About the service: East Cheshire Housing Consortium is community based and provides individuals, primarily those with mental health problems, with short or long-term housing and support. They were providing personal care to 91 individuals at the time of the inspection. People they supported lived in a range of different accommodation including 24-hour housing, day time supported tenancies and individual tenancies with domiciliary support.

People’s experience of using this service:

The management of people's medicines was not always safe.

People who used the service had comprehensive and person-centred risk assessments and care plans to guide staff supporting them. Staff supported people with positive risk taking and understood how to keep people safe.

People who used the service and staff told us they felt staffing was not always sufficient. There had been a high use of agency and casual workers, people told us they were not always satisfied with this. We saw the provider had taken action to recruit the right standard of staff and this had taken some time. However, consistency of the same agency and casual workers had been considered when staffing rotas were devised.

People who received care in their own homes told us they were happy with call times and if a call was missed due to their absence the service would make contact with them.

The provider had systems to guide staff about how to deal with any allegations of abuse.

Staff reported accidents and incidents to the registered manager. The registered manager told us about their plans to improve the way incident analysis was recorded.

The service did not have a policy and procedure to guide staff in how to protect themselves, people who they support and visitors from infectious disease. Staff received training in infection prevention and we were told there had not been any outbreaks of infectious disease.

Pre-admission assessments were detailed and the information collated was formally communicated to the staff team. This meant known risks for individuals were effectively mitigated.

There were shortfalls in training for new and casual staff. Long term staff told us that they had received suitable training to enable them to support people in a safe and effective way. During the inspection the registered manager evidenced scheduled training for all staff.

The provider did not always ensure people's consent to care and treatment was sought in line with the Mental Capacity Act 2005.

People were supported to maintain a healthy lifestyle and they were provided with choice and control.

People told us they felt confident to raise their concerns.

People told us they were supported by staff in a kind, dignified and respectful way. Our observations saw staff engage with people in a genuine and caring way. Staff and people they supported had formed positive relationships and respected each other.

The service involved people in decisions made about their care and supported people to attend regular health and social care reviews. The service engaged with multi-agency professionals and their guidance was recorded and followed.

People were supported to live an enriched life and engage in things that were important for them. The service provided specialist support for people with a broad range of mental health problems and this was done in a person-centred and non-discriminative way.

The service was implementing an end of life and bereavement policy at the time of the inspection. They had made links with the local hospice.

The registered manager was transparent and responsive to inspection feedback. During the inspection they told us about how they would address the failings found at the inspection.

Improvements were needed to ensure the service was assessed for quality and outcomes for people who accessed the service. The service had oversight by two senior support managers and a registered manager who shared responsibilities across all of the schemes. People and staf