The inspection was announced and carried out on 25 August 2016.

The service was last inspected on 09 May 2014, when we found the service to be compliant with all the regulations we assessed at that time.

Imagine, Act and Succeed (IAS), is a local registered charity that provides support services for adults whose primary need for care is due to their learning disability. Support is provided for people with varying complex needs, who choose to live alone or in a shared service. IAS 71-73 supports people in the Wigan and Leigh area. At the time of the inspection there were 102 people receiving support from IAS.

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.

We received excellent feedback from people receiving support, their relatives and healthcare professionals regarding the support provided by IAS. One relative told us; “There was nobody more indulged and protected than [person]. Nothing is too much trouble here, this is their home now. [Person] is very happy and so am I. [Person] has done things that I would never have dreamed they would do. I would recommend IAS without a shadow of a doubt.”

People who used the service told us they felt safe and we found suitable safeguarding procedures in place which were designed to protect vulnerable people from abuse and the risk of abuse. The service had a robust recruitment process which included a Disclosure and Barring Service (DBS) check having been undertaken and suitable references obtained before new staff commenced employment. People received the level of support required to safely manage their medicines. Risks to people's health and safety were managed and plans were in place to enable staff to support people safely. There were sufficient numbers of staff to ensure people's needs were met.

People were supported by staff teams that received tailored training that reflected their individual needs, and how they wanted and needed to receive their care. Staff put their training into practice and delivered outstanding, effective care. One relative commented at the positive difference in their relative and described them as having had a complete change in personality since receiving support from IAS.

We looked at the service policy guidance on the Mental Capacity Act (MCA) and whether appropriate authority had been obtained when depriving a person of their liberty. We saw that the service had been involved with other professionals undertaking mental capacity assessments. Staff demonstrated a good understanding of the requirements of MCA and deprivation of liberty and confirmed they received annual training, known as cascade, which included this as part of their safeguarding training.

People were supported by staff that were creative in their ways of communicating with people to ensure they understood people’s needs. Staff encouraged people to maintain their independence and to develop new skills and confidence to empower people receiving support to try new experiences.

The service had a culture of individualised care which placed people at the heart of the service. Positive and caring relationships had developed between staff and people who used the service and staff recognised the importance of people maintaining and developing new friendships. People were treated with dignity and respect and equality and diversity was recognised through effective person centred care planning.

People told us staff provided consistent personalised care and support. Care records were focused on empowering people to achieve their goals and aspirations.

People were promoted to live full and active lives. IAS had developed further services built upon people’s aspiratio

Our inspection team was co-ordinated and carried out by an inspector from the Care Quality Commission who helped answer our five questions; is the service caring? Is the service responsive? Is the service safe? Is the service effective? Is the service well led?

As part of our inspection we visited four of the houses where people were supported by staff from IAS. Below is a summary of what we found. The summary is based on our observations during the inspection, speaking with people who used the service, their relatives, the staff supporting them and from looking at records.

If you want to see the evidence supporting our summary please read the full report.

Is the service safe?

We spoke with five people who used the service during our inspection who told us they felt treated with respect and dignity by staff at all times. People told us they felt safe and comfortable in the presence of staff. The provider had systems in place in relation to the Mental Capacity Act and Deprivation of Liberty Safeguards although no applications had been submitted to the local authority. This means people were safeguarded as required.

Systems were in place to ensure managers and staff learnt from events such as accidents and incidents, complaints, concerns, whistleblowing and investigations. This reduced the risks to people and helped the service to continually improve.

We found people’s nutrition and hydration needs were met safely. People had ‘food and drink’ support plans in place which captured information such as allergies, likes, dislikes and whether people required assistance to eat and drink.

We looked at staff recruitment files and found staff were recruited safely. This included ensuring a minimum of two references were obtained and DBS (Disclosure Barring Service) checks made.

Is the service effective?

There was an advocacy service available if people needed it, this meant when required people could access additional support.

