This inspection was announced and carried out on the 30 November and 2 December 2016. The provider was given 48 hours’ notice because the location provides a domiciliary care service; we needed to ensure we would be able to meet with people where they were receiving the service.

Saracen Care Services provides personal care and support to people with a learning disability and/or mental health needs to live in their own homes either on their own or sharing with others in supported living services. A supported living service is one where people receive care and support to enable them to live independently. People have a tenancy agreement with a housing provider and receive their care and support from Saracen Care Services. At the time of our inspection 13 people were receiving a personal care service.

The service was last inspected on 1 and 2 September 2014. At the previous inspection there were no breaches of regulation.

There was a registered manager in post at the service. 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 of the Health and Social Care Act 2008 and associated Regulations about how the service is run.

There was a clear management structure for providing good quality care. This included; A registered manager, general practitioner, business and quality manager, care director, three care managers, a training and development manager and office based staff. There were senior support workers and support workers providing support for people in their own homes.

The service was safe. Risk assessments were implemented and reflected the current level of risk to people. There were sufficient staffing levels to ensure safe care and treatment.

The service was not always responsible for people’s accommodation; however we found they had ensured people’s homes were safe and comfortable, through liaison with landlords and other relevant agencies. The Care Quality Commission’s role in these settings was to focus on the regulated activity of personal care and had no regulatory responsibility to inspect the accommodation. We saw that the provider had environmental risk assessments and a log of all maintenance records that had, or were due to be completed

People were receiving effective care and support. Staff received training which was relevant to their role. Staff received regular supervisions and appraisals. The service was adhering to the principles of the Mental Capacity Act 2005 (MCA) and where required the Deprivation of Liberty Safeguards (DoLS).

Staff told us there was an open culture and the environment was an enjoyable place to work. Staff were extremely passionate about their job roles and felt integral to the process of providing effective care to people. Management and care staff had a good understanding of people’s needs and wishes and communicated effectively to support them. Where it was clear people’s needs had changed, the registered manager worked with the person, families and health and social care professionals to check if the support needed changing to accommodate any additional care needs or reduced support. Staff said the service was very responsive to feedback.

The service was caring. We observed staff supporting people in a caring and patient way. Staff knew the people they supported well and were able to describe what they like to do and how they wanted to be supported. People were supported sensitively with an emphasis on promoting their rights to privacy, dignity, choice and independence. People were supported to undertake meaningful activities, which reflected their interests.

The service was responsive to people’s needs. Support plans were person centred to provide consistent, high quality care and support. People using the service and their relatives were able to raise concerns and were listene

Three adult social care inspectors carried out this inspection. The focus of the inspection was to follow up on previous breaches of regulations and answer five key questions; is the service safe, effective, caring, responsive and well-led?

As part of this inspection we spoke with nine people using the service and 15 staff. We also reviewed records relating to the management of the service which included seven care plans, daily care records and staff training records. Below is a summary of what we found. The summary describes what people using the service and the staff told us, what we observed and the records we looked at.

Is the service safe?

This service was safe. People and staff knew how to recognise and respond to abuse. The service ensured people were empowered to protect themselves as well as provided with protection. Some of the record keeping around people’s finances was not being completed thoroughly to ensure financial abuse was identified as early as possible.

Where risks existed, people were involved in agreeing how these would be managed. The focus was on taking informed risks to maintain people’s independence. This included acting in accordance with the Mental Capacity Act 2005.

People’s medicines were being stored, recorded and administered safely. Staff had access to the information they needed to safely administer medicines. The competence and performance of staff was being checked to identify any problems as soon as possible.

Is the service effective?

This service was effective. People’s support needs and preferences were met. Staff were knowledgeable about the people they supported and used this to help people be as independent as possible and to develop new skills.

Staff received the line management and support they needed to care for people competently. This included identifying and meeting ongoing training and development needs.

Staff monitored people’s physical and psychological wellbeing and ensured support was in place to meet their changing needs. Where necessary, staff contacted health and social care professionals for guidance and support.

Is the service caring?

This service was caring. People were treated with kindness and respect. People receiving support told us they were very happy with the support staff provided.

People told us there were plenty of opportunities to express their views about their support and the running of the service. People were involved in making decisions and were consulted by staff.

People were encouraged and supported to be as independent as possible. This required staff to have a detailed knowledge of people’s needs and preferences. The result was people were treated with dignity and as individuals.

Is the service responsive?

The service was responsive to people’s needs and wishes. Support plans accurately recorded people’s likes, dislikes and preferences. Staff had information that enabled them to provide support in line with people’s wishes. People were involved in developing and reviewing these plans.

People were supported to take part in activities and to do so as independently as they were able. People were supported to further develop their skills so that their independence increased. Staff helped people to remain in contact with those individuals who were important to them and provided support to meet their spiritual and social needs.

Is the service well-led?

This service was well-led. People using the service and staff said they understood the new management structure. Staff felt well supported and able to challenge poor practice. There was a commitment to listening to people’s views and making changes to the service in accordance with people’s comments and suggestions.

The service carried out regular audits to monitor the quality of the service and plan improvements. Learning also took place following incidents or complaints. Where a shortfall was highlighted, action was taken promptly. Information was shared with CQC about significant events in a timely manner.