This inspection took place on 12 September 2017 and was announced. We gave the service a short period of notice that we would be attending as we needed to ensure that senior personnel would be available during the inspection. This was the service’s first inspection since newly registering with us in February 2016.

At the time of this inspection the service supported 25 people living in different premises, including single occupancy properties and shared occupancy accommodation. The service is registered for the provision of personal care in people’s own homes. This includes support with personal care, such as assistance with bathing, dressing, eating and medicines. We call this type of service a ‘supported living’ service.

People’s accommodation was provided by separate landlords, usually on a rental or lease arrangement. Somerset Care Realise was responsible solely for the provision of personal care and not for the provision or maintenance of the premises. People who used the service had a wide range of cognitive impairment and/or other support needs, ranging from mild to severe learning disabilities, autistic spectrum disorders and early onset dementia. People were aged between 19 and 70 years of age. Some of the people had very complex support needs and required a large support package from the service, and other people were more independent and received support for just a few hours a day to help with their daily routines.

People told us they felt safe. People’s risk had been assessed and recorded, and risk management guidance for staff was available when needed. People’s risks were assessed for when at home and when accessing the wider community. Where people had specific medical risks, guidance was available for staff to refer to during any emergency.

There were safe recruitment procedures undertaken. The service had staff vacancies but there were systems in place to ensure people’s needs were met. There were systems to monitor reported incidents and accidents and people’s medicines were managed safely and in line with their assessed needs.

People received effective care from staff that had received training to meet their needs. Where the need was identified, additional training specific to the needs of a person was provided. Staff were also supported through a regular supervision process to discuss their performance. Annual appraisals ensured development goals and objectives were set. New staff received and induction.

Where required, people received support to eat and drink and identified nutritional risks were managed. People had support to access healthcare professionals and staff were trained in the principles and application of the Mental Capacity Act 2005.

Staff were caring and people received care in line with their needs. During our conversations with staff, it was evident they knew people well and understood them. Staff commented on how they tried to encourage and promote people’s independence. Staff understood people’s medical needs and how certain conditions were managed. We observed positive interactions between people and staff during our visits to people’s houses. The service had received compliments about their care provision. People were involved in care planning and received key information about the service and its aims.

The service was responsive. People felt they received a responsive service and we observed interactions to support this. People received an assessment prior to care being provided to ensure the service could meet their needs. People’s care plans were personalised, containing key information on how to support and communicate with them. There were systems in place to review care records. People were given information on how to complain. Surveys were sent to people in order to capture their views, and a new ‘customer forum’ was about to be launched to involve people in policy, care provision and quality assurance.

The service had adequate governance systems to monitor the