About the service:

Estuary Community Support and Supported Living Services is a domiciliary care agency. It provides personal care to people with learning disabilities and/or autistic spectrum disorder living in their own houses and flats in the community. It also provides care and support to people living in five 'supported living' settings so that they can live in their own home as independently as possible. People's care and housing are provided under separate contractual agreements. CQC does not regulate premises used for supported living; this inspection looked at people’s personal care and support.

At the time of our inspection, 47 people were using the service.

People’s experience of using this service:

• The service embraced the values that underpin the ‘Registering the Right Support’ and other best practice guidance. These values include choice, promotion of independence and inclusion. People with learning disabilities and autism using the service can live as ordinary a life as any citizen.

• Safe recruitment systems were in place. Staff received an induction to the service and on-going training, supervision, and support to enable them to effectively perform their roles and meet people’s individual care and support needs.

• Risks to people had been assessed and staff knew what to do to keep people safe from avoidable harm. Where required, people received support to take their prescribed medicines safely.

• Staff knew people well, and they were kind and sensitive to people’s needs. Positive relationships had been formed between staff and people using the service. People told us staff were friendly and helpful and treated them with dignity and respect.

• People received person centred care. A holistic approach was taken to assessing, planning and delivering care and support. Staff had access to up to date information and care and support was provided in line with people’s preferences and needs.

• Staff embraced the registered provider’s visions and values to deliver a high-quality person-centred service, helping people to continue living in their own home, maintain their independence and lead happy and fulfilled lives.

• People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice.

• People were supported to eat and drink enough to ensure they maintained a balanced diet. Referrals to other health professionals were made when required.

• People were actively encouraged to express their views on the service they received and be involved in the running of the service.

• There were effective quality assurance systems in place to drive continuous improvement.

Rating at last inspection: At our last inspection, the service was rated ‘Good’. Our last report was published on 9 March 2016.

Why we inspected: This was a planned inspection based on the ratings at the last inspection.

Follow up: We will continue to monitor this service and plan to inspect in line with our re-inspection schedule for those services rated Good.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

This inspection took place on 19 January 2016, 8 February 2016 and 26 February 2016 was unannounced and carried out by one inspector.

Estuary Community Support and Supported Living Services provide a mixture of services to younger adults who have learning disabilities and/or autistic spectrum disorder. People may be either living in their own homes in the community or in one of the services’ supported living schemes.

There were two registered managers in post, one managed community services and the other managed the supported living schemes. 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. Both registered managers were responsible for this location.

People received their care and support in a way that ensured their safety and welfare. Staff knew how to protect people from the risk of harm. They had been trained and had access to guidance and information to support them with the process. Risks to people’s health and safety had been assessed and the service had support plans and risk assessments in place to ensure people were cared for safely.

Sufficient numbers of staff had been safely recruited, they were well trained and supported to meet people’s accessed needs and preferences. People received their medication as prescribed. Where people’s medication was managed by the service there were safe systems in place for receiving, administering and disposing of medicines.

Registered managers and staff had a good understanding of the Mental Capacity Act (MCA) 2005 and Deprivation of Liberty Safeguards (DoLS). Appropriate DoLS applications had been made when needed in the supported living schemes.

People were supported to have sufficient food and drink to meet their individual needs. Their support needs had been assessed and the support plans gave staff the information they needed to meet people’s individual needs safely. People’s healthcare needs were monitored and staff had sought advice and guidance from healthcare professionals appropriately.

Staff knew the people they supported well and were kind, caring and compassionate. They ensured that people’s privacy and dignity was maintained at all times. People expressed their views and opinions and they participated in activities both in the supported living schemes and in the local community.

People concerns or complaints were listened to and acted upon. There was an effective system in place to assess and monitor the quality of the service and to drive improvements.

People told us that they felt well treated. They said that they had received good information about the service. Some people told us that they had participated in meetings where they had discussed whether or not the service had met their needs. Other people said they had the opportunity to go to meetings but had not wanted to go so were asked by staff if they were happy with the service. People said that they had been fully involved in writing their care and support plans.

People told us that they had received a full assessment of their needs before moving in and that they were regularly asked about their care. They told us that the staff were nice, kind and always friendly. People said that they felt safe when the agency’s staff visited their homes. They told us that the staff knew what they were doing and they believed they must be well trained. People told us that they were happy with the quality of care provided by Estuary Community Support.

Most of the people using the service had given their consent to be supported with their care and treatment. However improvements were needed to ensure that where people may lack capacity their needs were formally assessed and appropriate actions taken to protect their best interests.

When people started to use the service an initial assessment was carried out that took into account their cultural, religious and individual needs. The support plans had been developed from the information in the initial assessment. They were person centred and reflected people’s individuality, choice and preferences.

People were protected against the risk and spread of infection because the provider had effective systems in place.

People received their care and treatment from care workers who had been properly trained, supported and supervised.

People received safe, effective and compassionate care from a well led service that responds quickly to their changing needs.