This inspection took place on 21 and 30 May 2018. At the last inspection on 9 December 2015, we did not give a rating to the service as there was only one person using it. There was not enough information about the experiences of a sufficient number of people using the service over a consistent period of time to give a rating to each of the five questions and an overall rating for the service.

Karma Liv-in is a ‘care home’. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection. The service provides accommodation and support with personal care for up to five adults with learning disabilities, mental health needs and/or physical disabilities. At the time of our visit, there were three people using the service.

There was a registered manager in place. 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 spoke positively about the care and support they received and felt safe using the service. Staff were knowledgeable about safeguarding and knew how to identify and raise safeguarding concerns to keep people safe. Risks associated with people's care and support had been assessed.

The provider had robust staff recruitment procedures which ensured that staff had the appropriate skills and experience for the role. People were supported by enough staff to meet their individual needs and wishes.

People were supported to take their medicines safely. There was a policy and procedure about safe administration of medicines. Staff had been trained to administer medicines in a safe manner.

Staff were supported to maintain and develop their skills through training and development opportunities. They had regular contact with the registered manager to discuss any issues or concerns they might have relating to people's care and support.

The provider had policies and procedures in relation to the Mental Capacity Act 2005 and Deprivation of Liberty Safeguards (DoLS) and staff understood when an application should be made, and how to submit one. Before people received any care or support they were routinely asked for their consent.

People were involved in the assessment and planning of their care and support. Each person had a care plan outlining how they needed support and how they liked to be helped. Referrals were made to health care professionals for additional support or guidance if people’s health changed.

People were supported with their meals to ensure they received food and drinks they liked to help keep them as healthy as possible. They were treated with dignity and respect and staff were kind and respectful to them.

Staff supported people to maintain their independence where possible. People were able to make choices about their care and their views were taken into account. Staff understood the need to respect people's privacy.

There was an open culture within the service, which was focussed on people. Staff were clear about their roles and responsibilities and had access to policies and procedures to inform and guide them.

Systems were in place to monitor the quality of the service and action was taken when it was identified that improvements were required. There was a system in place to tell people and their representatives on how to make a complaint.

This inspection took place on 9 December 2015 and was unannounced. There was no previous inspection as the service started operating in March 2015. We did not give a rating to the service as there was only one person using the service. There was not enough information about the experiences of a sufficient number of people using the service over a consistent period of time to give a rating to each of the five questions and an overall rating for the service.

Karma Liv-in provides accommodation and support with personal care for up to five adults with learning disabilities, mental health needs and/or physical disabilities.

There was a registered manager in place. 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 found staff understood what constituted abuse or poor practice and systems were in place to protect people from the risk of harm. Potential risks to people’s health and well-being were identified, reviewed and managed effectively.

Effective recruitment practices were followed to ensure staff employed were suitable to support people and there were sufficient numbers of staff available to meet people’s individual needs.

Staff received training and support to deliver a good quality of care to people and a training programme was in place to address identified training needs.

People were involved in planning the care and support provided by the service. They received health support from staff that knew them well and understood their individual needs.

The registered manager and staff understood their responsibility to comply with the requirements of the Mental Capacity Act 2005 (MCA) and Deprivation of Liberty Safeguards (DoLS).

The staff had developed good relationships with local healthcare services which meant people received the specialist support required.

Staff were caring in their approach and had a good understanding of people’s likes, dislikes and preferences. People’s privacy and dignity were respected.

There were effective management systems to monitor and improve the quality of service provided. The registered manager sought feedback about the service from people who used the service, their relatives and other health professionals.