About the service: Sense Supported Living Services (East Anglia) provides care and support to people with learning disabilities. At the time of the inspection it was providing support to two people who used the regulated service. This service provides care and support to people living in “supported living” settings so that they can live in their own home as independently as possible.

People’s experience of using this service:

• The service applied the principles and values of Registering the Right Support and other best practice guidance. These ensure that people who use the service can live as full a life as possible and achieve the best possible outcomes that include control, choice and independence.

• People were protected from abuse, neglect and discrimination.

• There was a positive approach to risk taking. Individual risks to people were assessed and managed to keep people safe while promoting their independence.

• Medicine systems were organised and people were receiving their medicines when they should.

• We made recommendations that were actioned about the auditing of medicines administration and to follow best practice guidance in relation to medicines taken as required (PRN).

• People’s needs were assessed holistically and staff were person-centred in the way that they supported people.

• People were supported by staff who had ongoing training to meet their 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.

• Staff were kind and caring and the service matched people with staff that shared interests and could meet their needs.

• The service was responsive to people’s needs. People were supported to pursue interests and hobbies and take an active role in the community.

• The service was well led and managed. The registered manager had made improvements to the service over the past year which people, relatives and staff were very positive about.

• Their was a commitment to continual learning and improvement in the service. Feedback from people, relatives and staff were used to develop an action plan for the service.

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

Rating at last inspection: At the last inspection the service was rated good. (Report published 12 September 2016)

Why we inspected This was a scheduled planned inspection based on the previous rating.

Follow up: Going forward we will continue to monitor this service and plan to inspect in line with our reinspection schedule for those services rated good.

The inspection took place on 3 August 2016 and was an announced inspection. This meant that we gave the service notice of our arrival so that we could meet with people who used the service.

The service is registered to provide personal care to people living in their own homes and there were five people using the service at the time of this inspection. The service provided care and support to people with a sensory impairment and physical and learning disabilities.

There was a registered manager for this service, who was available every day. 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 felt safe using the service. Staff were trained in adult safeguarding procedures and could identify what to do if they considered someone was at risk of harm, or if they needed to report concerns.

There were systems in place to identify risks and protect people from harm. Risk assessments were in place and carried out by staff who were competent to do so. Risk assessments recorded what action staff should take if someone was at risk and referrals were made to appropriate health care professionals to minimise risk going forward.

There were sufficient staff to keep people safe and meet people’s needs, and the registered manager had followed safe recruitment procedures. Staff were competent with medicines management and could explain the processes that were followed.

Policies and procedures were in place to guide staff in relation to the Mental Capacity Act 2005. The registered manager understood that there should be processes in place for ensuring decisions were made in people’s best interests.

Staff were caring, knew people well, and supported people in a dignified and respectful way. Staff acknowledged people’s privacy. People felt that staff were understanding of their needs and had positive working relationships with people.

Care provided was individualised according to each person’s needs and preferences. People and their relatives were involved in assessment and reviews of their needs. Staff had knowledge of changing needs and supported people to make positive changes to their care plans.

People and staff knew how to raise concerns and these were dealt with appropriately. The views of people, relatives, health and social care professionals were sought as part of the quality assurance process. Quality assurance systems were in place to regularly review the quality of the service that was provided.

People told us that staff asked them what they wanted to do and that they were happy with their support. One said, "I tell them what I want doing." They told us how staff were supporting them to minimise stress so that they made better decisions. Where people found it difficult to communicate, we found they were offered items to choose from and that pictures were used to help them make decisions. Where they were not able to do so, the service followed a proper process for ensuring decisions were in the people’s best interests. This showed the service was responsive to people's needs.

We found that people's needs, including risks, were assessed and staff had guidance about how to support people safely. People had a say in developing their own plans of care and one had been supported in making a DVD to show how their safety was promoted. Staff gave us information about people's needs which matched what was in their care plans. Staff also supported people with respect and at their own pace. People were comfortable and at ease with staff.

There were arrangements to ensure staff were reminded about reporting abuse and bad practice. They had training to support them in this. They also had access to a range of other training to support people effectively, as well as opportunities to discuss people's needs in staff meetings with their manager or with their peers. This helped show that people received safe care.

There were systems in place to ensure that the quality and safety of the service people received was checked. Where appropriate, actions for improvement were identified and followed up.

During this visit we saw three people who used this service that supported them to live in their own homes. One person informed us, "I am very happy with the way I am supported to live at home." Conversations heard and body language observed told us that people were content and involved with their day to day lives. We were told by people that they were listened to and concerns were acted upon. One person told us of the changes that had been made to make their life more enjoyable.

Care plans were written, updated when required and were focussed on the individual the care plan belonged to. The risks were identified and appropriate action was taken. Relevant professionals were involved and supported the needs of the individual person.

Staff were trained and supported to ensure good infection control procedures were followed and that they would be implemented as much as possible when working in someone’s own home.

No complaints had been received and any concerns were acted upon as and when they occurred.

Records were detailed, up to date and relevant to the individual they belonged to. Storage of records to be archived we were told were carried out by SENSE in a timely manner, with the previous year's records stored locally and then transported to a central store for the storage time required for records.

SENSE Dereham resource centre currently supports three people in their own home. On the day of our visit on 13 January 2012, two people were not able to see us for different reasons, we therefore visited one person in their home. This person told us they were happy with the staff who supported them. We were told that staff helped when needed and go out with the person when activities are undertaken. We saw that staff did work in a relaxed way and they were prompting and talking in a considerate way that respected the fact that this visit was about the person who receives support. The person we talked with was aware of why we visited and told us they had no problems and they were excited about a holiday that is planned with staff providing support. We were told ‘staff go shopping with me and help me to get some good food so I do not put on weight. I sometimes slip some treats into the trolley.’ There was much laughter following this conversation and we were then shown into the kitchen to look in the fridge.