We carried out an announced inspection of the service on 25 February 2016. Pure Offices is registered to support people with their personal care. Pure Offices specialises in providing care and support for people who live with a learning disability, in their own homes and when out in the community. At the time of the inspection there were twelve people receiving support with their personal care.

On the day of our inspection 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.

The risk to people’s safety was reduced because staff had attended safeguarding adults training, could identify the different types of abuse, and knew the procedure for reporting concerns. Risk assessments had been completed in areas where people’s safety could be at risk. People had the freedom to live their lives as they wanted to. Staff were recruited in a safe way and there were enough staff to meet people’s needs and to keep them safe.

Accidents and incidents were investigated. Assessments of the risks associated with the environment which people lived were carried out and people had personal emergency evacuation plans (PEEPs) in place. People’s medicines were stored, handled and administered safely.

People were supported by staff who received an induction, were well trained and received regular assessments of their work.

The registered manager ensured the principles of the Mental Capacity Act (2005) had been applied when decisions had been made for people. Staff ensured people were given choices about their support needs and day to day life. The registered manager was aware of the requirements to apply for and implement Deprivation of Liberty Safeguards.

People were encouraged to plan, buy and cook their own food and were supported to follow a healthy and balanced diet. People’s day to day health needs were met by the staff and external professionals. Referrals to relevant health services were made where needed.

People were supported by staff who were very kind and caring and treated them with respect and dignity. Treating people with dignity was one of the provider’s top priorities. Innovative methods were used to communicate with people to make them feel their views mattered and they would be acted on. Staff responded quickly to people who had become distressed. There was a high emphasis on person centred care and staff were aware of the importance of encouraging people to live their lives as independently as possible.

People were able to contribute to decisions about their care and support needs. People were provided with an independent advocate, if appropriate, to support them with decisions about their care. People’s friends and relatives were able to visit whenever they wanted to.

People’s support records were person centred and focused on what was important to them. The records were regularly reviewed and people and their relatives were involved. People were encouraged to take part in activities that were important to them and were provided with the information they needed, in a format they could understand, if they wished to make a complaint.

People, relatives and staff spoke highly of the registered manager; they found him approachable and supportive. The registered manager understood their responsibilities and ensured staff felt able to contribute to the development of the service. Staff roles were developed and the risks to the service were explained to them. People who used the service were encouraged to provide their feedback on how the service could be improved. There were a number of quality assurance processes in place that regularly assessed the quality and effectiveness of the support provided.

During the inspection there were 13 people who used the service. Due to the complex needs of the people who used the service we used other methods to assist us with our inspection. We spoke with five relatives and asked them about the care their family member received. We spoke with the registered manager and four support workers. We reviewed support plan documentation, staff personnel and training files and company policies and procedures.

Throughout this inspection we focused on these five key questions; is the service safe, effective, caring, responsive and well-led?

Below is a summary of what we found. The summary describes the records we looked at and what relatives of people who used the service and the staff told us.

If you want to see the evidence that supports our summary please read the full report.

Is the service safe?

We asked relatives of people who used the service whether they felt their family member was safe when support was provided by the staff. A relative we spoke with said, “I have no worries at all when the staff are with them and they go out together.” Another relative said, “My son is absolutely safe.”

The relatives we spoke with told us they were involved in decisions about their family member’s support. All spoke positively about the registered manager and the staff stating they were pleased that they were consulted. However, support plan documentation did not always record when discussions with relatives had been held.

There were procedures in place to identify and prevent abuse to people occurring. Staff showed a good knowledge of the referral process and could explain the process they would follow, both internally and externally, should they suspect someone had been the victim of abuse.

The CQC monitors the operation of the Deprivation of Liberty Safeguards (DoLS) which applies to care homes. At the time of the inspection no application for DoLS had been made, but the registered manager could explain the process for doing so.

Is the service effective?

We asked relatives of people who used the service what they thought of the support provided by the staff. One relative we spoke with said, “They had a new support worker start recently. They were introduced to my daughter first and really got to know her before she then went out alone with her. She gained my daughter’s trust. It was a really effective and clever way of approaching this.”

We looked at three staff personnel files, training records and the training matrix. The training matrix showed what training had been completed by the staff. The training matrix, on the whole, showed training was up to date, although we identified some areas where training for some staff had expired.

Staff received regular supervision and assessment of their work and areas for future development were identified.

All four of the staff we spoke with told us they felt appropriately trained for their role.

Is the service caring?

We asked relatives of people who used the service whether they felt the staff provided support in a caring manner. One relative said, “I can’t fault the staff in anyway. From start to finish they have accommodated my son so well. The staff are spot on.”

Is the service responsive?

People’s individual needs were assessed and responded to appropriately. One support plan we looked at stated the person required staff to use Makaton signs and symbols. Makaton is a language programme which uses signs and symbols to help people to communicate. It is designed to support spoken language and the signs and symbols are used with speech, in spoken word order. We spoke with this person’s relative and they spoke very highly of the staff. They said, “They [staff] are great with my son, they know his needs straight away.”

We saw the provider’s policy which stated how they prevented people from unlawful discrimination.

Is the service well-led?

Staff spoken with told us they felt able to raise any issues they had with the registered manager. They told us they felt supported and their views were respected. A support worker we spoke with said, “I get on really well with the manager, they are very approachable and supportive. They are always there to help.” A relative we spoke with said, “The manager is spot on and thorough. They ensure such a consistent approach to the care provided.”

The registered manager was aware of the parts of the service that required improvement and plans were in place to ensure the improvements were made.