This inspection took place on 21 and 22 March 2017 and was announced.

The previous inspection was carried out on 29 October 2015 and was rated as requires improvement. Recommendations were made that care plans and risk assessments should be reviewed on a regular basis and that the registered provider should seek advice and guidance on a suitable audit system. An action plan was received which showed that improvements would be made. At this inspection we saw that relevant improvements had been made.

Deafness Support Network (DSN) provides personal care and support to people who are D/deaf. The support is carried out in their own homes. The agency provides support for up to twenty-four adults who are D/deaf and may have dual sensory impairment; learning disability; physical disability or mental health problems. The office is situated in the suburbs of Northwich, near to all the town's amenities and within easy access to main road networks. People live within one of four houses which are situated near to the office. At the time of our inspection there were 23 people using the service.

The word Deaf (with a capital D) is used to denote an individual whose first language is British Sign Language (BSL), whilst the term D/deaf is widely recognised by service professionals and refers to everyone with a hearing loss which includes Deaf, deafened and hard of hearing. D/deaf will be used throughout this report.

There was a registered manager employed to work at the service. They had been registered with the Care Quality Commission for six years. 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 the previous inspection on 29 October 2015 we made two recommendations: that the registered manager ensured that care plans and risk assessment documentation should be reviewed to ensure they are kept up to date and accurate; and that the service sought advice and guidance from a reputable source about a suitable audit system for the service. We saw that improvements had been made and that care plans and risk assessments were clear and up to date and a new audit system was in place.

People told us they were happy with the service provided and that the staff were caring, kind and friendly. People said “The staff are good”, “I have no complaints” and “Staff are kind.”

Staff told us they enjoyed working at the service and providing support to people. They said they were supported by the team leaders and registered manager.

Care plans were person centred, well documented and up to date. They gave clear guidance to the staff team. Risk assessments were undertaken for a variety of tasks and these were reviewed regularly and up to date. The management of medication was safe.

Staff were aware of how to report a safeguarding concern. They were aware of the policies and procedures available to safeguard people from harm and told us they would not hesitate to report any concerns.

Staff had a good understanding of their responsibilities in relation to the Mental Capacity Act 2005 (MCA). Care records demonstrated people's involvement in decision making. Mental capacity assessments were completed and best interest meetings took place when needed.

Staff had received a range of training that included moving and handling, safeguarding, medication and health, safety and fire. All staff had either to use British Sign Language as their first language or have attained BSL level 2 within two years of employment. A range of other training was available to the staff team. Staff told us that the training was good. Staff had access to supervision sessions, annual appraisals and were invited to attend regular staff meetings.

Staff recruitment files showed that robust rec

We inspected this service on 29 October 2015 and gave short notice to the provider prior to our visit.

This domiciliary care service is owned by Cheshire Deaf Society and is registered to provide personal care to adults who have a sensory impairment. The agency provides services to twenty-four adults who are D/deaf and may have dual sensory impairment; learning disability; physical disability or mental health diagnosis. The service is situated in Northwich, close to local shops. The service is provided to people living in their own accommodation, rented through a partner landlord. This arrangement is often known as ‘supported living’. At the time of our inspection there were 23 people who received a service.

The word Deaf (with a capital D) is used to denote an individual whose first language is British Sign Language (BSL), while the term D/deaf is widely recognised by care service professionals and refers to everyone with a hearing loss which includes Deaf, deaf, deafened and hard-of-hearing. D/deaf will be used throughout this report.

There was a registered manager employed to work at 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 told us they were well supported by the staff team and that they were kind towards them.

Care plans were available for all of the people who used the service. These included sufficient information to enable staff to meet people’s needs. Also included were risk assessments, how the individual communicated and a health action plan. Some care plans and risk assessments were not up to date and a recommendation was made regarding these.

Recruitment systems were in place and pre-employment checks were carried out. Staff received a full induction to understand their role and to ensure they had the skills to meet people’s specific needs. However some documentation was not available or missing and the registered manager stated they would review this area.

People told us they felt safe and secure. People received care and support from a team of established care staff who knew them well. Staff were aware of safeguarding procedures and were confident they would report any concerns.

Staff had a full understanding of the specialist care and support people required. Training and support for staff was undertaken and focused on the specialist needs of people using the service.

Staff told us they were supported by the registered manager. Staff had regular staff meetings with their line manager as well as an annual appraisal.

Some audit processes were in place to monitor and manage how care and support was being delivered and took account of accidents and incidents, as well concerns and complaints. Further audits with regard to care plans, medication and service user falls would be of benefit and a recommendation was made.

A complaints policy was available to people who used the service and no complaints had been received since the last inspection. CQC had not received any complaints regarding this agency.

We looked at three support plans and other care records and all had an assessment of their health and social needs completed.

We spoke with four people who used the service, three staff and professionals involved in the service. People who used the service said “I like the staff”, “I am involved in my support plan” and “Sometimes I get bored.” All the people spoken with said they didn’t have any concerns or complaints. Staff commented “The staff team work well together”, “We have regular team meetings”, “The best part of my job is supporting the people who use the service and the friendly staff team” and “The manager is fair, friendly and has high standards.” Other professionals commented “The staff are very good. They are attentive and well informed about patients needs", "They provide a wonderful service" and "The staff seem to interact well with the clients."

We looked at staffing levels at the service. We saw the rota and discussed staffing issues with the manager.

We saw that Deafness Support Network had not received any formal complaints since the last inspection and the Commission had not received any complaints about the service.

We observed interactions between the people who used the service and staff during the day and found there was a relaxed and friendly atmosphere between them.

We spoke with seven people who used the service. They told us that the staff were kind and that they were supported to be independent and to learn new skills. One person said they were happy where they were and that they found the staff supportive and caring. Another person said its boring here, not much happening but I am glad I have a job. People were pleased that the service employed both Deaf and hearing staff.

We spoke with five staff members and they confirmed that they liked working at Deafness Support Network. Many of the staff said that the shifts of twelve hours was long and at times tiring. Some people said they didn't have time for meal breaks and other people said that staff took it in turns to go and have a break and a meal.