This was an announced inspection, carried out on 11, 12 and 18 December 2017.

This service provides care and support to people living in three ‘supported living’ settings, so that they can live in their own home as independently as possible. People’s care and housing are provided under separate contractual agreements. CQC does not regulate premises used for supported living; this inspection looked at people’s personal care and support.

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.

At our last visit on the 27 October 2015 the service was rated as good. This inspection identified that the service continued to meet all the relevant fundamental standards and the rating remains good.

People told us that they were kept safe whilst living at the service. Systems were in place to protect people from the risk of harm. Staff understood their responsibilities around safeguarding people from abuse and protecting their rights. Robust recruitment processes were followed and there were sufficient skilled and experienced staff on duty to meet people’s needs. There were safe systems in place for the management of medicines. Medicines were administered safely and administration records were up to date

Staff received support through supervision and team meetings. They were able to discuss any matters, such as their personal concerns, work or training needs. There was a programme of planned training which was relevant to the work staff carried out and the needs of the people who used the service.

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 in the service support this practice.

People received personalised care and support from staff who knew them exceptionally well. The registered provider ensured consistency in care as a dedicated team of staff supported the same people. Support plans contained detailed, personal and relevant information to enable staff to meet and promote people’s individual needs. Staff worked well with external health and social care professionals to make sure people received the care and support they needed. Staff were responsive in meeting changes to people’s health needs

Staff were caring and treated people with kindness and respect. Observations showed that staff were respectful of people’s rights, choices, privacy and dignity and encouraged people to maintain their independence.

The service was well managed and quality assurance systems were in place to ensure people received a safe and effective service. We were notified as required about incidents and events which had occurred at the service.

Further information is in the detailed findings below.

The inspection took place on 27 October 2015. The inspection visit was announced in accordance with the Care Quality Commission’s current procedures for inspecting domiciliary care service.

The service was previously inspected on a 25 November 2013 when it was found to comply with the requirements of regulations.

One to One Support is a domiciliary care service that provides support and personal care to people adults who may have learning difficulties, sensory impairment and mental health concerns. The service is provided to people living in their own accommodation (over three locations), rented through a partner landlord. This arrangement is often known as ‘supported living’. At the time of our inspection there were 11 people who received a service.

There was a registered manager in place. 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 told us they felt safe and secure. People received care and support from a team of established care staff who knew them well.

People’s feedback was valued by the service. The most recent survey confirmed peoples experience in receiving care and support was positive.

Care plans were available for all of the people who received the service. Each person’s care plan was up to date and included sufficient information to enable staff to meet people’s care needs.

Staff had a full understanding of the specialist care and support people required. Training and support for staff was happening on a regular basis and focused on the specialist needs of people using the service.

Staff told us they were supported by the registered manager. Staff had regular one to one meetings with the registered manager as well as monthly staff meetings.

Recruitment systems were robust by carrying out pre-employment checks. Staff received a full induction to understand their role and to ensure they had the skills to meet people’s specific needs. This helped ensure people received care and support from staff that were competent and well matched to the role.

Audit systems were in place to monitor and manage how care and support was being delivered and took account of accidents and incidents, as well concerns and complaints.

The registered manager demonstrated strong values and a desire to learn about and implement best practice throughout the service.

We spoke with four people who used the service and one relative. They all told us they were happy with the care provided and had no concerns. One person told us they were supported to be involved in activities in the local community. Other comments included; "I'm really pleased. They are very helpful", "Everyone is really good. I'm very pleased with the way (my relative ) has developed since we started using One 2 one" and "Everything is smashing. I know I'm well looked after".

We spoke with five members staff including the manager. They told us they thought the service employed enough staff to meet the needs of the people who used the service.

From discussions with staff and examination of training records we saw that staff were supported by the company to gain National Vocational Qualifications (NVQ) levels 2 and 3 in social care. Staff training was also current in areas such as first aid, manual handling, safeguarding and fire safety.

We saw that the manager or senior staff members did spot checks on care assistants to ensure the needs of people who used the service were met and staff were undertaking their duties in a safe and appropriate manner.

We found that records were kept securely and could be located promptly when needed. This included staff personnel files and records for people who used the service.

We found that people were able to express their views and were involved in making decisions about their care and treatment. We spoke with four people who used the service who confirmed they had been involved in the implementation of their support plans. We found that people were supported with their independence and community involvement. Comments from people who used the service included

“They(the staff) are perfect”

“The staff do a lot for me”

We looked at four care records and all had assessments of people's health and social needs completed. There were individual support plans and risk assessments in place. There was evidence within them to show they were evaluated on a regular basis. This meant that the service could demonstrate they could meet people's needs and maintain their health and wellbeing.

We contacted Chester and Cheshire West Local Authority who confirmed there were no issues of concern with regards to the service. We have received no concerns about the service.

We found that the provider has robust and effective systems in place in relation to the recruitment and training of its employees. We spoke to four members of staff. Comments from them included

“I enjoy my job immensely”

“Nothing stops me from doing a good job”

“I have good relationships with all of my colleagues”

The people who were able to say told us that they were being treated well by the staff members supporting them and that they were involved in all aspects of their care. A person who had only recently started to receive a service from the agency told us, “They are helping me to be independent”.

People told us that they were happy with the service the agency provided and that they liked the staff members supporting them. Comments included, “I like my independence”, “They are a lovely bunch of people”, “The staff are very good”.