About the service: Precious Homes Birmingham provides personal care to people in their own homes within a supported living setting. At the time of the inspection there were 16 people receiving personal care at the service.

People’s experience of using this service:

People felt safe and were supported by staff who understood how to report concerns and manage risks to keep people safe. Staff were recruited safely and people were supported by a regular team of staff. Medicines were given in a safe way and lessons were learnt when things went wrong.

There were systems in place to monitor the quality of the service. People were given opportunity to feedback on the quality of the service. People spoke positively about the management structure at the service and felt confident that concerns raised would be taken seriously.

Rating at last inspection: Good (Report Published 31 October 2018)

Why we inspected: The inspection was brought forward due to information of concern being received. The concerns related to the safety and care provided to people by staff employed by the provider.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

This inspection took place on 21 and 22 August 2018, and was announced. This was the first ratings inspection of this service since it became registered October 2017.

This service provides care and support to people living in a ‘supported living’ setting in 22 ordinary flats, so that they can live in their own home as independently as possible. The 22 ordinary flats are split into two units known as Falcons Lodge and Robins view. 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 care service has been developed and designed in line with the values that underpin the Registering the Right Support and other best practice guidance. These values include choice, promotion of independence and inclusion. People with learning disabilities and autism using the service can live as ordinary a life as any citizen. Registering the Right Support CQC policy.

At the time of our inspection there was no registered manager in post. However, two people were managing each of the two units and had applied to CQC to become registered with us. 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 supported by staff who were aware of their responsibilities to raise any concerns they may have in terms of people's health and wellbeing. Where safeguarding concerns had been raised, they had been responded to an acted on appropriately. Staff were aware of the risks to people and were provided with information to assist them in managing those risks safely. People were supported to take their medicines as prescribed, and staff competency checks were in

place to ensure staff followed correct procedures. Accidents and incidents were reported and responded to in a timely manner.

Pre-assessment processes in place provided staff with the information they needed to support people effectively and to meet their needs. Staff had received an induction and training that provided them with the skills to meet people's needs. 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.

People said staff were kind and caring and were respectful of their choices. People's preferences were taken into account, and staff ensured people’s privacy and dignity was maintained. People were supported by staff who knew them well and what was important to them. People were supported to promote their independence. There was a system in place to record people's complaints which people and relatives knew about.

The service had not been consistently well led since it became registered with CQC. People and health professionals did not always say they felt the service was well managed or well led. One part of the service had a high turnover of managers which resulted in problems with the quality and consistency of care. The staff now felt supported by the management team. Audits were in place to assess the quality of care of various areas within the service, but these had always been effective in the past. The provider had a clear vision for the development and growth of the service and had recently invested in new technology to assist with this.