service. The provider had recently employed a temporary regional manager to oversee the locations. There were also service leads in post for each location who were responsible for the day to day running of the location. Some service leads were responsible for more than one location. 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 did not always receive appropriate training or ongoing or periodic supervision to make sure competence was maintained. Not all staff had received an induction. Recruitment practices were safe as background checks were carried out to ensure staff were suitable to work with vulnerable adults. The service leads, staff and people who used the service told us they thought there were enough staff.

The registered person did not have effective systems in place to monitor the overall quality of service delivery and provide support to the service leads at the locations.

Risk assessments were in place for people living in the locations. However, we saw some areas within the locations that were not maintained and some certificates and assessments were out of date. We noted there were infection control concerns in some of the locations.

We were not able to see from the training information provided if all staff had received training in the Mental Capacity Act (2005). People made decisions about what they wanted to do day to day. The care and support plans we looked did contain a decision making profile but we did not see any best interest decision documented. Some staff had received safeguarding training. All the staff we spoke with were able to recognise and respond to signs of abuse.

People’s needs were assessed and care and support was planned and delivered in line with their individual care needs. However, some care and support plans had not been reviewed for some months. People engaged in a range of activities, both in-house and in the community. We observed interactions between staff and people were friendly and knew how to respect people’s privacy and dignity.

On the whole medicines were safely managed. People’s health was monitored as required and people attended health care appointments. People’s nutritional needs were met.

People we spoke with were supported by members of staff to raise any complaints or concerns if they wished.

We found breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see the action we have told the provider to take at the end of this report.