FitzRoy Supported Living - Hodge Hill provides a supported living service to people with learning difficulties within their own homes so they can live as independently as possible. At the time of the inspection the service was providing personal care to 20 people who were living in their own homes within seven separate 'supported living' facilities all within proximity to each other.

The care service has been developed and designed in line with 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.

People’s experience of using this service:

The service people received was flexible and supported people with limited communication to lead unique and valued lives that incorporated their preferences and met their needs. Staff knew people well and could tell us how they managed risk and behaviours that challenge that respected the person and supported their dignity.

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.

Staff told us they had appropriate training, knowledge and support to keep people safe. Observations showed people were comfortable in the company of staff.

People and their relatives we spoke with felt confident in the management. They told us there was a caring culture within the service and staffing levels were appropriate.

It was clear staff morale was good and everyone was committed to ensuring people received care and support based on their preferences and life choices. The acting service manager told us the low staff turnover allowed positive relationships to be built with people receiving support and strong teamwork to develop.

People and their relatives were involved in the development of support plans. These were regularly reviewed to reflect people’s current needs. The management of risk was included within the support plan to minimise the likelihood of preventable harm occurring.

Staff files we looked at evidenced the acting service manager used the same safe recruitment procedures we found at our last inspection. Staff told us training was ongoing and they were supported to gain vocational qualifications in health and social care.

There was a complaints procedure which was made available to people and their family. People we spoke with told us they were happy with the support they received. The service continued to have good oversight of relevant procedures through monitoring and auditing to ensure people received effective support and the service was well led.

The acting service manager used a variety of methods to assess and monitor the quality of the service. We noted activities were provided as part of the support people received. Staff told us they supported people to activities that enhanced their physical and mental wellbeing.

The service engaged with outside agencies to ensure people received timely healthcare support. The management team engaged with other agencies to gain updates on legislation, best practice and learn from other providers experiences.

More information in the full report.

Rating at last inspection:

Good (Report published 27 April 2016)

Why we inspected:

This was a planned comprehensive inspection based on the rating at the last inspection.

Follow up:

We will continue to monitor intelligence we receive about the service until we return to visit as per our re-inspection programme or if any issues or concerns are identified.

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

Our inspection was announced and took place on 24 March 2016. We gave the provider 48 hours’ notice that we would be visiting the service. This was because we wanted to make sure staff were available to answer any questions we had or provide information that we needed. We also wanted the registered manager to ask people who used the service if we could visit them in their home. At our last inspection on 20 November 2013 the service was meeting all of the regulations that we assessed.

The service is registered to provide personal care to people in their own homes. At the time of the inspection the service was providing personal care to 13 people who were living in their own home’s within five separate ‘supported living’ facilities all within close proximity to each other.

There was a registered manager in post and they were present during our inspection. 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 felt safe using the service and they were protected from the risk of abuse because the provider had systems in place to minimise the risk of abuse.

People were supported by staff that were kind, caring and respectful and knew them well. People were treated with dignity and respect. Staff understood people’s needs well. Staff received the training and support they needed to carry out their role.

Staff had a good understanding of risks associated with people’s care needs and knew how to support them. There were enough staff to support people safely. Recruitment procedures ensured that only staff of a suitable character to care for people were employed.

Medicines were stored and administered safely, and people received their medicines as prescribed. People were supported to have their healthcare needs met.

The registered manager and staff understood the principles of the Mental Capacity Act 2005 (MCA) and Deprivation of Liberty Safeguards (DoLS), and supported people in line with these principles. People were supported to make everyday decisions themselves, which helped them to maintain their independence.

People were supported to eat and drink food that met their dietary requirements and that they enjoyed eating.

There were systems in place to ensure that the service was assessed and the quality of care provided to people was monitored.

The service was previously registered as a care home and had transferred to ‘supported living’ recently. The service consisted of four flats with three people living in each and a bungalow for one person. There were 13 people being supported by the service when we inspected.

We visited the office where the service is organised from and we also visited the flats where people lived. We met with nine people, five staff, the deputy manager and registered manager.

We saw that people were relaxed and comfortable with staff. Staff that we spoke with had a good understanding of the needs of the people they supported. One person told us, "The staff are good and help me to go to lots of different places". Another person said, "I am okay, the staff are okay".

We found that systems were in place to ensure that people received their medication safely as prescribed by their GP.

Robust recruitment practice ensured that only staff that were suitable to work with vulnerable people had been employed.

Staff were supported, supervised and trained to provide safe and effective care.

Effective systems were in place for assessing and monitoring the quality of the service so that people benefited from a well- managed service.