Macclesfield Supported Living Network provides support with personal care to adults with learning disabilities who live in five bungalows and flats in Macclesfield. The network is managed during normal office hours and provides a service 24 hours a day for 365 days a year. The service had capacity to provide support for 36 people but was providing support for 33 people at the time of inspection.

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. However, the effective domain is rated as requires improvement due to mental capacity assessment processes not always being completed. This has not affected the overall rating of the service that retains a good rating.

This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection.

The service had been developed and designed prior to the development of the values that underpin the Registering the Right Support and other best practice guidance. These values included choice, promotion of independence and inclusion. However, we saw that people with learning disabilities who used the service were able to live as ordinary a life as any citizen. We saw that people’s homes did not house more than six people.

Risks to people's safety and well-being had been identified and plans put in place to minimise risk. Support plans were detailed and person centred. Medicines were managed safely and staff had the appropriate training to support people effectively.

The provider had systems in place to ensure that people were protected from the risk of harm or abuse. We saw there were policies and procedures in place to guide staff in relation to safeguarding adults and whistleblowing.

Support plans showed that people's GPs and other healthcare professionals were contacted for advice about people's health needs whenever necessary. We saw the service had responded promptly when people had experienced health problems.

People who used the service that we spoke with all gave positive feedback about the support received. The service had a relaxed feel and people could move freely around their own homes as they chose. People were able to have control over their lives and participate in activities they enjoyed.

Staff were recruited safely and then supported in their roles with induction, training, supervision and appraisal. Ongoing competency checks were also completed.

Policies and procedures were in place and updated, such as safeguarding, complaints, medication and other health and safety topics. Management and quality assurance systems had been devised and were in place to drive continuous improvement and the service.

Further information is in the detailed findings below

This inspection was announced and took place on the 18 March 2016. Three home visits to people receiving support from Macclesfield Supported Living Network took place on the 22 March.

Macclesfield Supported Living Network is part of Cheshire East Council’s Care4CE and provides support with personal care to adults with learning disabilities who live in bungalows and flats grouped together in Warwick Mews, Macclesfield. Support is also provided to a number of people who live locally in the wider community. The network is managed during normal office hours and provides a service 24 hours a day for 365 days a year. At the time of the inspection 38 people were receiving a service. Within the network they are referred to as customers.

Macclesfield Supported Living Network 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.

The registered manager, (their job title within the organisation was resource manager) was based in the office and had oversight of the service. Day to day management in the settings where support was provided was undertaken by six supervisory support workers who each had responsibility for a number of properties.

Because of their communication needs we were unable to ask all of the people receiving a service about whether they thought the staff members supporting them were caring. Those who did comment were positive about the staff members.

The service had a range of policies and procedures which helped staff refer to good practice and included guidance on the Mental Capacity Act 2005. This meant that the staff members were aware of people's rights to make their own decisions. They were also aware of the need to protect people's rights if they had difficulty in making decisions for themselves.

We asked 10 staff members about training and they confirmed that they were receiving regular training and that it was up to date.

We looked at a total of six support files and five medication files in the office and during the home visits that were undertaken. The files we saw explained what was important to the individual and how best to support them. This helped to ensure that people’s needs continued to be met.

Staff members we spoke with were positive about the service and during the three home visits we observed them interacting with the people they were supporting in a professional, caring and friendly manner. The staff members we spoke with were positive about the quality of the support being provided.

We found that the provider used a variety of methods in order to assess the quality of the service they were providing to people. These included asking the people themselves what they thought and regular audits on areas such as the support and medication files, including risk assessments and medication. The records we looked at during the inspection were being appropriately maintained.

We spoke to two people who used the service and one relative and they all said that they were very happy with the support that they received. One person said; "The staff are lovely. They help me do what I want to do."

We looked at the care plans and risk assessments for three people and saw that they were person centred and regularly reviewed and updated.

We looked at the procedures in place for keeping people safe from harm and we saw that they were clear and the staff understood how to recognise the signs of abuse and use the systems in place.

We spoke to the registered manager and three members of staff who all said that they enjoyed working at the service and that they thought that the service offered quality support to the people who lived there.

We looked at the systems in place for recruiting new staff and saw that all the appropriate checks were carried out prior to staff commencing work at the service.

We looked at the procedures in place to assess and monitor the quality of the service. We saw that these were organised and the views of the people who used the service were taken into account to make improvements.

Macclesfield Supported Living Network helps people with learning disabilities make decisions and engage in activities. On the day of our inspection we spoke to the registered manager, four members of staff and four people who received care. We found that people who were able to give consent for their care did so and those that were not had protection to ensure their best interests were maintained.

We saw that there was an effective complaints system in place. Information was provided to people about how they could complain if they so wished. There had been no complaints made about the service in the previous 18 months. Staff knew how to record and respond to complaints appropriately.

During our visit to the network we spoke with three tenants who live there. They said they are happy living there, are involved in making decisions about the support they receive and what they do and are supported to be as independent as possible. For example, one person said, “I do what I want when I want. I wanted to be more independent when I came to live here and I am”. Another said, “I am happy here and supported well so I can be pretty independent”.

They gave us examples of this support including help with banking and bills, cleaning the house, cooking and visits to the dentist and optician. They also told us about the things they did during the week. This included socialising with other tenants, friends and families, swimming, shopping, bowling, attending college and going to the youth club.

All said that staff are kind and caring, they get on with staff well and their support needs are met. Two said they could speak with staff if they had concerns or worries and that staff would listen to them and help sort things out. For example, one said, “I have a key worker who listens to me and who I can talk to”. Another said, “Staff are kind and treat me well”. One tenant also gave us an example of how staff had supported them to sort out a concern they had. Another said that there had been changes to staffing that had unsettled them at first but they had now got used to the new staff.