This inspection took place on the 14, 18, 20 December 2017 and 4 January 2018 and was announced. The provider was given a short notice period that we would be undertaking an inspection. At our previous inspection in June 2016, the service was meeting the regulations that we checked and received an overall rating of Good.

Livewell (Care & Support) Ltd provides care and support to 27 people living in 12 ‘supported living’ settings, 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.

There was a registered manager in post who had recently registered with CQC. 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.

Livewell (Care & Support) Ltd met the values that underpin the Registering the Right Support and other best practice guidance. These values include choice, promotion of independence and inclusion. People with learning disabilities and autism using the service can live as ordinary a life as any citizen.

People told us they felt safe when supported by staff who had received training in recognising and reporting abuse. Risk assessments had been completed to guide and support staff to reduce risks and prevent people from harm. Recruitment checks were undertaken to ensure only suitable staff were employed in sufficient numbers to meet people’s assessed needs. People received their medicines by staff that had been trained to do this safely.

Staff received training and support to enable them to have the skills and knowledge for their role. Staff spoken with understood people's needs and supported them to follow their chosen lifestyles and achieve their goals. People’s human rights were respected by staff because staff applied the principles of the Mental Capacity Act 2005 and the Deprivation of Liberty Safeguards in their work practice. People were supported to maintain their healthcare needs.

People had developed positive relationships with staff that knew them well and promoted their independence and autonomy. People’s privacy and dignity was respected and promoted by the staff team and people were supported to maintain relationships with those who were important to them.

People were involved in making decisions about their support. Staff supported people to live the life they choose and participate in meaningful opportunities. People knew how to raise a complaint and had confidence any issues would be listened to and addressed. Staff were aware of the signs to look out for which may indicate people were unhappy.

People told us the service was managed well and in their best interests. People were involved in developing the service; which promoted an open and inclusive culture. Staff understood their roles and responsibilities and felt valued by the provider. The registered manager and provider understood their legal responsibilities and kept up to date with relevant changes. There were systems in place to monitor the quality of the service to enable the management team to drive improvement.

Livewell is registered to provide care, supported living and domiciliary care to people who may have disabilities, autism, or other long term health conditions. At the time of our inspection 32 people were using the service. Our inspection took place on 15 June 2016 and was announced with 48 hours’ notice to enable staff to be present to speak with us. People who used the service and their relatives were contacted by telephone on 16 June 2016. The service was last inspected on the 15 November 2013 where it met all of the standards.

The manager was new in post and due to clerical issues had not yet submitted an application to register with us as is required by law. 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 in the Health and Social Care Act 2008 and associated regulations about how the service is run.

People were kept safe, with detailed risk assessments in place. Medicines were given appropriately and we found that there was a suitable amount of staff available with the skills, experience and training in order to meet people’s needs.

Structures for supervision allowing staff to understand their roles and responsibilities were in place and staff felt well supported by managers. People’s ability to make important decisions was considered in line with the requirements of the Mental Capacity Act 2005.

People were supported to take sufficient food and drinks and their health needs were met. Staff maintained people’s privacy and dignity whilst encouraging them to remain as independent as possible.

Relatives and staff spoke positively about the approachable nature and leadership skills of managers. People told us that they were able to raise any concerns they had and felt confident they would be acted upon.

Systems for updating and reviewing risk assessments and care plans to reflect people’s level of support needs and any potential related risks were effective. Quality assurance audits were undertaken regularly. The provider supported the manager and staff well. Notifications were sent to us as is required by law.

At the time of our inspection the service was providing care and support to 17 people. All of the people lived in homes that offered 'supported living' across eight sites within the Worcestershire area. We spent some time at the offices where the services was organised from and we sampled some records. With people's consent we shadowed the registered manager and visited two houses. We spoke with seven staff, the manager and registered provider.Following our inspection we spoke on the telephone with two people who used the service, three relatives and a professional.

One of the people we spoke with told us, "I have a very nice home and I do lots of things".

A relative told us, "They are professional and very organised". People that we spoke with told us that they were happy where they lived and they liked the staff who supported them. We saw that people were relaxed and comfortable with staff. Staff interacted well with people and demonstrated a good understanding of the needs of the people they supported.

We found systems were in place to ensure that people received their medication safely.

Staff were supported, supervised and trained to provide safe and effective care.

Effective systems were in place for assessing and monitoring the quality of the service so that people benefited from a well led service.