Next Stage - A Way Forward is registered to provide a support service to adults who require care, support or supervision to be able to be actively involved in the day-to-day routine of living. They also assist people in caring for themselves, while always looking to promote independence. The office is based in Warrington close to the town centre. The service also has two transitional units that are aimed to supporting people back into the community.

At the last inspection, the service was rated Good.

At this inspection we found the service remained Good. At this inspection we found the service remained good, however we found a rating of requires improvement in the safe domain. We found medication procedures at the home were safe, however we identified a recording issue regarding medication and staff were not always aware of procedures when to update office staff regarding on-going safeguarding issues.

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 the service had supported this practice.

We spoke with the people who received a service from Next Stage - A Way Forward and all gave positive feedback about the support and the staff who gave it. People were supported to have maximum choice and control over their lives and participate in activities they enjoyed.

Care plans and risk assessments were person centred and detailed how people wished and needed to be supported. They were regularly reviewed and updated as required. Care 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.

The provider and registered manager used different methods to assess and monitor the quality of the service. These included regular audits of the service, ‘Service User Forum’ and staff meetings to seek the views of people and staff about the service. The providers were also involved in the running of the service.

The services policies and procedures had been regularly reviewed by the provider and these included policies on health and safety, confidentiality, mental capacity, medication, whistle blowing and safeguarding.

Staff were recruited safely and there was evidence that staff received a proper induction and suitable training to do their job role effectively. All staff had been supervised in their role. Staffing levels were consistent and were adapted to meet people’s needs.

The service operated in accordance with the principles of the Mental Capacity Act 2005 (MCA). It was clear from care records and discussions with people that their consent was always sought in relation to care and treatment and people understood how to make a complaint if they were dissatisfied with the service.

Further information is in the detailed findings below.

We carried out this inspection on 6 November 2015. This location was last inspected in September 2013 when it was found to be compliant with all the regulations which applied to a service of this type.

There was a registered manager 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.

Next Stage - A Way Forward is a domiciliary care service that provides care and support to people in their own homes. The service currently supports 32 people. This includes people with mental health needs and learning disabilities. The care ranges from a few hours of support a week up to 24 hour care for people in supported living. A supportive living service is one where people live in their own home and receive care and support in order to promote their independence. People have a tenancy agreement with a landlord and receive their care and support from the domiciliary care agency. As the housing and care arrangements are separate people can choose to change their care provider without losing their home.

Throughout the inspection we consulted people who used the service. We also spoke with staff from the service and obtained the views of four health and social care professionals who had contact with the service. Feedback was positive and people said they had no concerns about the care they received or the staff who provided it. People told us that staff were caring and treated people with dignity and respect. They told us that the service provided was excellent. They said they had complete trust in the staff and felt safe when they were around.

Staff were confident about any action to take if they had any safeguarding concerns and were confident the registered manager would follow up any concerns they might have.

Risk assessments clearly identified any risk and gave staff guidance on how to minimise the risk. They were designed to keep people and staff safe whilst allowing people to develop and maintain their independence.

People were supported by stable and consistent staff teams who knew people well and had received training specific to their needs. Efforts were made to match staff with people by identifying any shared interest, hobbies and compatibility.

Staff told us they enjoyed their work and were well supported through supervision, appraisals and training. The registered manager spoke highly of the staff team describing them as committed and enthusiastic in their approach to their work.

Staff had high expectations for people and were positive in their attitude to supporting them. They were respectful of the fact that they were working in people’s homes. The service offered flexible support to people in order to meet their needs.

Support plans offered person centred care and ensured the person was fully involved in setting goals and monitoring and reviewing achievements. The plans clearly guided staff in how to support people well at various times of the day and in different situations. This allowed a consistent approach form staff when they were supporting people.

The management team had a clear set of values which were apparent throughout our visit. People who used the service told us that the service was excellent, well organised and effective. Staff told us they felt valued and empowered. They said the management team were supportive and the service was very well managed.

We spoke with three people who used the service. We were told: “The reason I like them is because they make me happy”. And: “I love working with [named carer] because she is so nice”.

We spoke with professionals about the care provided by Next Stage – A Way Forward. All were positive about the service provided and the staff.

We found that care files were well maintained, easy to read and contained detailed person centred information about people who used the service. Care plans had been regularly reviewed and updated.

People received their medication in a safe manner. Care staff had attended medication training as part of the induction programme provided by the service and regular updates were undertaken.

We found that the service had robust recruitment systems in place to make sure that staff were suitable and safe to care for vulnerable people.

We were shown the company's complaints policy and found that people who used the service had been given information on how to make a complaint.

The people we spoke with told us that they were supported in the way they wanted to be and staff assisted them to be independent.

They said staff were respectful and that they enjoyed the social activities that they were supported to take part in and the group activities such as luncheon clubs. The service supported people to take part in educational courses such as flower arranging. One person spoken with said they had started swimming and enjoyed it.

People said that they felt the staff team supported them well. Comments such as “ excellent, couldn’t be better” “ I have improved a lot since being supported by Next Stage” “they help me to do my shopping and get out and about” and “ I had an accident and needed help to shower and get dressed and they were always there to help me” were made by people who use the service.

People spoken with said they felt safe and supported.