The inspection took place on 16 and 18 March 2016. Living Ambitions provides support to individuals in their own home. The service supports individuals with a learning disability and some people may also have a physical disability, and at the time of the inspection was supporting 83 people living in supported living accommodation and provided outreach support to a further 21 people in their own homes.

The service had a registered manager in post. A registered manager is a person who has registered with the Care Quality Commission (CQC) 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 associate Regulations about how the service is run.

The service is registered for the provision of personal care in people's own homes. This includes assistance or prompting with washing, toileting, dressing eating and drinking. We call this type of service a 'supported living' service. The service also provided other forms of support such as shopping and assistance to access the community.

Some of the people's accommodation was provided by separate landlord, usually on a rental or lease arrangement. The service was solely responsible for the provision of the support service and not for the provision of the premises. This meant people could choose an alternative service provider if they wished. People who used the service had a wide range of support needs, ranging from mild to severe learning disabilities. Some of the people had very complex support needs and required support from the service 24 hours a day. Other people were more independent and received support for just a few hours a day to help with their daily routines.

People were safe and staff knew what actions to take to protect them from abuse. The provider had processes in place to identify and manage risk.

People received care from a consistent staff team who were well supported and trained.

Care staff understood the need to obtain consent when providing care.

The provider had systems in place to support people to take their prescribed medicines safely.

People were supported with meals and to make choices about the food and drink they received. Staff supported people to maintain good health and access health care

professionals when needed.

Assessments had been carried out and personalised care plans were in place which reflected individual needs and preferences.

The provider had an effective complaints procedure and people had confidence that concerns would be investigated and addressed.

The service benefitted from a clear management structure and visible leadership. A range of systems were in place to monitor the quality of the service being delivered and drive improvement.