This inspection took place on 20th December and was announced. Domiciliary Care Agency is part of Autism Anglia and provides a supported living service to people with autism spectrum disorder who have a learning disability. At the time of inspection 30 people were being supported by the service to live in their own homes.

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 2008and associated Regulations about how the service is run.

Staff were trained in how to protect people from abuse and harm. They knew how to recognise signs of abuse and how to report any concerns and use the whistleblowing procedure if necessary.

Risks to people were well managed as staff knew the people they cared for and were provided with clear guidance to reduce identified risks and protect people from harm.

There were sufficient staff numbers with arrangements in place which meant that people received one to one care to meet their specific needs.

Staff were recruited safely. All staff were subject to a probation period and to disciplinary procedures if they did not meet the required standards of practice.

Medicines were stored, administered and recorded safely and correctly. Staff were trained in the safe administration of medicines and maintained relevant records that were accurate.

All of the staff received regular training in mandatory subjects as well as specialist training which was specific to the needs of people using the service. This provided staff with the knowledge and skills to meet people’s needs in an effective and individualised way.

The service supported its staff through supervision and appraisal to maintain and develop their professional skills and were committed and pro-active in supporting people to grow and develop and provide people with positive care experiences.

People’s consent to care and treatment was sought in line with current legislation. All staff and management were trained in the principles of the Mental Capacity Act (MCA) 2005 and management understood their responsibilities to make appropriate applications to the court of protection when people were being deprived of their liberty.

A flexible approach to mealtimes was used to ensure people could access suitable amounts of food and drink that met their individual preferences and promoted their independence.

Staff supported people to attend healthcare appointments and liaised with their GP and other healthcare professionals as required.

Effective communication practices were employed by staff using a range of methods tailored to individual needs. Staff responded to meet people’s needs promptly and treated people with kindness and compassion.

People were able to spend private time when they chose to and their privacy was respected and maintained at all times.

The service thoroughly assessed people’s needs and care plans gave clear guidance on how people were to be supported. Care was personalised so that each person’s support plan reflected their preferences.

The organisation placed people at the heart of the service and they were supported to attend a range of educational and occupational activities as well as being able to develop their own independent living skills.

Staff supported people to undertake a choice of leisure activities within the home and in the community.

There was an effective complaints procedure in place and complaints were responded to appropriately.

The service was well led with systems in place to check that the care of people was effective, the staffing levels sufficient and staff appropriately trained so they had the skills to provide safe care and support. Quality assurance systems were in place to obtain feedback, monitor performance and drive improvements.

As part of our inspection we accompanied a member of staff when they visited two of the supported living schemes. We were introduced to four people who used the service and met their support workers.

We observed that staff worked in a caring and professional manner. We found staff were knowledgeable about people’s individual needs, and worked positively with other providers to support people’s educational, health and social care needs.

One person who used the service described to us how staff had supported them to become more confident and independent. They told us that staff, “Are not here to tell you what to do, but guide you in the right direction.”

We also gained feedback from one person's relative and a social care professional who had worked closely with the service. One of these people told us how staff enabled, “Individual growth,” by providing opportunities for people to access meaningful activities.

People who used, had contact, or worked with the service, told us that they felt it was well led. This was because the management and staff focused on the people who used it, and demonstrated a commitment to ensuring people received person centred care.

We found the provider had appropriate arrangements in place to manage medicines, to ensure people’s safety and wellbeing.

We found there were enough, experienced and skilled staff to be able to provide people with a flexible service.

Relatives of people who completed surveys as part of the agency’s own quality assurance system were complimentary about the service. They made positive comments about staff saying “The staff have a very good relationship with [our relative] and know [them] very well. [Our relative] remains happy and settled with all his carers.” Another relative said “Thank you everyone who works so hard with [our relative] to ensure [their] life is happy and fulfilled. We know that many staff go beyond the call of duty to support [our relative] and this means so much to us.”

We found that the agency had a wide range of policies and procedures in place for the safe running of the agency. We saw that record keeping was well organised and the provider was able to provide all relevant records when requested.

Most of the people who use this service have some difficulty understanding and responding to verbal and non verbal communication.

However those people with whom we spoke said that they enjoyed being in their home and that the staff were kind. Two people said that they were always doing something interesting and different.