About the service:

Exclusive Care Limited is registered to provide personal care to people to people living in supported living settings, so that they can live in their own home as independently as possible.

People’s experience of using this service:

Previous breaches of regulations were now being met. This meant people experienced a better quality of care that was safely delivered and managed. However, some work continued to be needed to ensure that people's records were fully person centred and completed. The registered manager had an action plan to address this area.

People were kept safe from harm because assessments identified the key risks to their health and well-being. Plans were in place to respond to people’s needs. One person’s relative said, “[Person] is as safe with the staff as they are with us, I can’t fault the care at all.”

Staff received the information that they needed to provide people with individualised care and support. Staff were aware of people’s nutritional needs and supported these well.

People were supported by a sufficient number of staff who had been trained to keep people safe.

People’s medicines were now safely managed and administered as the prescriber intended.

Consent was now obtained in line with legal requirements, although improvement was required around documenting decisions made. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible. The newly developed policies and systems supported this practice.

People were cared for in a dignified manner. People’s confidential information was stored securely.

People were involved in the review and development of their care. People enjoyed a range of activities that met their individual interests.

Concerns and complaints were promptly responded to. People and relatives were confident to raise concerns when necessary.

People using the service and their relatives told us that the registered manager and other senior staff were approachable and could be contacted at any time.

Governance systems were now in place to monitor the quality of care provided. Leadership was now visible across the service, and staff, health professionals and relatives were all positive about the sustained improvements.

Registering the Right Support has values which include choice, promotion of independence and inclusion. The service has been developed and designed in line with the principles and values that underpin Registering the Right Support and other best practice guidance. This ensures that people who use the service can live as full a life as possible and achieve the best possible outcomes. The principles reflect the need for people with learning disabilities and/or autism to live meaningful lives that include control, choice, and independence. People using the service receive planned and co-ordinated person-centred support that is appropriate and inclusive for them.

Rating at last inspection: Inadequate. The inspection was carried out on 11,13, 18 and 23 July 2018 and the report was published on 21 August 2018. At this inspection the rating has improved.

Why we inspected: This comprehensive inspection was planned based upon the findings from our previous inspection. At that inspection we found six breaches of regulations, rated the service inadequate and placed the service in special measures. This was because staff were not aware and did not respond to people’s changing needs, people were not safely supported by enough staff. Those staff employed did not know how to keep people safe from harm or abuse or how to manage and administer medicines safely. Staff were not receiving appropriate training or development or being supported by the management team through regular appraisal and supervision. Staff told us they did not feel supported. Language used to describe people's behaviours or personalities was not dignified and people’s preferences were not always met. Care was no