About the service:

Mencap Merseyside and Lancashire Support Service consists of 35 ‘supported living’ services across Liverpool, Sefton, Knowsley, Wirral, Wigan, Lancashire and Trafford. At the time of inspection, the service was providing support to 126 people with different health needs, mental health conditions, learning disabilities and/or autism, in their own tenancies.

People’s experience of using this service:

We found and heard some very positive examples, but also identified improvement needs. This is a large service and we considered everything we looked at in proportion, to achieve a balanced judgement based on people’s experience, which was overall very good.

We considered that to support the consistent safety and quality of such a large service through robust planning and overview, record-keeping and governance needed to be improved. We made a recommendation regarding this. We therefore rated Well-Led as Requires Improvement. This is not a reflection on the positive, person-centred and inclusive culture of the service, which everyone we spoke with talked very highly about.

The outcomes for people using the service reflected the principles and values of Registering the Right Support, by promoting choice, independence and inclusion. People's support focused on them having as many opportunities as possible for them to gain new skills and become more independent.

People felt safe with the support from staff. People told us or showed us in their individual ways that they were happy with their care. Staff and relatives told us about the positive, person-centred and inclusive quality of the service. There were enough staff to meet people’s needs and staff support was flexible about individuals’ wishes. Staff felt well supported and told us everyone worked well together to provide a good service for people.

People and relatives told us they had no reason to complain, but that staff listened to them and acted on any suggestions. People were supported to be active in ways that were meaningful to them, as well as encouraged to try new things. Staff helped people to build or maintain new relationships within the service, as well as within the wider community. People, relatives and staff were actively engaged in the design and delivery of the service.

Rating at the last inspection:

At the last inspection we rated the service as Good (19 October 2016). At the last inspection, we rated the service as Outstanding in Caring. At this inspection, we again heard some very positive examples. However, some of our findings showed that this was not consistent across the service and we therefore rated Caring as Good. Further detail is in our Caring findings in the full report.

Why we inspected:

This was a planned inspection that was scheduled based on the previous rating. We inspected to check whether the service had sustained its Good rating. We found that the service continued to meet the characteristics of Good in most areas we looked at and the overall rating remained unchanged.

Follow up:

We will follow up on this inspection through ongoing monitoring of the service, through conversations and notifications.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

We carried out an announced inspection on 15 August 2016.

Mencap - Merseyside and Lancashire Support Service is registered to provide personal care to people living in their own homes. People who use the service are provided with a range of support hours each day in line with their assessed needs. People who use the service have access to out-of-hours emergency support. At the time of the inspection Mencap - Merseyside and Lancashire Support Service was supporting 166 people.

A registered manager was in post. 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 provider moved offices in June 2015 and had a long history of providing services in the region prior to this.

The people that we spoke with had no concerns about the safety of services. The provider had delivered training for staff and managers regarding adult safeguarding. The staff that we spoke with were able to explain the different types of abuse and what action they would take if they were concerned that abuse or neglect were taking place.

The care files that we saw showed clear evidence that risk had been assessed and reviewed regularly. Risk was reviewed by staff with the involvement of the person or their relative and maintained a focus on positive risk taking to support independence.

Staff were trained in the administration of medicines but because people’s needs varied, they were not always responsible for storage and record-keeping. Some people who used the service were able to self-administer their medication, others required prompting. Medication Administration Record (MAR) sheets were completed by staff where appropriate. The records that we saw had been completed and showed no errors or omissions.

Staff were trained in a range of subjects which were relevant to the needs of the people using the service. Subjects included; safeguarding adults, moving and handling, administration of medication, Mental Capacity Act 2005 and equality and diversity. We looked at records relating to training and saw that all training had been refreshed in accordance with the provider’s schedule.

People were supported to shop for food and prepare meals in accordance with their support plans.

People’s day to day health needs were met by the services in collaboration with families and healthcare professionals. Staff supported people at healthcare appointments and used information to update support plans.

Everybody that we spoke with was positive about the way in which staff provided support, the way that staff spoke to them and the impact the service had on their life. We had the opportunity to observe staff providing support during the inspection. We saw that staff demonstrated care, kindness and warmth in their interactions with people. It was clear from their conversations and manner that the staff knew each person well and genuinely valued them as individuals.

The records that we saw demonstrated that staff and the provider paid great attention to detail in the production and distribution of information. People told us that they always felt involved in discussions and were kept well-informed about things that were personal to them. They were also given information about things happening in their region and nationally. Some people were supported to attend important events about disability rights and shared this information with other people using the service.

The staff that we spoke with described the services as promoting choice, independence and control for the individual. We were provided with a number of examples where staff and managers had engaged with people in a meaningful and appropriate way to establish goals and objectives. In each of the examples people had been suppor