Mencap – North Suffolk and Coastal Domiciliary Care Agency is registered to provide personal care to younger adults and people who have learning disabilities or autistic spectrum disorder who live in supported living schemes in the Norfolk and Suffolk areas. At the time of our inspection 21 people were receiving personal care from the service and there were 39 support staff employed.

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 2008 and associated Regulations about how the scheme is run.

People had their needs assessed and reviewed so that staff knew how to support them to maintain their independence. People’s support plans contained very detailed person centred information. The information was up to date and correct.

Staff understood the principles of the Mental Capacity Act 2005 (MCA) and could describe how people were supported to make decisions.

People were assisted to be as safe as possible because risk assessments had been completed for all assessed risks. Staff had the necessary information they needed to reduce people’s risks.

The risk of harm for people was reduced because staff knew how to recognise and report abuse.

The provider’s recruitment process was followed and this meant that people using the service received care from suitable staff. There was a sufficient number of staff to meet the needs of people receiving a service.

People’s privacy and dignity was respected by staff and staff treated them with kindness. There was a complaints procedure in place, with ‘easy read’ formats. People were supported to make a complaint if they needed to.

Systems were in place to monitor and review the safety and quality of people’s care and support. People and their relatives had been contacted for their comments about the service provided.

Staff meetings, supervision and individual staff appraisals were completed regularly. Staff were supported by service managers and the registered manager during the day. An out of hours on call system was in place to support staff, when required, in the evening and overnight.

Each care plan we reviewed had a document in place that used symbols and pictures so that people who used the service could be involved in the consent process.

People we spoke with told us that staff always included them in the delivery of their care. They told us that staff always respected their privacy and listened to and responded to their wishes. One person said that, "Staff helps me when I ask." Another person told us, "Staff have helped me to take my medication on my own." One relative told us “The carers treat my relative very well. They are excellent and treat people with respect.”

People told us they had been given information before they started to use the service and were in regular contact with the manager. One person told us that they were asked about their relative’s care plan and if they were satisfied.

People said they felt safe and had no concerns about the care provided. They told us that they felt confident to express any concerns they might have.

We spoke with staff who said they received regular training, supervision and felt well supported. One person told us “The manager was always contactable for advice and support.”

Mencap Personal Support - Waveney and North Suffolk provides a domiciliary care service. At the time of our inspection the service was providing support to 19 people living in supported living services and one person received community support. There is a registered manager in post.

On the day of the inspection we saw people were preparing to go out and were involved in making decisions about how they wanted to spend their day. Interactions between staff and people who used the service were warm and caring. Staff talked passionately about the people they supported. They knew the needs of the people in their care well and were able to describe their needs.

Where people were unable to express their views due to communication difficulties, staff used different methods to understand their preferences about how they wanted their care provided. We saw that visual images, such as photographs, pictures and symbols were used to help people understand information.

The service had a keyworker system in place. A key worker is a named member of staff who works with the person and acts as a link with their family, where appropriate, to ascertain information which helps to provide appropriate care. We saw that regular key worker meetings were taking place, providing an opportunity for people to have a say about their care and what was important to them.

The provider had systems in place to manage risks, safeguarding matters, people’s finances and medication which ensured people’s safety. People who used the service had been provided with information so that they knew about their rights and saying ‘No to abuse’. Where safeguarding concerns had been raised the service had taken appropriate action by liaising with the local authority to ensure the safety and welfare of the people involved.

The provider had a positive attitude towards managing risk. Risk assessments were detailed and gave staff clear direction as to what action to take to minimise risk. These focused on what the individual could do, and ensured that activities were carried out safely and sensibly.

People were supported to have healthy and nutritious meals. Where people required support to eat and drink, for example, through a Percutaneous Endoscopic Gastrostomy (PEG) feeding tube we saw that staff had been trained to ensure they were competent to use the equipment and knew what to do if things went wrong.

Staff and relatives spoken with felt there were enough staff to meet people’s needs. We saw that staff received the support and training they needed in order to carry out their duties to a good standard.

The service was well managed and we found there was a positive relationship between staff and management. Staff told us that their manager treated them fairly and listened to what they had to say and that they could approach them at any time if they had a problem or something to contribute to the running of the service.

Documents showed that mental capacity assessments and best interests meetings had taken place, when decisions needed to be taken on behalf of someone who was deemed to lack capacity. This meant that the provider understood the requirements of the Mental Capacity Act (MCA) 2005 and put them into practice to protect people.