Potens Torbay Domiciliary Care Services provides a supported living service to people with a learning disability or mental health needs. A supported living service is where people live in their own home and receive care and support in order to promote their independence. At the time of our inspection, not everyone using the service received personal care. CQC only inspects the service being received by people provided with personal care. The service provided support to seven people; four people lived in Conifer Lodge and the other three people lived in their own homes in the community. Two of these people were receiving personal care. We visited the supported living setting at Conifer Lodge. People had their own rooms and shared other parts of the house including the lounge, kitchen, and dining room.

This announced inspection took place on 10 October 2017. The provider was given 48 hours' notice because the location provides a domiciliary care service and people are often out during the day; we needed to be sure that someone would be in. One social care inspector carried out this inspection.

At the last inspection, the service was rated Good overall. At this inspection, we found the service remained Good.

Why the service is rated good:

People received a safe service. One person said "I have no worries at all.” Everyone looked very comfortable and relaxed with the staff who supported them. People told us there were enough staff to meet their needs and to spend time socialising with them. Risks had been appropriately assessed and staff had been provided with clear guidance on the management of identified risks. One person’s relative raised concerns about medicines in July 2017. We found new systems had been put in place. People were protected from the risks associated with unsafe medicine administration because medicines were managed safely.

People received effective care because staff had the skills and knowledge required to support them. Staff monitored people's healthcare needs and advice and support was sought from healthcare professionals when needed. 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 supported this practice.

Staff provided a caring service to people. People told us, and we observed, that staff were kind, caring, and patient. Comments included “I’m very happy, it’s a brilliant home” and “You ought to move in, it’s lovely”. People were involved in decisions about the care and support they received.

Staff were responsive to people's individual needs. Care and support was personalised to each person which ensured they were able to make choices about their day to day lives. People were aware of how to make a complaint and felt able to raise concerns if something was not right.

The service was well led. People and staff told us the management team were open and approachable. The manager and provider sought people's views, listened to them and used suggestions to make improvements. One person said “The manager is great.” Staff told us improvements had been made in the past couple of months. The manager and provider had monitoring systems which enabled them to identify good practice and areas of improvement.

Further information is in the detailed findings below.

Potens Torbay Domiciliary Care Services provides a supported living service to people with a learning disability or mental health needs. A supported living service is where people live in their own home and receive care and support in order to promote their independence. At the time of our inspection, the service provided support to five people living in three houses. We visited the supported living setting at Conifer Lodge. People had their own rooms and shared other parts of the house including the lounge, kitchen, and dining room.

We carried out this announced inspection on 29 July 2015. The last inspection took place in February 2014 during which we found there were no breaches in the regulations.

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.

People were happy and relaxed on the day of our inspection visit. People felt safe and comfortable in their home. People said “I feel safe here, it’s my home” and “I’m very happy with my support”. Staff understood the signs of abuse, and how to report concerns. Appropriate staff recruitment checks had been undertaken to ensure staff were suitable to work with vulnerable people.

Staff treated people with respect and kindness. There was lots of discussion and people clearly enjoyed talking with staff about their interests. Staff responded with warmth and there was lots of laughter.

People received support from skilled, trained, and experienced staff who knew them well. People told us ““The staff are excellent” and “All the staff are lovely, I get on really well with them. That’s the way life should be”. A healthcare professional said one person they visited had a good relationship with staff and felt settled. There were enough staff to meet people’s needs, enabling people to go out when they wanted to.

People were enabled through positive risk taking to progress, gain new skills, and increase their independence. People were active members of their local community and took part in a range of activities.

People were involved in planning their support. Staff had an awareness of the Mental Capacity Act 2005 (MCA). The MCA provides the legal framework to assess people’s capacity to make certain decisions, at a certain time. When people are assessed as not having the capacity to make a decision, a best interest decision is made involving people who know the person well and other professionals, where relevant. The registered manager told us if people had been assessed to lack capacity, decisions would be made in the person’s best interest and take into account the person’s likes and dislikes. One person had been assessed as lacking capacity in relation to finances. The registered manager had made a referral to the local authority for an appointee to manage their finances. The Court of Protection appoints a person to make best interest decisions about people’s finances.

The service had an open culture, a clear vision and values, which were put into practice. Staff felt well supported by the registered manager and staff team to fulfil their role. The registered manager worked alongside the staff in the home. People knew the registered manager well and found them to be approachable. Comments included They’re very good” and “I do go to the manager”.

People were actively involved in the running of the service. There were regular meetings where people were encouraged to give feedback. People took part in staff interviews and had devised a list of questions to ask. People had asked for an extra safety check to confirm visitor’s identity and this had been introduced.

The provider had systems in place to assess and monitor the quality of care and support provided. The service encouraged feedback and used this to drive improvements.

We asked staff how they ensured people were able to make informed decisions and consent to the support offered to them. One support worker said “I discuss with people and inform them that such and such could happen if they choose A or B; this helps them to make an informed decision. The final decision is theirs”. One person we spoke with said “Staff ask my consent without any doubt. I am definitely encouraged to make my decisions; if I need advice they are there”.

One person told us “I am very happy, no worries, no complaints at all. Staff treat me with courtesy and are polite. They help me to be independent; that goes without saying. Never in my entire life have I been in such a nice place. It is really brilliant. To be part of this is very rewarding”.

In the support folders we looked at we saw assessments of people's ability to self-administer their medicines and, when relevant, risk assessments had been completed. Detailed support plans for managing medicines had been completed for people where this was appropriate.

One of the people we spoke with said “staff ask me how things are going fairly often”. Another person said “If I was unhappy I would tell the staff and they would listen”.

As the people using this service have busy lives and we wanted to be sure to meet some of them, we gave two days notice of our inspection. During the inspection we spoke with two of the five people using the service. One declined to speak with us, and two others were out. We also spoke with the manager and with two support workers.

People told us their support ”was the best”. They said they felt safe and that the support they received “liberated” them and made the “world their oyster”. People received support in line with the organisations values which included empowerment and enabling. People were supported to overcome obstacles to social inclusion and to be meaningfully occupied. For some people this meant working, for others learning to drive.

Support workers were enabled to help people to build upon and further develop their abilities. Support was provided in the form of appropriate training, positive role modelling and informal supervision. The way the support workers rota was organised meant that there were always enough support workers to support people in flexible and creative ways.

Systems were in place to monitor risk and to improve the quality of the service provided. Records were accurate, well organised and kept securely and safely.