About the service: Mencap North Notts is a service which provides care and support to people living in 12 ‘supported living’ settings, so that they live as independently as possible. People’s care and housing are under separate contractual agreements. CQC does not regulate the premises used for supported living: this inspection looked at people’s personal care and support. There were 36 people using the service.

People’s experience of using this service:

The outcomes for people using the service reflected the principals of Registering the Right Support in the following ways; promotion of choice, control and independence and inclusion. For example, people’s support focussed on them having as many opportunities to gain new skills and live as full a life as possible. Staff and managers concentrated on finding solutions to barriers which may have prevented people from doing activities they enjoyed.

People received caring and compassionate support from staff who had the appropriate skills and knowledge to carry out their role. We found that staff were passionate about the work they did and people using the service were at the forefront of everything they planned. This included staff thinking of innovative ways that people could achieve outcomes despite challenges. For example, barriers to social inclusion when a person using the service becomes anxious and upset with some groups of people outside of the service.

People’s rights to make their own decisions was respected. People were supported to access healthcare services where needed. People had enough to eat and drink and staff encouraged healthy eating.

People received personalised support based on their assessed needs and preferences. Staff knew how to support people in a way that they preferred. People knew how to complain.

The service was managed by a registered manager who had a very clear vision about the quality of care they wanted to provide. There were six service managers who shared that vision and who supported staff in a meaningful way ensuring that staff always had regular supervision and less formal chats when faced with challenges. Each service manager managed two services. Staff told us that they felt well supported to do their role and were encouraged to be innovative.

Rating at last inspection: At the last inspection the service was rated Good (report published July 2016)

Why we inspected: This was a planned inspection based on the rating at the last inspection.

Follow up: We will monitor all intelligence received about the service to inform the assessment of the risk profile of the service and to ensure that the next planned inspection is scheduled accordingly.

This inspection took place on 10 and 11 May 2016 and was announced. Mencap North Nottinghamshire Services provide care and support for people with a learning disability who live in their own home in the community. At the time of inspection 33 people were receiving care and support from the service

The service 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.

People who used the service and those supporting them knew who to report any concerns to if they felt they or others had been the victim of abuse. Any risks to the health and safety of people and staff had been identified and detailed plans were in place to reduce these risks. Accidents and incidents were investigated. There were enough staff to support people well and ensure that people’s needs were met. People received their medicines as prescribed.

People were supported by staff who had received the appropriate training and supervision to support them effectively. People received the support they required from their staff to ensure they had sufficient to eat and drink. People were provided with the support they needed to enable them to have access to their GP and other health care professionals when they needed them.

The Care Quality Commission (CQC) monitors the use of the Mental Capacity Act 2005 (MCA) and the Deprivation of Liberty Safeguards (DoLS). Staff were aware of the principles of the MCA and how this might affect the care they provided to people. Where people had the capacity they were asked to provide their consent to the care being provided.

People were supported by staff who were caring and treated them with kindness, respect and dignity. People were involved in the planning and reviewing of their care to ensure that they received the care they wanted.

Care plans were written in a way that focused on people’s choices and preferences. A complaints procedure was in place and people felt comfortable to speak up if they were unhappy about any aspect of the service they received.

The culture of the service was open. People were supported by staff who were clear about what was expected of them and staff had confidence that they would get the support they needed from the registered manager. People and staff were asked for their opinions about the quality of the service. The registered manager undertook audits and observed practice to ensure that the care provided met people’s needs.

Prior to our visit we reviewed all the information we had received from the provider. We spoke with two people who used the service and three relatives. We also spoke with the registered manager, three members of staff and looked at service information and records.

The people we spoke with told us they had received information explaining about the service and that they knew how to make a complaint if needed. They said they felt staff respected their views and wishes and that they felt listened to and valued.

Comments included, “I have lots of information at home about the service, they (staff) talk to me about my care plans and I have signed them. I have a rota to tell me who will be visiting me.”

Relatives we spoke with told us that their relative received an assessment before using the service. They said they had been involved with their relative in the development of care plans and had been consulted when care plans were updated.

Comments included, “Yes, I was involved in the assessment process and I’m involved in the review of care plans. It’s a brilliant service; they (staff) are all excellent from the top down.”

People who used the service told us they felt staff supported them to remain safe, living in the community and that staff were kind, caring and supportive.

Comments included, “Anything I want doing they (staff) will do and take me where I want to. I asked for a change with one of my workers once I phoned the office and they sorted it out.”

Due to the complex needs of people who used the service, they were unable to tell us about the quality of the service they received. Therefore we used a variety of other methods to assess the quality of care and support. We looked at the support records of five people who used the service, visited the homes of three people and observed the interactions between them and their support worker, conducted telephone interviews with five relatives, spoke with seven support workers, the service manager and registered manager.

Representatives of people who used the service were consulted on decisions relating to their family member. One relative told us, “I am always involved in the decisions. The staff call me if anything needs to change.”

People's needs were met and care was provided in a way that ensured they were safe. One relative told us, “My daughter’s needs are being met, the staff are doing a wonderful job. We couldn’t ask for anymore, they (staff) are fantastic.”

The provider had sufficient safeguards in place that ensured people were protected from the risk of abuse.

There were enough qualified and trained staff to meet people's needs. A relative told us, “There are good, young staff, who understand my daughter's needs and can relate to her.”

The quality of care and support provided was continually assessed by the management team. Any fall in staff performance was identified and where appropriate, measures were put in place to ensure standards improved.