There was a registered manager in post. 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. In this report when we speak about both the company and the registered manager we refer to them as being, ‘the registered persons’.

At the last inspection on the service was rated, ‘Good’.

At the present inspection the service remained, ‘Good’. Suitable quality checks were being completed and had ensured that there were enough staff on duty. In addition, people told us that they received person-centred care.

There were systems, processes and practices to safeguard people from situations in which they may experience abuse including financial mistreatment. Risks to people’s safety had been assessed, monitored and managed so they were supported to stay safe while their freedom was respected. Medicines were managed safely. Background checks had been completed before new staff had been appointed.

Furthermore, there were arrangements to prevent and control infection and lessons had been learned when things had gone wrong.

Staff had been supported to deliver care in line with current best practice guidance. People were helped to eat and drink enough to maintain a balanced diet. In addition, suitable steps had been taken to ensure that people received coordinated and person-centred care when they used or moved between different services. People had access to healthcare services so that they received on-going healthcare support.

People were supported to have maximum choice and control of their lives. Staff supported them in the least restrictive ways possible. The policies and systems in the service supported this practice.

People were treated with kindness, respect and compassion and they were given emotional support when needed. They had also been supported to express their views and be actively involved in making decisions about their care as far as possible. People had access to lay advocates if necessary. In addition, confidential information was kept private.

Information was provided to people in an accessible manner. In addition, people had been supported to pursue their hobbies and interests. The registered manager recognised the importance of promoting equality and diversity. People’s concerns and complaints were listened and responded to in order to improve the quality of care. Arrangements had been made to support people at the end of their life.

There was a registered manager who promoted a positive culture in the service that was focused upon achieving good outcomes for people. They had also taken steps to enable the service to meet regulatory requirements. Staff had been helped to understand their responsibilities to develop good team work and to speak out if they had any concerns. People, their relatives and members of staff had been consulted about making improvements in the service. The provider had put in place arrangements that were designed to enable the service to learn, innovate and ensure its sustainability. There were arrangements for working in partnership with other agencies to support the development of joined-up care.

Further information is in the detailed findings below.

Housing and support Solutions provides personal care and support for people in their own homes who have a learning disability or autistic spectrum disorder and also in supported living settings. The service can provide care for adults of all ages. At the time of our inspection the service was providing support for 13 people. The service covered Lincoln and surrounding areas.

There was not a registered manager in post at the time of 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.

Staff knew how to respond to any concerns that might arise so that people were kept safe from harm. People had been supported to safely manage medicines. Risk assessments were in place to help keep people safe. There were enough staff to provide support to people. Background checks had been completed before new staff were appointed.

Staff had received training and support to help them to support people in the right way. This included being able to assist people to eat and drink enough in order to stay well. In addition, people had been supported to receive healthcare if they needed it.

The provider and staff were following the Mental Capacity Act 2005 (MCA). This act is intended to ensure that people are supported to make decisions for themselves. When this is not possible the Act requires that decisions are taken in people’s best interests.

Staff recognised people’s right to privacy, promoted their dignity and respected confidential information.

People had been consulted about the support they wanted to receive and they had been given the assistance they needed. Staff had supported people to pursue their interests and hobbies. There was a system for resolving complaints which was accessible to people.

Regular quality checks had been carried out to ensure that people received the appropriate support. Staff were supported to raise concerns. The service was run in an open and relaxed way.

People who used the service told us they were treated with respect and care and that support was delivered according to individual assessed needs. Consent policies and procedures were in the process of being reviewed. People told us they were "involved in the planning of their care". People said that staff were kind and assisted them with all aspects of their care. We reviewed a sample of care plans and noted they were person centred and enabled people to be supported, without deskilling people.

We were shown the complaints policy and noted that complaints were investigated appropriately. The staff we spoke with showed a good knowledge of safeguarding policies and procedures and demonstrated how they would recognise and report suspected abuse. The provider is required to notify the Care Quality Commission without delay about events relating to the health and wellbeing of people who used the service. We found that the provider had recorded accidents and incidents appropriately, but they had not always sent the notifications to the Care Quality Commission. The Manager agreed to review this process immediately, to ensure that these would be correctly reported in the future.

We saw people’s choices and preferences were reflected in the care plans and written in a way that promoted independence and reflected their diverse needs, circumstances and aspirations. Pictures were used throughout the care plans so they could be accessible to people. We looked at people’s health actions plans which were written by the person themselves or with assistance from their support worker. We saw the plan described their personal preferences and how they wished their care to be delivered.

One relative told us, “I have no qualms with the service. They keep XXX’s house clean and re-decorate whenever it’s necessary. If something’s not right I go into the office and talk with the managers and they sort things out.”

During our visit we asked staff if they felt they were supported to do their job and they told us they had regular supervisions and staff meetings and felt able to raise any issues with senior staff and management and were confident that these issues would be dealt with appropriately.

Whilst each person’s key worker was responsible for the day-to-day maintenance of their care plan, it was evident team leaders and the registered manager undertook checks on all documents relating to the support people were given on a monthly basis. In addition, a weekly audit on people’s personal finances was undertaken each week. This confirmed the service was regularly monitored and assessed to ensure people were provided with safe care and support.