People’s health and care needs were assessed with them, and they were involved in the creation of their support plans. Specialist dietary, mobility and equipment needs had been identified in support plans where required. Two people we spoke with told us they recalled being involved in their support plan review which was done each year.

People’s needs were taken into account with the layout of each house which enabled people to move around freely and safely. The premises had been sensitively adapted to meet the needs of people with physical impairments and had suitable disabled access if required.

Is the service caring?

People were supported by kind and attentive staff. On the day of our inspection we observed staff spoke to people in a caring manner and were patient and understanding in respect of their varying support needs. People’s preferences, interests, aspirations and diverse needs had been recorded and care and support was provided in accordance with people’s wishes.

We visited people in their own homes. Some lived on their own (with support from staff), others received constant support from staff on a supported living basis. People spoke positively about the support they received. Comments included; “I have been with IAS roughly 18 months. The support is good. Very good. I like going out. I’m supported with food preparation and domestic tasks. I work at the office on a Friday and I really like it” and “I’m happy, I like it” and “I go out with staff and choose what food I would like” and “I’m happy with my care and support overall” and “The staff are very good”.

Is the service responsive?

The people we spoke with told us they had access to a range of activities in and outside the service regularly. People told us they were supported by their carers to attend appointments in the local community when required.

There was a complaints procedure in place. People knew how to make a complaint if they were unhappy but had never been given reason to. People can therefore be assured that complaints are investigated and action is taken as necessary when required.

There were other various quality assurance systems in place. These included the sending of surveys to people who used the surveys, audits, house checks and through regular discussions during the annual support plan review.

Is the service well-led?

The service worked well with other agencies and services to make sure people received their care in a joined up way. We saw evidence in support plans of involvement with doctors, dentist and opticians.

There were several quality assurance systems in place. We looked at a sample of these which identified shortfalls were addressed promptly. Quality assurance systems included surveys, tenant/staff meetings and annual support plan reviews.

The staff we spoke with were clear about their roles and responsibilities and told us they developed good relationships with people who used the service over time. This helped to ensure people received a good quality service at all times.

We saw recorded evidence of the person's consent to the decisions that had been agreed around their care. We noted that people who used the service and their support team had been involved in completing assessments of social and personal care needs. People also had detailed plans about how support staff were to meet their needs and promote their safety and wellbeing.

We met with four people who received support from IAS and observed that staff were providing safe and appropriate care. The relationships we saw during the home visits were warm, dignified and respectful.

The agency had a safeguarding policy in place. This included local procedures which staff would follow if they needed to report an alleged incident to the correct authorities. This was designed to ensure that any possible problems that arose were dealt with openly and people were protected from possible harm.

There was a consistent team of staff within the service and we did not have any concerns regarding either their numbers or suitability. All staff spoken with demonstrated that they had been well trained and supported to undertake their various roles. It was noted that staff turnover was very low and staff told us that this was indicative of the way they were managed, supported and valued by the provider, IAS.

Information about the safety and quality of the services provided was gathered on a continuous and ongoing basis to include feedback from the people who used the service.

“We receive information by emails, phone calls and newsletters; they are very good at communicating”.

“I attend the family forums, they listen to what we say and always take action”.

“The staff are astounding, they look after my brother brilliantly”.

“I feel safe and happy here, the staff look after me”.

“I regularly carry out quality visits with a staff member, it’s a good system and I hope more relatives are encouraged to take part”.

We spoke with two people who were using the service and two relatives.

Their comments were very positive and everyone agreed that they liked the service provided. They used words to describe it such as

'' The staff are very personable and helpful. They are keen to support my relative in the way that they want.''

'' Staff always have my relatives best interests at heart. ''

'' All the staff are brilliant.''

People expressed a lot of confidence in the staff and the managers and felt that they had no problems.Everyone spoken with knew how to access staff, the managers and how to make a complaint.

We found that documentation showed that staff followed company procedures and that the daily records were signed by staff members

We contacted the quality monitoring team from the local social services department. They stated that they had no concerns about this service provider