Crimson Hill Support provides support and personal care for people with learning disabilities and mental health conditions who live in their own homes. The agency is registered to provide personal care to people of all ages including children. They specialise in providing support to people with complex needs and behaviour that may challenge themselves or others. At the time of the inspection they provided personal care to approximately 50 people living in Somerset.

At our last inspection, we rated the service good. At this inspection, we found the evidence continued to support the rating of good and there was no evidence or information from our inspection and on going monitoring that demonstrated serious risks or concerns. This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection.

At this inspection, we found the service remained Good.

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.

People told us they felt safe. Staff understood how to recognise and report signs of abuse or mistreatment. Staff had received training on how to recognise the various forms of abuse, which was regularly updated and refreshed. The provider carried out risk assessments to identify any risks to people using the service and to the staff supporting them. There was a lone working policy, which staff knew about. Safe recruitment processes were completed.

There were sufficient numbers of staff available to keep people safe. There was a stable staff team which provided people with continuity of care. The rota recorded details of people’s visit times and which staff would provide the visit. The registered manager or team leaders were on call outside of office hours and carried details of the rota, telephone numbers of people using the service and staff with them.

Staff supported people safely with their medicines if required. Staff followed good infection control practice. Staff knew the reporting process for any accidents or incidents. Records showed that the provider had taken appropriate action where necessary, and made changes to reduce the risk of a re-occurrence of an incident. The service had suitable processes to assess people’s needs and choices, the registered manager went out to assess people prior to a package of care commencing to check the service could meet the person’s needs.

Staff had appropriate skills, knowledge and experience to deliver effective care and support. All new staff completed the Care Certificate. The Care Certificate is an identified set of national standards that health and social care workers should follow when they are new to working in the care sector. Records showed staff received comprehensive training, which enabled them to carry out their roles effectively. Staff received regular supervision and appraisal from the registered manager and team leaders. Staff completed food hygiene training, they knew about good practice when it came to nutrition and hydration.

Staff asked people for their consent before delivering care or support and they respected people’s choice to refuse care. Care records showed that people signed a contract of care where they gave their consent to the care and support provided. All the people we spoke with said they had been included from the beginning in every aspect of planning their care.

The provider was responsive to people’s needs. Staff supported people, and involved them, (as far as they were able), to draw up and agree their own support plan. All the relatives we spoke with said they had very good communication with all staff at every level and were involved in thei

This inspection was unannounced and took place on 25, 28 and 30 September 2015. The inspection was carried out by one inspector. The last inspection of the service was carried out on 17 October 2013. No concerns were identified with the care being provided to people at that inspection.

The service provides support and personal care for people with learning disabilities and mental health conditions who live in their own homes. The agency is able to provide a service to people of all ages including children. They specialise in providing support to people with complex needs and behaviour that may challenge themselves or others. At the time of the inspection they provided support to approximately 50 people living in Somerset.

One of the providers is also the registered manager of the service. 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 who used the service had been involved and consulted in drawing up and agreeing a plan of their care and support needs as far as they were able. Where appropriate close members of their family had also been consulted. The care plans were detailed and set out the goals each person had identified that would help them gain greater independence. Risks to their health and safety had been assessed and people had been consulted and involved in drawing up measures to reduce the risks where possible.

People received support from staff who were caring, patient and understanding. One person told us “The care workers are all nice” and a relative described the staff as “gentle”. Staff spoke with pride in their jobs and gave examples of how colleagues had gone ‘above and beyond’ their call of duty to help people become happier and achieve a better quality of life. Comments from staff included “Staff have a genuine affection for people. We care. There are some amazing staff.”

There were enough staff to meet people’s complex needs and to care for them safely. People were protected from the risk of abuse and avoidable harm through appropriate policies, procedures and staff training. Staff received relevant training to effectively support each person’s mental and physical health needs. Staff were positive and enthusiastic. Comments included “It’s a wonderful place to work” and “They are a good employer”.

The agency worked closely with health and social care professionals to ensure each person received a support package that was tailored to meet their individual needs. A social worker told us “It is refreshing to come across an agency who know what the service users need and are prepared to go that extra mile to meet that need.”

Medicines were administered safely by staff who had been trained and were competent.

People were supported to participate in a variety of social activities in the community. The service had good local links to promote people’s involvement in the community.

People were supported to maintain good health. Staff supported and encouraged people to eat healthy and nutritious foods. Staff from the service supported people to attend hospital and community appointments when needed.

The provider had a range of monitoring systems in place to ensure the service ran smoothly and to identify where improvements were needed. Action plans were in place to show how improvements would be made. People were encouraged to speak out and raise concerns, complaints or suggestions in a variety of ways. Regular staff meetings were held and staff told us they could speak out in these meetings. We also saw evidence of formal complaints raised with the manager and these had been investigated and responded to.