The inspection took place on 26 September 2018 and was announced. The last inspection was carried out on 5 August 2015 and the service was rated good overall and in all domains.

Lifeways is a national supported living scheme. Lifeways (Bolton) provides support for people living in the community in group home settings and caters for people with a diverse range of needs, such as learning disabilities, autism and acquired brain injuries. The office is located in Bolton and a small car park is available.

People lived in their own flats within houses with some communal areas and shared facilities. There was an office within the houses and sleep-in room for staff. The service could accommodate 121 people. At the time of the inspection there were 111 people using the service and 12 vacancies.

The registered manager had left the service, but the area manager, who had worked at the service for a significant length of time, was in the process of registering. 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 told us they felt safe within the service. Safeguarding training was undertaken by all staff and they were aware of how to recognise and report any concerns. There was a whistle-blowing hotline for employees to report any poor practice they may witness. Staff recruitment was robust and there were sufficient staff deployed to ensure people’s needs were met.

Health and safety measures were in place for all properties and checks were carried out at each property on a weekly basis. General and environmental risk assessments were in place and were updated as required.

Medicines systems were safe and staff received appropriate training in medicines administration. There was an infection control policy, risk assessments were in place and staff undertook regular training in this area.

Initial assessments and risk screens were completed when people were referred into the service. Care files included a range of health and personal information and details of support needs.

Documents could be produced in easy read, or other formats to help people be fully involved in all aspects of their support.

The staff induction programme was comprehensive and on-going training opportunities for staff were plentiful. Supervisions were undertaken on a regular basis and there were annual appraisals.

The service was working within the legal requirements of the Mental Capacity Act 2005 (MCA). Capacity and consent was assessed for each individual and best interests decisions made where necessary with input from relevant professionals, family and advocates.

People we spoke with were positive about their support. We observed staff interactions with people and saw that they were respectful, kind and friendly. All staff had training in dignity and people’s privacy and dignity was respected.

The service was committed to inclusion and encouraged people to be involved with their support planning as much as they were able. Confidentiality was respected and records were kept securely by the service.

Staff supported people to increase and maintain independence, ensuring people were encouraged to do as much as they could for themselves. Where people had capacity, the service ensured they had all the information available to enable them to make informed decisions and choices.

Care files were person-centred and included information contributed by the person who used the service and/or family members. People we spoke with were supported to attend college or with work placements and had a number of leisure activities and hobbies that they pursued with support from staff.

There were regular tenants’ meetings in each of the properties and quarterly service user foru

The inspection took place on 05 August 2015. We gave the provider 48 hours’ notice because the location provides a domiciliary care service and we needed to be sure that a member of the management team would available on the day.

Lifeways is a national supported living scheme. Lifeways (Bolton) provides support for people living in the community in group home settings and caters for people with a diverse range of needs, such as learning disabilities, autism and acquired brain injuries. The office is located in Bolton but was previously registered in a location in Chorley. This was the first inspection of the service at this location.

The service had 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 we spoke with who used the service, and their relatives, told us they felt safe. If anyone did not feel safe this was addressed immediately by the service. Every effort was made to ensure compatibility when placing people in supported living placements.

We saw there were sufficient staff to attend to people’s needs and staffing levels were arranged according to the individual needs of the people who used the service. Staff were recruited safely, with all the correct checks in place.

Safeguarding issues were addressed appropriately and in a timely manner. We saw that the service had attended and contributed to strategy meetings where appropriate and had accurately documented issues and outcomes. Personal risk assessments were thorough and were in place within the service. Health and safety processes were followed and equipment and premises were checked and maintained by the service.

There was an up to date and appropriate medication policy. Medicines were given safely by trained staff. Regular medicine audits were undertaken by the service.

Staff were given a thorough induction within the service, which was tailored to their particular requirements. Training was on-going throughout their employment and supervisions and appraisals were undertaken on a regular basis.

Care plans were complete and up to date and there was evidence that other professionals and agencies were consulted when required. Consent was sought from people who used the service, if they had capacity. The service worked within the requirements of the Mental Capacity Act (2005) (MCA).

All the people who used the service, relatives and professionals we spoke with told us the staff were kind and caring. We saw that people’s dignity and privacy were respected by staff.

There was evidence within the care plans that people who used the service were fully involved with their own service provision. People were encouraged to be as independent as possible and were supported to do as much as possible for themselves.

Staff advocated for people who used the service in forums such as multi-agency meetings. Information was produced in easy read format to be as inclusive as possible.

Care plans were person centred and individualised and outlined people’s preferences, likes and dislikes. These plans were reviewed on a regular basis to ensure all information was up to date. We saw evidence that staff endeavoured to give people choice in what they did.

There were regular service user group meetings and tenants meetings. These gave people who used the service the opportunity to raise any concerns or make suggestions to improve the service. Regular satisfaction questionnaires were also sent out to people who used the service and their relatives to ascertain their level of satisfaction with the service.

There was an up to date complaints policy and complaints were taken seriously and addressed appropriately by the service.

People we spoke with all told us the management were approachable, helpful and supportive. There was always a member of the management team who was contactable for help and support.

A number of audits were carried out at the service. The results of these were analysed to identify any patterns or trends and used to inform continual improvement to service delivery.

Staff meetings were held regularly, giving a forum for staff to discuss work issues and put forward suggestions. The service attended and contributed to a number of multi-agency meetings to help ensure continuing good working relationships with other agencies and professionals.