The inspection took place on 19 October 2016 and was an announced inspection. This meant that we gave the service notice of our arrival so that we could meet with people used the service.

The service is registered to provide personal care to people in their own homes. People who used this service were living together in shared houses. On the day of our visit 19 people were using the service. The service provided care and support to people with learning disabilities.

There were two registered managers for this service, one of these was on annual leave at the time of our visit and therefore we spoke with just one 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.

People and their relatives told us that people were safe using the service. Staff were trained in adult safeguarding procedures and knew what to do if they considered someone was at risk of harm, or if they needed to report concerns.

There were systems in place to identify risks and protect people from harm. Risk assessments were in place and carried out by staff that were competent to do so. Risk assessments recorded what action staff should take if someone was at risk and referrals were made to appropriate health care professionals to minimise risk going forward.

There were sufficient staff to keep people safe and meet their needs, and the registered managers had followed safe recruitment procedures. Staff were competent with medicines management and could explain the processes that were followed. Policies and procedures were in place to guide staff in relation to the Mental Capacity Act 2005. The registered managers understood that there should be processes in place for ensuring decisions were made in people’s best interests. Staff sought consent from people and recorded this.

Staff were caring, knew people well, and supported people in a dignified and respectful way. Staff maintained people’s privacy. Relatives felt that staff were understanding of people’s needs and had positive working relationships with people.

Care provided was individualised according to each person’s needs and preferences. People and their relatives were involved in assessment and reviews of their needs. Staff had knowledge of changing needs and made relevant changes to care records with the people who used the service.

People and staff knew how to raise concerns and these were dealt with appropriately. The views of people, relatives, health and social care professionals were sought as part of the quality assurance process. Quality assurance systems were in place to regularly review the quality of the service that was provided.