The inspection was carried out on 5 and 10 September 2018 and was announced.

IDEM Living Ltd is a domiciliary care service offering support to people within supported living accommodation. The service supports 10 people within the Huyton area of Liverpool.

The service has 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 a legal responsibility for meeting the requirements of the Health and Social Care Act 2008 and associated Regulations about how the service is run.

At this inspection we found the service remained Good. The service is rated Good as it had met all the requirements of the fundamental standards.

The registered provider continued to have safe recruitment practices in place. All staff had completed an induction and the Care certificate at the start of their employment and undertaken shadow shifts with an experienced member of staff. Mandatory training was consistently completed as well as refresher training in accordance with good practice guidelines. Staff received support through supervision. Staff told us they felt well supported and spoke positively about the management team.

Staff had a good understanding of how to safeguard the people they supported. The registered provider had safeguarding policies and procedures in place that staff understood and felt confident about raising any concern they had.

People had their needs assessed before they were supported by the service. This information was used to develop person centred care plans and risk assessments that reflected people's individual needs and preferences. People's needs that related to age, disability, religion or other protected characteristics were considered throughout the assessment and care planning process. Staff had a good understanding of people's histories, likes, dislikes and preferred routines. People were supported to undertake activities of their choice and their independence was promoted. Staff supported people with their food and drink needs.

Medicines were managed safely in accordance with best practice guidelines. There were medicines policies and procedures in place that offered clear guidance to staff. Medicines training had been completed and staff had their competency regularly assessed.

Staff had developed positive relationships with the people they supported. People's independence was promoted through documentation and interactions observed between people and staff. Privacy and dignity of people with respected and they were consistently offered choice.

The registered provider had a clear complaints policy and procedure in place available in accessible formats. Relatives told us they felt confident to raise any concerns and thought they would be listened to and acted upon.

The Care Quality Commission is required by law to monitor the operation of the Mental Capacity Act (MCA) 2005 and report on what we found. We saw that the registered provider had policies and procedures available for staff to follow in relation to the MCA. Staff demonstrated a basic understanding of this and had all completed training.

The registered provider had audit systems in place that were used to highlight areas of development and improvement within the service. Feedback was regularly sought from people, relatives, staff, as well as health and social care professionals.

Policies and procedures were available for staff to offer them guidance within their role and employment. These were regularly reviewed and updated by the registered provider.

Further information is in the detailed findings below.

The inspection was announced and took place on 7 December 2015. We give community based adult social care services 48 hours’ notice to ensure we can access the information we need. This was IDEM Livings first comprehensive inspection since they were registered by CQC in April 2015.

IDEM Living support people to live independently in their own homes. They also offer outreach support to people within the community. The service currently provides personal care and support to 5 people in the Huyton and surrounding area of Liverpool.

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.

Relatives told us they felt their family members were safe. Comments included “(Name) feels is very safe and extremely well supported” and “The team really listens to the family and the communication is excellent”.

Staff had received training in how to recognise and report abuse. All staff were clear about how to report concerns and were confident that any allegations made would be fully investigated to help ensure people were protected. There were sufficient numbers of suitably qualified staff to meet the needs of the people who used the service.

People were supported to take their medicines by staff that were appropriately trained. People received care and support from regular staff that knew them very well, and had the knowledge and skills to meet people’s individual needs. People told us staff always treated them respectfully and promoted choice regarding their care, support and the activities they participated in. People and their relatives spoke very positively about staff, their comments included “I am happy with my support team and the care I receive” and ”Best support I have ever had for (Name)”.

Before people started using the service the registered manager visited them to assess their needs and discuss how the service could meet these. From these assessments individualised care plans were developed with the person and their relatives to agree how the care and support would be provided.

Care plans provided staff with clear direction and guidance about how to meet people’s individual needs. The service was flexible and responded to people’s needs. Relatives told us how well staff responded to individuals and always ensured they went the extra mile. They also told us the team always welcomed suggestions to improve the service further.

People said they would not hesitate to speak to staff if they had any concerns about the service they received. People and their relatives knew how to make a formal complaint if they needed to. One relative said, “I did have cause to raise a concern with the registered manager and I was made up by the very prompt action by IDEM and the communication throughout”.

There was a management structure within the service which provided clear lines of responsibility and accountability. There was a positive culture within the service, the management team provided strong leadership and led by example. Staff said “I have never been so well supported by a company” and “I feel really valued as an employee”.

There were quality assurance systems in place to make sure that any areas for improvement were identified and addressed. Members of the management team were visible in the service and regularly visited people in their homes and sought their views about the service. One person said “I am always welcome when I visit the office with my staff” and “Staff are always looking at ways to improve the quality of my life”.