At our last inspection in June 2017 we found two breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. These were breaches of Regulation 18, Staffing and Regulation 12, Safe care and treatment. The registered provider sent us a report saying what action they were going to take to meet the requirements of the regulations. We carried out this inspection to check whether the service had completed these actions. We found the service had made sufficient improvement.

The Cottam Road service provides care and support to people living in three supported living settings, Cottam Road, Cherry Trees and Brindley Crescent, so people 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. The registered provider head office is based at the Cottam Road site. At the time of our inspection the service was supporting 26 people.

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. Registering the Right Support CQC policy.

The service had a registered manager in post at the time of our 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.

At our last inspection we found there was not enough staff deployed to meet the needs of people using the service at the Cottam Road supporting living site. People had not always being able to pursue their chosen activities because there was not staff member available to support them. At this inspection we found that sufficient improvement had been made. At this inspection, people we spoke with did not raise any concerns about the staffing levels at the service and not being able to pursue activities.

People we spoke with all said they felt 'safe'. Staff had undertaken safeguarding training and were knowledgeable about their roles and responsibilities in keeping people safe from harm.

Detailed risk management plans were in place to guide staff on the action to take to mitigate the identified risks.

At our last inspection we found concerns about the management of medicines. At this inspection we saw that on-going action was being taken to monitor and reduce errors. Additional checks had been implemented to improve the management of medicines. Staff had received training and their competency to administer medicines had been checked.

Some people using the service had been actively involved in recruiting new staff for the service. The registered provider carried out checks to ensure people employed were of good character.

There were systems in place to monitor incidents and accidents. There were arrangements in place for the service to make sure that action was taken and lessons learned when things went wrong, to improve safety across the service.

People and relatives we spoke with were happy with the care and support provided. People made positive comments about the staff.

People were involved in developing their support plans, which were person-centred and kept under review.

At our last inspection we found that staff had not been given appropriate support through a programme of on-going supervision and appraisal. At this inspection we saw a robust system had been put in place to ensure staff received appropriate support.

People were supported to have maximum choice and control of their lives and staff supported them in the

The inspection was carried out 20 June 2017 and was unannounced, which meant the provider and staff did not know we would be visiting. This was the first inspection we have carried out at this location since the provider changed their registration.

Cottam Road is registered to provide personal care and support to people within their own homes and in their local community. The service provided includes personal care, cooking meals and daily activities. The service has three supported living locations at Cottam Road, Cranworth Close and Brindley Crescent which are in Sheffield and Rotherham. The registered provider head office is based at the Cottam Road location. At the time of this inspection the service was supporting 28 people who wished to retain their independence and continue living in their own home.

There was 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.

Staff were not always provided in enough numbers to meet the needs of the people who used the service. This meant people had not received the support they needed to pursue their chosen activities.

We checked the records of medicine administration. We found there had been a number of medicine administration errors. The registered manager told us they were working with the pharmacist to improve the medicines administration and to ensure all staff were competent in the procedures.

A system had been introduced for the double checking of medicines administered 30 minutes after their due time by another member staff that was not involved in the administration, due to the number of medicine errors. However in only 50% of cases was this a different member of staff. Staff said this was because there was not always another staff member available to check.

Staff knew how to report any safeguarding issues they may become aware of or witness. They knew they had a duty to protect people and had received training in how to recognise abuse and how to report this to the proper authorities.

Staff had been recruited safely and checks had been done to ensure people who used the service were not exposed to staff who had been banned from working with vulnerable people.

Staff were not given appropriate support through a programme of on-going supervision and appraisal.

People were encouraged to maintain a healthy lifestyle. This included being provided with meals that took into consideration their preferences and being supported to access healthcare professionals.

The service followed the requirements of the Mental Capacity Act 2005 Code of practice and Deprivation of Liberty Safeguards. This helped to protect the rights of people who were not able to make important decisions for themselves.

Staff were observed as being kind, caring, and treating people with dignity and respect. There was an open, trusting relationship between the people being supported and staff. Staff understood people's needs.

Care plans were written with the person, with support from their families/advocates where appropriate. People were supported to be involved in identifying their care and support needs. People's likes and preferences were recorded and staff knew the people well.

On the whole we saw people were supported to be involved in activities within their home and in the community. People, who were able to, made choices about how they spent their time and where they went. Staff told us activities were “quite often” cancelled when staffing numbers were low.

The registered provider had a complaints procedure in place, which people who used the service could access. Any learning from the investigation of complaints was shared with the staff.

The registered provider and registered