Herts and Essex independence at home was inspected on 13 and 16 April 2018 and the inspection was announced. A previous inspection was undertaken in May 2016 and the service was rated good. At this inspection we found that the service had retained its overall good rating and had continued to develop in specific areas and as a result we have rated caring as outstanding.

Herts and Essex independence at home provides care and support to people living in specialist housing. The accommodation is the occupant’s own home. People’s care and housing are provided under separate contractual agreements. CQC does not regulate the premises; this inspection looked at people’s personal care and support service.

People using this service lived in two ordinary flats and one house shared by four people. The properties were all located in the Bishops Stortford areas. As part of the inspection we visited the main office which was located in Saffron Walden and two of the properties where people were supported. In total the service supported six people with a learning disability.

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.

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. A key principle is that people with learning disabilities and autism can live as ordinary a life as any citizen.

People spoke highly of the service and the quality of care they received. Relatives echoed this and told us that they would not hesitate to recommend the service to others.

People were assisted to develop their skills and live their life as independently as possible. They were empowered to have a voice and realise their potential. They were supported to work and had good access to their local community enabling them to lead a full and interesting life.

Staff were clear about their responsibilities and the values that underpinned their work. Care was person centred and focussed on the needs of the individual. People’s needs were regularly reviewed and they were supported by a consistent staff team who knew them well. Staff had excellent relationships with people and their relatives. Any concerns or issues were addressed in an open and transparent way. Staff had access to regular training opportunities to ensure that their skills and knowledge was kept up to date.

There were sufficient numbers of staff who were used flexibility to meet people’s individual needs.

Recruitment procedures had been strengthened since the last inspection and were well organised, providing safeguards to people.

Staff were clear about the actions they needed to take to protect people and manage the risks associated with their care. The staff worked alongside a number of professionals to promote peoples wellbeing. People were supported with their nutrition and medicines. Staff were trained in medicine administration and regular audits were undertaken to identify shortfalls and learning.

The manager was approachable and staff were motivated and enabled to contribute to the service development. There was a quality assurance system in place to drive forward continuous improvement.

Herts and Essex independence at home is a supported living service which supports people with a Learning disability in their own homes. This support includes assistance with personal care, shopping, domestic and social activities. On the day of our visit there were five people being supported in two properties in Bishops Stortford. We visited the head office and one of the properties as part of the inspection.

This was the first inspection of this service since it was registered with the Care Quality Commission (CQC). The inspection was announced and we gave the provider notice as we needed to make sure that someone would be in when we visited.

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 were happy with the support provided and were listened to. Relationships with staff were positive and people were supported to lead interesting and fulfilling lives.

There were systems in place to safeguard people and staff were clear about the actions they needed to take to protect people. People were supported to be independent and risks were identified and managed.

There were sufficient numbers of staff who were used flexibility to meet people’s individual needs.

Recruitment procedures were in place but they did not fully protect people. However, the manager immediately changed the systems in place to ensure that people were not placed at risk.

People were supported to take their medicines as prescribed. Staff were trained and regular audits were undertaken to identify shortfalls and learning.

Staff received induction training to prepare them for their role and make them aware of the ethos of the organisation. Ongoing training was provided to ensure that staff skills and knowledge was kept up to date.

The principles of consent and capacity were understood and people’s wishes were respected. People were supported to access healthcare and there were clear plans in place for those individuals with specific health conditions. People were supported to prepare meals and to eat a varied and nutritious diet.

Staff knew individuals and their relatives well. Staff knowledge was underpinned by care plans which were detailed and informative. Regular reviews were undertaken of people’s needs and care plans amended accordingly. People were supported to access a range of employment and leisure opportunities in the local community.

The service was managed in a positive way. The manager was approachable and staff were well motivated and encouraged to contribute to the service development. There was a quality assurance system in place to drive forward continuous improvement