This inspection took place on 26 April 2017 and was announced. We gave the provider 48 hours’ notice of our visit because the location provides a domiciliary care service [care at home]; we needed to make sure that there would be someone in the office at the time of our visit. The service was last inspected in December 2014 and at that time was meeting all the regulations.

Community Living and Support Services Limited are registered to provide personal care. The service provides care and support to two people who live in their own homes and to 36 people living in their own homes within 'supported living' accommodation. People's care and housing are provided under separate agreements; this inspection looked at their personal care and support arrangements.

There was a registered manager in post who was present throughout the inspection. 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 told us that the service provided to them was safe. Staff followed the appropriate safeguarding procedures to ensure the risk of harm to people was minimised. Sufficient staff had been employed following robust recruitment checks. We found that overall medicines management within the service were effective and people received their medicines as prescribed.

Staff received regular supervision and support. Training was provided to staff so they could meet people’s care needs. People’s rights were protected and they had choices in their daily lives. People received support to plan, make and prepare their meals. Staff worked with other healthcare professionals to ensure people’s healthcare needs were met.

People told us they were happy with the service provided. People described staff as kind and lovely. People were involved in making decisions about their own care needs. People were supported by a staff team who understood the importance of treating people with dignity and respect and promoting people's independence.

People’s support plans demonstrated that they were supported to have maximum choice and control of their lives. People were involved in developing and reviewing their support plans and individual needs. People were supported to choose and access activities which were of interest to them. People told us they were engaged and supported in day to day living skills. People were able to raise their concerns and processes were in place to ensure complaints were investigated and responded to.

The registered manager provided staff with appropriate leadership and support. The service sought people’s feedback through questionnaires, reviews and telephone contacts about the quality of the service. The registered manager assessed and monitored the quality of care consistently. However, some training records were incomplete and it was not possible to identify if all staff had the appropriate up to date knowledge and skills.

When we visited, the service was providing personal care to 26 people, some of whom were not able to give us their views because of their complex needs and conditions. We used a number of methods to understand the experiences of the people who used the service including speaking with the people, looking at care records and speaking with staff.

People who used the service were involved in planning their care. They were supported to make choices about the care they received. Where decisions were made on a person’s behalf they were done so with their agreement and in their best interest.

Care was planned and designed to meet the individual health and welfare needs of the people who used the service. A person we spoke to expressed confidence that their care was planned, managed and delivered with dignity in the way that was promised. They told us, “They know my needs and what I like”.

We saw that the provider had made suitable arrangements to ensure that people who used the service were safeguarded against the risk of abuse.

We found that people were cared for by staff who were supported to deliver care and treatment safely and to an appropriate standard. A member of staff told us, “I can discuss anything at my supervision and don’t feel I have to say what they want to hear”.

The provider was able to protect people from unsafe care and treatment by regularly assessing and monitoring the quality of the service provided.

When we visited, the service was providing personal care to 21 people some of whom were not able to give us their views because of their complex needs and conditions. We used a number of methods to understand the experiences of the people who used the service including speaking with the people, their relatives, looking at care records and speaking with staff and other care workers.

People told us that the workers caring for their relatives had a good manner, respected people's dignity and spoke to them as adults. One person who used the service told us, “The staff are very helpful, they seem to understand me”.

Care was planned and designed to meet the individual health and welfare needs of the people who used the service. A person we spoke to expressed confidence that their relative’s care was planned, managed and delivered with dignity in the way that was promised.

We saw that the provider had made suitable arrangements to ensure that people who used the service were safeguarded against the risk of abuse.

We found that the provider had robust recruitment processes in place to ensure people were cared for, or supported by, suitably qualified, skilled and experienced staff.

The provider was able to protect people from unsafe care and treatment by regularly assessing and monitoring the quality of the service provided.

This inspection took place on 5 and 12 December 2014 and was announced. The provider was given 48 hours’ notice of the first date of our office visit. This was because the location provides a domiciliary care service and we needed to be sure that we could speak to someone who co-ordinates the staff providing personal care. At our last inspection in March 2014 the service needed to make improvements to support people with the management of their diet, monitor that staff complied with the policies of the service and ensured that people received the service at the times it was commissioned. They responded to the actions and told us what they us were going to do. We found that improvements had been made in these areas.

At the time of the inspection the service was providing a personal care and support service to 11 people in their own homes and 21 people who lived in supported living flats.

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.

We spoke to some people who used the service on the telephone and some people came into the service’s office to speak with us. People we spoke with told us they liked the staff supporting them and felt safe when they were being supported. Staff understood what signs to look for that may indicate that a person was unhappy or being abused and were confident any concerns they had would be taken seriously.

People were being supported by enough suitably qualified and trained staff. Staff we spoke with were knowledgeable about the care that people needed. Staff had received suitable induction and training to meet the needs of people living in their own homes.

The Mental Capacity Act 2005 (MCA) states what must be done to ensure that the rights of people who may lack mental capacity to make decisions are protected, including when balancing autonomy and protection in relation to consent or refusal of care. The MCA Deprivation of Liberty Safeguards (DoLS) requires providers to submit applications to the Court of Protection for authority to deprive someone of their liberty. We did not find anyone being deprived of their liberty and people were being assisted to consider any choices that may be unsafe for them.

People were supported and encouraged to eat healthily and sufficient amounts to maintain their health and received their prescribed medicines safely. They had access to appropriate health care when needed and were supported to maintain and develop daily living skills. Professionals from social care and health backgrounds that we spoke with were happy with the support provided by the staff and management of the service.

Where the service was commissioned to support people with their leisure time we found that people were encouraged to look at work, educational courses and pursue their personal interests.

People who used the service told us that they could speak to staff and management about their concerns and told us that they would be listened to. The provider obtained feedback from people and involved relatives and professionals about the service to identify where improvements could be made.