This inspection took place on 13 December 2016 and was announced. We told the provider 24 hours before our visit that we would be coming. At our last inspection in August 2014, we found that the service was meeting all of the standards that we inspected.

EnhanceAble Living provides a domiciliary care service to over 50 people living in Kingston and the surrounding area. People who used the service had needs associated with a physical and/or learning disability, an acquired brain injury, autism or dementia. The support people received was to help enhance their social skills and prevent isolation because of their disability. Some people were not able to fully express their opinion of the service verbally but could communicate through Makaton signing and showing us pictures of the activities they took part in. Most people required some type of personal care during their support time. A few people only needed help with day-to-day tasks such as housework, shopping, meal preparation and household duties. We only looked at the service for people receiving personal care during this inspection as this is the service that is regulated by the Care Quality Commission.

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 2008 and associated Regulations about how the service is run.

People told us they felt safe with the support they received from staff. There were arrangements in place to help safeguard people from the risk of abuse. The provider had appropriate policies and procedures in place to inform people who used the service and staff how to report potential or suspected abuse. Staff we spoke with understood what constituted abuse and were aware of the steps to take to protect people.

People had risk assessments and risk management plans to reduce the likelihood of harm. Staff knew how to use the information to keep people safe. The provider ensured there were safe recruitment procedures in place to help protect people from the risks of being cared for by staff assessed to be unfit or unsuitable for the role.

Appropriate arrangements were in place in relation to administering and the recording of medicines which helped to ensure they were given to people safely.

Staff received training in areas of their work identified as essential by the provider. We saw documented evidence of this. This training enabled staff to support people effectively.

The registered manager had a good understanding of their responsibilities in relation to the Mental Capacity Act 2005. Records showed people were involved in making decisions about their care and support and their consent was sought and documented.

People were involved in planning the support they received and their views were sought when decisions needed to be made about how they were supported. The service involved them in discussions about any changes that needed to be made to keep them safe and promote their wellbeing.

The type of activities people engaged in were chosen by the person and tailored to meet their individual needs.

Staff respected people’s privacy and treated them with respect and dignity. Staff supported people according to their personalised care plans.

The provider encouraged people to raise any concerns they had and responded to them in a timely manner.

Staff gave positive feedback about the management of the service. The registered manager was approachable and fully engaged with providing good quality care for people who used the service. They encouraged a positive and open culture by being supportive to staff and by making themselves approachable.

The provider had systems in place to continually monitor the quality of the service and people were asked for their opinions about the service and action pl

People who used the service and their families told us that they felt well cared for, safe and very happy with the service they received. Comments included, “Absolutely exceptional”. "Do more than their job, nothing is too much trouble". We saw that risk assessments were completed as part of the care planning process and support plans detailed how the person liked to be supported and the tasks the support included.

There were effective recruitment and selection processes in place which included employment reference and Disclosure and Barring Service (DBS) checks (formerly known as Criminal Record Bureau (CRB) checks). We saw that staff received mandatory safeguarding training that was updated bi-annually as part of a rolling training programme.

The provider carried out a variety of quality assurance to assess and monitor the quality of care provided to people who used the service. People who used the service were aware of the complaints process and how to use it.

People we spoke with were positive and complimentary about the service that EnhanceAble Living provides. One person told us that the service was "wonderful" and that if it wasn't for the service he would be very lonely. Another praised the staff team and described them as "brilliant", saying his life had changed since moving from residential care to support in the community.

People told us that they felt they were able to do the things they wanted and that they received support from the service to help maintain their life in the community and to keep in touch with friends.

A single inspector carried out this inspection. The focus of the inspection was to answer five key questions: is the service safe, effective, caring, responsive and well-led? The summary describes what people using the service and the staff told us, what we observed and the records we looked at.

On the day of our inspection 50 people were using the services of EnhanceAble Living. All people using the service had some form of learning or physical disability. We looked at the care records of seven people, spoke with 11 people and four members of staff. We also emailed a questionnaire to 14 other members of staff.

Below is a summary of what we found.

Is the service safe?

Care plans were individually written and included comprehensive information about the person using the service. This helped staff to understand a person’s needs. Risk assessments relating to the care and support being provided were regularly reviewed to ensure people's individual needs were being met safely. The provider had a safeguarding vulnerable adults and children’s policy in place and staff had also received recent training.

Is the service effective?

People using the service had agreed and signed a contract detailing the hours and days that staff would work with them. Including a choice of the gender of staff that would help them and the type of help required. Care plans were reviewed annually with the person using the service

Staff were trained and supported by the manager. Staff received a range of training and regular one to one supervision and yearly appraisals.

Is the service caring?

The service was caring. People told us how they were helped by staff to achieve their goals of independent living and what that meant to them. People said “This service has transformed my life, staff are marvellous. I am now able to go out and about.”

Families that we spoke with said “This is an excellent service, because the staff are friends.” People commented that staff were always on time and ‘never let them down.’

Is the service responsive?

People's needs were reassessed on a regular basis and we saw the service responded to any changing needs.

There was a one page monthly round up of a person’s activities. These notes were especially helpful when more than one member of staff supported a person. They gave a clear picture of the activities a person had or hadn’t enjoyed and their progress towards independence.

Is the service well-led?

The service employed a manager who knew their staff and people well. Records showed that staff received a six week induction programme that included at least four weeks of shadowing more experienced staff.