This inspection took place on 16, 17, 18, 19 and 24 May 2017. The provider was given 24 hours' notice to make sure someone would be in.

Lifeways Community Care (Sunderland) provides a supported living service to people within their own homes or shared houses. The service provides personal care and support to 88 people across several local authorities in the North East. People who use the service have learning disabilities, autism spectrum disorders and/or physical disabilities. People who use the service are supported with personal care, medicines, cooking, shopping, activities and other day to day tasks.

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

We have made a recommendation about medicines. This was because the procedures for the administration of 'when required' medicines and topical creams were not always robust as there was no clear guidance for staff to refer to.

People and their relatives told us the service was safe as people were well looked after. Staff told us they were confident any concerns they raised would be listened to and investigated thoroughly to ensure people were protected. Staff had completed up to date training on safeguarding adults, and could describe different types of abuse and signs to look out for.

A thorough recruitment and selection process was in place which ensured staff had the right skills and experience to support people who used the service. Identity and background checks had been completed which included references from previous employers and a Disclosure and Barring Service (DBS) check.

Contingency arrangements were in place in case of accidents or staff emergencies and on-call management arrangements were in place. Each person had a Personal Emergency Evacuation Plan (PEEP), which provided staff with information about how to support them to evacuate the building in an emergency situation such as a fire or flood.

Staff training in key areas was up to date. Staff told us they felt confident to care for the people who used the service.

People were supported to maintain a balanced diet and to have enough to eat and drink. People were supported to maintain their physical and mental health needs.

People had maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service reinforced this practice.

People and their relatives made many positive comments about staff being caring, respectful and kind. The locations we visited had a homely atmosphere and there were positive interactions between staff, people who lived there and their relatives.

People had access to important information about the service, including how to complain and how to access independent advice and assistance such as an advocate.

Staff supported people to do the things they enjoyed and also encouraged independence with daily living. Support plans contained clear information about the person's level of independence as well as details of areas where staff support was required. Support plans detailed people's needs and preferences.

People, relatives and staff told us the service was well led and the registered manager was approachable. All areas of the service were quality assessed regularly and overall identified shortfalls and areas for improvement.

There were systems in place to gather regular feedback from people who used the service and their relatives. Feedback was acted upon.

The agency provided support to 55 people at the time of our inspection. We carried out telephone interviews with two people using the service, two family members and three care staff.

The registered manager and senior service manager supported us at the inspection visit.

One person using the service said “I like my carers.” Another person told us “Everything is okay, I’m happy.”

One relative said “X is making good progress with Lifeways.”

Another relative said “Staff are good.”

We found people's needs were assessed and care was planned in line with their needs. The records were person centred, this means written in a way that describes how a person would want their needs to be met and focused on them as individuals.

Relatives told us they felt included in the care arrangements and decisions.

People who used the service were protected from the risk of abuse.

Family members felt able to report any concerns to the agency.

We found that there were systems in place to monitor the quality of the service, and make improvements where required.

The information in people’s support plan indicated that staff involved people in making decisions about how they liked to be looked after. There was also information to show that where people were not able to be fully involved with decisions about their care, relatives were encouraged to be involved with the decisions relating to people’s care and welfare.

Relatives told us they were “happy” with the support plans and felt that staff kept them informed about people’s care. One relative told us “I have seen the care plan. The manager came and discussed this with me and we agreed on it”.

We looked at the files of eight people who used the service. All the files contained detailed assessments of the needs of the individuals which were reviewed at regular intervals to reflect people current support needs. One person told us “I have a care plan and staff accompany me for my hospital appointments”. Another person told us “I see my doctor all the time. The staff take me to see him”.

The people who used the service told us that the staff helped them to do things for themselves. These included support to prepare their meals. People also told us that they were supported to be involved in formulating their care plans. One person told us they were regularly consulted about the review of their care plans and said the staff respected them and always sought their views on all matters relating to them.

Two people told us that they felt safe and the staff supported them well. One person said to us, “Having the staff in my house 24 hours a day makes me feel safer”. They went on to tell us that they had no concerns about the way the staff treated them.

This inspection took place on 10 and 12 February 2015 and was announced. We gave the provider 48 hours notice of the inspection.

Lifeways Community Care (Sunderland) is registered to provide the regulated activity of personal care. It provides up to 24-hour on-site domiciliary care and support service to people who need personal care due to their mental health, learning difficulties or acquired brain injuries, who were tenants in their own homes. Lifeways Community Care provides this service for people living in Sunderland as well as to people living in a number of neighbouring local authority areas; including Northumberland, Newcastle upon Tyne, North Tyneside, Gateshead, Middlesbrough and South Tyneside. There were 53 people using the service at the time of our inspection.

The service had 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 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 got good support from the staff and felt safe with them. Their comments included, “I am well looked after and they do a good job. I feel safe here.” Staff had been trained to recognise signs of abuse and knew how to report any concerns.

Staff support was provided at the times people needed it and managed flexibly so people’s individual wishes could be accommodated. Staff had been thoroughly vetted before they were employed and effective measures were in place to cover any unexpected staff absences.

People’s medicines were managed effectively so that they received them safely. People told us they got the support they needed with their medicines.

The provider had ensured the staff were trained to provide the care people needed. This included basic training in the fundamentals of care, as well as more specialised training.

Staff provided the support people needed to have a balanced diet. Any risks to individuals around eating and drinking had been identified and expert advice sought when necessary. People commented favourably about the support they received with their meals. For instance, one person said, “I like the meals the staff do for us.”

People got the support they needed to maintain good health and access medical advice and routine check-ups when needed. There were effective audit systems in place to monitor people’s health and wellbeing.

The service supported people to express their views and be actively involved in making decisions about their care. For instance, one person told us, “I have a care plan and I go through it now and again with them.” This showed that people felt listened to by the staff. People also felt the staff respected their privacy and dignity and this was echoed in comments we received from local authority care managers who had regular contact with the service. For instance, one care manager commented, “I am satisfied that Lifeways treat clients with compassion, kindness, dignity and respect. I have noticed that managers and staff really do go the extra mile here.”

Detailed support plans were in place to guide staff as to how people’s care should be provided. It was clear from our communication with people that they had been involved in drawing up their plan of care. As a consequence, the support provided to people reflected their wishes and aims. This meant people got the support they needed and wanted. For instance, people were able to get out into the community and enjoy their preferred social activities or go to work. A typical comment we received was, “They help me to go out a lot. I really like the metro park and going to the food shops.” This showed the service provided the personalised care people wanted.

People understood how to make a complaint or raise any concerns about their care. They were very happy with their care and told us their opinions about their care were sought by the provider.

The registered manager provided good leadership to the staff team and managed the service well. The provider and registered manager had promoted a positive culture, which meant both people using the service and staff had ample opportunities to discuss their views about the service. People’s views were taken into account which meant the service was provided in a flexible way to meet people’s needs and wishes. An example of this was the way people chose the staff they wanted to support them.

There were effective systems in place to check on the quality of care being delivered. This included regular meetings with people who used the service and staff, visits by management to people and regular auditing of each aspect of people’s care. We found these methods were used to improve the quality of care people received. A care professional who had regular contact with the service told us, “All in all, I think Lifeways provide a good quality service.”