We carried out this inspection on 29 June, 03 and 17 July 2017. We gave the service 48 hours' notice of our inspection to ensure that someone would be present in the office, and we were able to speak with staff and people using the service.

Next Steps Hertfordshire is registered to provide personal care to people living in their own home. The service specialised in providing flexible home support across a 24 hour period to people with learning disabilities living in their own homes. The service specialised in supporting adults who had lived in large institutions for a long period of their life or had several failed placements prior being supported by Next Steps Hertfordshire. At the time of the inspection 15 people were using the service. At our previous inspection on 29 September 2015 the service was rated as good.

There was a registered manager in post. A registered manager is a person who has registered with the 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 and associated Regulations about how the service is run.

People received care and support that met their needs while encouraging their independence. Risk assessments were in place for all aspects of people's lives and these helped to ensure that people's choices were not restricted. Positive risk taking underpinned the approach to risk management within the service in order to support people to live fulfilling lives. People felt safe and staff knew how to respond to any concerns that may affect people's wellbeing. People were supported by sufficient numbers of staff who had been recruited through a robust process that matched staff to people’s individual needs. People's medicines were managed safely and where possible people were encouraged to manage their own medicines.

Staff received a robust individualised induction and on-going training tailored to the needs of the person they worked with. This helped to ensure they had the appropriate skills for their role and further development opportunities were made available. People only received care once they had provided their consent and for those people unable to provide this, staff followed the appropriate procedures to ensure the care delivered was in people`s best interest. People were provided with a good variety of nutritious meals and staff ensured people had access to health and social care professionals as needed, and when they requested them.

People were at the centre of the service, which was organised to suit their individual needs and aspirations. People’s achievements were celebrated and their views were sought and acted on. People were supported by staff that were passionate and consistently treated them with dignity and respect. Without exception, people who used the service and their relatives we talked to were very complimentary and positive about the staff that supported them.

People were able to pursue their individual interests as well as engage in meaningful activities both within the home and in the local community. People participated in a range of personal development programmes that were designed to provide new experiences for people to develop new skills. People who used the service accessed a range of community facilities and completed activities within the service. People knew how to make a complaint, and where complaints were raised these were responded to promptly.

People were very positive about the management of the service and the views of people were sought in relation to the quality of care provided. The registered manager was a role model to both staff and people alike. There was an extremely positive culture within the service with clear visions, values and enthusiasm about how the registered manager and provider wished the service to be provided and these values were shared with the whole staff team. A robust system of auditing, mo

We carried out an inspection of Next Steps on 22 September 2015. This was an announced inspection where we gave the provider 48 hours’ notice because we needed to ensure someone would be available to speak with us.

Next Steps provides services to adults with learning disabilities, autism and complex needs. People who used the service previously lived in hospital, long term residential care or had moved away from home for the first time. The service supported people to move to supported living services or their own homes so that they could live more independently. Where people were living in supported living services the owner and registered manager lead projects with people, their families and health and social care professionals to design accommodation that was innovative and met people’s individual needs. At the time of our inspection there were eleven people who received a service from the agency.

We last inspected the service on 11 February 2014 and found the provider was meeting the required standards at that time.

The service had a registered manager. 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 service is run.

People had confidence and were comfortable with the staff who worked with them and said they helped them feel safe. Staff knew their roles and responsibilities and were knowledgeable about the risks of abuse and reporting procedures.

There was a strong emphasis on providing care which focused on the individual. People were supported to plan their support and they received a service that was based on their personal needs and wishes. The service was flexible and responded positively to changes in people’s needs. People who had come from long term care facilities had taken control of their lives and had been supported to acquire and develop life skills and form links within the area where they lived.

People told us the service was well-led and that the culture of the service was about ensuring a high standard of care for each person. Care staff told us they enjoyed working for the service, they received good training and felt very well supported.

The owner and manager promoted co-working with everyone involved in people’s care and were passionate about providing care tailored to each person enabling them to be empowered and have their voice heard. They went the extra mile in securing the right property and staff for each person referred. The culture of the service was open, constantly striving to improve and develop seeking and responding to people’s feedback.

Next Steps Hertfordshire has provided care and support to people who live with learning disabilities in their own shared and privately rented accommodation. During our inspection of the service on 11 February 2014, people said they had been involved in decisions about the levels of care and support provided to them. This had included support in choosing a house in a suitable location and helping the provider to select members of care staff. One person said, “We choose what we do and where we go….I decide what to do with my time and they [staff] help me.”

We looked at records which showed that people’s care and support needs had been assessed and documented. They were personalised and gave staff clear guidance on how to meet people’s individual needs and requirements. A relative of a person who used the service told us, “[Family member] is very, very happy. They have made fantastic progress toward living a more independent life….[staff] have helped them develop new life skills and become more confident and independent.”

People who used the service had been protected from the risk of abuse. Published guidance about safeguarding vulnerable people had been made available to staff and put into practice. One person who used the service commented, “I feel safe….I am not worried about anything.”

Records showed that suitable arrangements had been put in place to ensure staff were appropriately supported to perform their roles. One member of staff told us, “[The manager] is brilliant in terms of support and is always available for advice and guidance.”

The provider had put systems in place to regularly assess and monitor the quality of services provided.