Keiron Starns Care Agency provides care and support to three people with learning disabilities living in the community.

This service provides care and support to people living in one 'supported living' setting, so that they can live in their own home as independently as possible. People's care and housing are provided under separate contractual agreements. CQC does not regulate premises used for supported living; this inspection looked at people’s personal care and support.

At our last inspection we rated the service good. At this inspection we found the evidence continued to support the rating of good and there was no evidence or information from our inspection and ongoing monitoring that demonstrated serious risks or concerns. This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection.

People said they felt safe. Staff knew how to keep people safe. Risk assessments were in place and we saw examples of positive risk taking. These enabled people to be as independent as possible whilst maintaining their safety. Safe recruitment processes were undertaken. Medicines were managed safely.

Staff had been trained to carry out their roles. They had regular supervision sessions with the registered manager and all said they felt well supported. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice. One relative said, “[Person’s name] has developed a great deal more independence and confidence since he has opted for independent living.”

We observed many positive interactions between staff and people using the service. One person said, “Staff are nice. They make me laugh.” Staff we spoke with spoke passionately about the support they provided.

Support plans were person centred and clearly detailed people’s preferences and choices about how they wanted to be supported. People were involved in writing and reviewing their plans. There was a complaints procedure in place. No complaints had been received since our last inspection.

The registered manager was a visible presence. Their values were clearly embedded in the service. Staff told us the registered manager was “very, very good” and “brilliant.” One relative said, “[Registered manager] has ensured that my son is able to develop his skills through enrolling him in college and finding him employment in the community.” There were quality assurance processes in place.

Further information is in the detailed findings below.

Keiron Starns Care Agency provides personal care for two people with learning disabilities who live in their own home.

This inspection took place on 29 October 2015. We gave short notice of the inspection, to ensure someone was available to assist us with the inspection.

There was a registered manager in post at the service. 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 and associated Regulations about how the service is run.

People who use the service and visiting professionals were positive about the care provided. Comments included, “All staff work in a caring and supportive manner….respecting their needs and choices” and “care received seems really good”. People received support to take their medicines and risks people faced were managed safely.

There were systems in place to protect people from abuse and harm and staff knew how to use them. Staff understood the needs of people they were supporting.

Staff received training suitable to their role and an induction when they started working for the service. They demonstrated a good understanding of their roles and responsibilities, as well as the values and philosophy of the service.

People were supported to develop clear support plans, setting out their needs and how they would like staff to support them. The plans were regularly reviewed with people to ensure they were kept up to date.

There was strong management in the service and the registered manager was clear about how they expected staff to support people. The registered manager assessed and monitored the quality of care and took action to address any shortfalls that were identified.

The service had been inspected 26 September 2013 and found to be non- compliant in one area. The service told us it would be compliant by October 2013.This inspection was a scheduled inspection but also checked on the area of non-compliance.

One inspector visited the service and answered our five questions, Is the service caring? Is the service responsive? Is the service safe? Is the service effective? Is the service well led?

Below is a summary of what we found. The summary is based on our observations during the inspection, speaking with people using the service, 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?

People’s needs were assessed and reviewed regularly to ensure they were being met safely.

Care plans instructed staff how to meet people’s needs in a way which minimised risk for the individual.

People were supported to access healthcare services, as necessary.

At this inspection medication was administered safely and at the correct times to ensure people’s health and well-being.

Care workers were recruited safely and all necessary checks were undertaken before they started to work alone.

Systems were in place to make sure that the manager and staff continually monitored the quality of care offered to people. Health and safety was taken seriously by the service and all the appropriate policies and procedures were in place.

Is the service effective?

The service met people’s needs and worked with them to involve them in all aspects of daily living. We saw that people were given opportunities to make as many decisions for themselves as they were able. People were supported to be as independent as possible.

People told us they were: ‘‘very happy living in our home’’. They told us that they enjoyed their activities and their life.

Is the service caring?

We saw that care workers were knowledgeable about people’s individual needs and treated them with great respect and dignity.

People were being accompanied on a holiday to enhance their experience and lifestyle.

People’s preferences, interests and diverse needs had been recorded and care and support had been provided in accordance with people’s wishes.

Is the service responsive?

The service had a variety of ways of listening to people who used the service. People were invited to staff meetings so that they could fully participate in the running of the service.

The service made changes to their medication procedures in response to the last Care Quality Commission inspection.

Is the service well-led?

Staff told us that they received formal supervisions and were always able to contact senior staff for support, if necessary. They told us they had never been asked to do anything they were not confident with and always received the appropriate help and guidance from the manager.

The manager of the service was knowledgeable about the needs of the people who used the service. They had robust methods of supporting and monitoring staff.

The service had a quality assurance system, records seen by us showed that the service had identified shortfalls and risks within the service.

Keiron Starns agency provides 24 hour support to three people who live in a shared house. The two people we spoke with told us about the decisions they made each day. One person told us they had refused preventative treatment. We were told this decision had been respected by the staff.

People knew they had a care record and they knew staff wrote about them. The two people we asked told us they discussed their needs with the manager. One person said “I tell the manager the clothes I want to buy.” They told us there was one to one time with staff each week and they attended day care centres. One person said “I go to the bank, we go shopping and I buy biscuits we have a drink.”

People told us the staff administered medicines. We saw improvements were needed to ensure people were not placed at risk from unsafe management of medicines.

The two people we asked told us if they were not happy they would tell the manager. Staff knew to observe for changes in people’s behaviour, as this might be a sign of problems. Staff knew how to approach people to establish the cause of the problem.

We spoke with two of the three people the agency provided personal care for, one relative of a person who used the agency and a social care professional.

The people we spoke with said they liked the staff and a discussion had taken place with the provider about their care and the facilities offered. Both individuals said they made decisions about their care and treatment which included making decisions about having flu vaccines.

The people we asked said their privacy was respected. They said they were able to close their bedroom doors but the doors were not lockable. We were told it was not necessary to have a key to their bedrooms.

People told us how the staff helped them. They told us the staff helped them to change their bed, they were helped with cooking and they participated in household chores such as dusting and vacuuming.

We saw people were supported to participate in group activities such as bowling and watching football games. The social care professional told us provisions had been made for people to be offered more opportunities for one to one support.

The relative we spoke with said the same standard of care was observed when they visited the home.

People told us they felt safe. The relative we asked said they had no concerns about the safety of their relative who used the agency.