Meadow Brook provides care and support to up to 20 people living in nine 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.

At our last inspection in October 2015 we rated the service as 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. This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection.

People were supported by adequate numbers of staff who were able to meet their needs in a safe way. Risks were well managed which meant people could live their lives with reduced risks to themselves or others. Staff knew how to protect people from the risk of harm or abuse and the provider’s procedures made sure staff were safe to work with people before they were offered employment. People received their medicines when they needed them and medicines were safely managed by staff. Staff followed procedures which helped to ensure people were protected from the risk of the spread of infection.

People were supported by a staff team who had the skills, knowledge and training to meet their needs. Staff understood how to ensure people’s rights were respected. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service support this practice. People were supported to eat well in accordance with their needs and preferences. People’s health and well-being were regularly monitored.

Staff were kind, caring and compassionate and they ensured people felt valued and respected. People were supported to plan their day in accordance with their needs and preferences. Staff communicated with people in accordance with their needs and abilities which helped people make an informed decision. People were supported to maintain contact with the important people in their lives.

People received a service which was based on their individual needs and preferences. People were involved in planning and reviewing the care and support they received. Staff helped people to take part in their chosen activities and also provided other opportunities such as holidays and visiting places of interest. People’s religious views and preferences were understood and respected by staff. People knew they could complain if they were unhappy about any aspect of the care and support they received. Information had been produced in a format which people could understand. Procedures were in place to ensure people’s preferences and wishes during the end of their life and following death were understood and respected by staff.

The management of the service made people, their relatives and staff feel valued and respected. There were effective systems in place which monitored the quality of the service provided. The skills, training and competency of the staff team were regularly monitored which helped to ensure people were supported by staff who could understand and meet their needs. The management and staff team worked effectively with other health and social care organisations to achieve better outcomes for people and improve quality and safety. There was an open and honest culture, admitting when things went wrong and learning from mistakes. The provider and registered manager understood their legal responsibilities and worked in accordance with these.

Further information is in the detailed findings below

This inspection took place on 7 October 2015 and was announced. At our previous inspection no improvements were identified as needed.

Meadow Brook is registered to provide personal care to people living in their own homes. People who use the service have learning disabilities or autistic spectrum disorder and staff provide 24 hour supported living. At the time of our inspection there were 19 people using the service.

A registered manager was in post and was present during our inspection. 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 were supported to make safe choices in relation to taking risks in their day to day lives. Staff had been trained and understood how to support people in a way that protected them from danger, harm and abuse.

There were enough staff to safely support people who used the service. The provider monitored staffing levels and made sure extra staff were available when needed. The provider had completed checks on staff prior to them starting to work to make sure they were suitable to work with the people who used the service.

People were involved in saying what their preferences were for receiving their medicine and what support they wanted from staff. They received their medicine from staff who were trained to safely administer these and who made sure they had their medicine when they needed it.

Staff had the skills and knowledge to support people’s needs. They were supported in their roles and attended training that was relevant to the people they looked after.

People were asked what support they wanted and made their own decisions about their care and treatment. When people could not make their own decisions these were made on their behalf and in their best interests by people who knew them to make sure their rights were protected.

People were supported by staff who knew them well and had good relationships with them. Staff made sure people were involved in their own care and made sure information was given to them in a way they could understand. People’s independence was encouraged and staff respected their privacy and dignity.

People had a choice of food to eat and were prompted to maintain a healthy, balanced diet. People’s routine health needs were looked after and people had access to healthcare when they needed it.

Staff provided care and support to people that was personalised and responded to changes in their needs. People’s preferences and wishes were known to staff and were respected.

Regular checks were completed by the registered manager to monitor the quality of service that staff delivered and improvements were made where needed.

People, relatives and staff were able to share their views about the service and were listened to. The culture of the service was to put people first and this was echoed by management and staff. Relatives were happy with the care people received and the support staff gave them.

During our inspection we spoke with nine people who used the service, ten members of staff, the manager and the chief executive of the charitable trust. People we spoke with expressed high levels of satisfaction with the service provided to them. A relative told us, "We couldn't be more satisfied. X is in good hands in a safe place. This is a partnership. Staff keep us informed of any changes and we are involved in all decisions. We can speak with staff any time if we wish to."

We saw that people were given choices in everyday life. Assessments of capacity had been regularly reviewed. Best interests meetings had been arranged where needed and included family members, staff from the service and other professionals.

Support plans provided detailed information about people's needs. Staff had the information they needed to support people.

The service provided continuity of staff to support people 24 hours each day. Staff were well trained and experienced. People who used the service had weekly activity plans they were involved in compiling. The main objective of the service was to provide opportunities for people to develop their skills and interests and access community facilities. The service had been successful in improving people's quality of life.

A relative told us, "The success of the service is down to the determination and commitment of staff at Meadow Brook.

Appropriate arrangements had been in place to monitor and review the quality of the service.

No one using the service was able to express their views about their experience in any detail. However, we met two people using the service who visited the office during our inspection. They both seemed happy and relaxed with the staff.

We found that people were involved in the planning of their care and support as far as they were able. Where appropriate, the staff consulted people’s relatives to help them make decisions.

We found that care plans were person centred and contained lots of information about people’s choices and preferences. The staff we spoke with told us that the care plans contained all they needed to know about the people they care for.

We found that the provider was protecting people from the risk of abuse, by taking reasonable steps to identify the possibility of abuse and prevent abuse from happening. Staff we spoke with understood the provider’s safeguarding procedures.

We were satisfied that the provider made all the appropriate checks on staff before their full employment started.

We found that the provider regularly monitored quality and performance and followed up action points from previous audits.

The agency currently provides support for 16 people with a learning disability.

We spoke to five relatives of people who use the agencies services, three members of staff, the manager and the nominated individual. People who use the service were unable to talk to us on the telephone due to the nature of their learning disability. We looked at selected care files and other records related to the running of the agency.

We saw that the agency provided clear detailed information about Meadowbrook to people considering or starting to use the service. People's needs were assessed before they started using the service to make sure they could be met and they were able to meet the staff who would be providing the care and support.

Relatives spoken with were very positive about the way that the agency delivers care. The service was described as “excellent” and people told us that it was person centred and tailored to individuals needs.

Support was offered to people in a variety of ways to make sure that they were seen as individuals and their lifestyle choices and preferences were respected. Care plans contained very good detail about people's needs and clear guidance to staff about how those needs should be met. Plans clearly recorded how staff supported people's independence and the attainment of life skills whenever possible.

Staff were knowledgeable about what constituted abuse and poor practice and were clear about how to report this should it occur. Policies, procedures and training were in place to make sure that people who use the agency were kept safe and the risk of abuse was known and minimised.

Staff were provided with extensive training, supervision and support by the manager and were confident that they were able to provide the care and support to people who use the agency.

Effective management systems were in place to make sure that the agency was well run. Quality assurance systems were in place to monitor the effectiveness of the service and identify any issues of concern or areas for review.