This inspection took place on 13 November 2018 and was announced.

This was the second comprehensive inspection carried out at Smith Crescent Supported Living Service; the last comprehensive inspection took place in April 2016 and was rated Good. The service continues to be rated as Good.

Smith Crescent Supported Living Service is a domiciliary care agency. It provides personal care to people living in supported living accommodation. On the day of our visit, they were providing care for eight people, two of which received personal care.

The service had a registered manager. 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 and associated Regulations about how the service is run.

The provider and registered manager had improved people’s care and support plans, documentation and policies to be accessible in an easy read format. Quality monitoring of the service ensured people continued to receive their care as planned in a safe way.

People were encouraged to make decisions about how their care was provided and their privacy and dignity were protected and promoted. People had developed positive relationships with staff who knew people very well. Staff had a good understanding of people's needs, choices and preferences.

People received care from staff they knew well. Staff recruitment procedures were followed and staff received training and support to carry out their roles.

Staff understood their roles and responsibilities to safeguard people from the risk of harm.

People were supported to access relevant health and social care professionals. There were systems in place to manage medicines in a safe way.

Staff demonstrated their understanding of the Mental Capacity Act, 2005 (MCA). Staff gained people's consent before providing personal care. People were involved in the planning of their care which was person centred and updated regularly.

People were supported to express themselves, their views were acknowledged and acted upon. People using the service and their relatives knew how to raise a concern or make a complaint. There was a complaints system in place and people were confident that any complaints would be responded to appropriately.

We inspected the service on 2 June 2016 and the visit was announced. We gave notice of our inspection because we needed to be sure somebody would be available at the office.

Smith Crescent Supported Living Service provides domiciliary care for up to nine people with learning disabilities in their own homes. At the time of our inspection nine people were using the service. The office is located in another of the provider’s locations and is close to one of the houses.

At the time of our inspection there was a manager in place. This person was in the process of registering to become the registered manager. It is a requirement that the service has a registered manager. 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 and their relatives felt safe with the support offered. Staff understood their responsibilities to support people to keep safe and to protect them from abuse. They dealt with accidents and incidents appropriately. The provider had made sure that people were being protected from avoidable harm. This was because they were assessing risks to promote people’s health and well-being. For example, where people could have shown behaviour that challenged, staff had guidance available to them.

People received support from staff who had been checked before they had started to work for the provider. This had helped the provider to make safer recruitment decisions about the suitability of prospective staff. Relatives were satisfied with the availability of staff supporting their family members and we found that cover for staff absence had been managed.

People received their medicines as prescribed in a safe way. Staff were trained in how to administer people’s medicines and were regularly checked for their continued competency to do so. Staff knew what to do should a mistake occur when handling medicines.

People were receiving support from staff who had the appropriate skills and knowledge. Staff received regular training and the provider had plans in place to enhance this further. Staff met regularly with their supervisor to discuss their work and to receive guidance and support to enable them to provide good support to people. Staff had received an induction when they had started to work for the provider so that they knew about their responsibilities.

People were being supported in line with the Mental Capacity Act (MCA) 2005. The provider had assessed people’s mental capacity where this was necessary and made decisions in people’s best interests. Staff understood their responsibilities under the Act and were aware of the need to make applications to the appropriate body where they had sought to deprive a person of their liberties.

People were supported to maintain a balanced diet and had access to healthcare services when required. People made decisions about their health where they could and staff knew how to monitor their well-being.

People received support from staff who showed kindness and compassion. Their dignity and privacy was being protected including the safe storage of their care records. Staff knew people’s communication preferences and the provider had made information easier to read. For example, pictures were used to aid people’s understanding. People were being supported to be as independent as they wanted to be by staff who knew their preferences. People had been involved in decisions about their support and had information on advocacy services that could help them to speak up.

People or their representatives had contributed to the planning and review of their support. People, where they could, had chosen how often to review their support and were involved in checking that their support continued to meet their n

People we spoke with were satisfied with the care and support they received through Smith Crescent Supported Living Services. They felt staff treated them well with respect and supported their dignity. "This is my home and staff only help when I want them to."

Thorough risk assessments were completed to ensure people using the service were supported in the most appropriate way so as to promote their individual needs and independence. "Staff help me when I need it like if I want to go to the shops."

People told they felt safe and protected from abuse. "The staff are kind and I like them all."

We looked at how people using the service were involved and respected. People told us that staff treated them with dignity and were polite and friendly. "The staff are really good." Staff spoken with were able to describe how they supported people using the service ensuring their dignity was respected as well as involving them in their care.

People told us that staff supported them with their shopping and menu planning. We saw that people had access to a wide variety of food including where people had specific dietary needs such as being vegetarian.

We asked about infection control and people using the service told us that staff use gloves and aprons when they need to and we saw that staff receive infection control training.

We looked at how the medication was monitored in the service, people told us that they received their medication when they need it and staff told us that they receive training and are due for up dated training soon. We looked at medication records and saw they were well kept and medication was stored securely.

People using the service told us that they thought the staff were very good and knew what they were doing. We saw that staff received regular support and training to ensure they had the skills to do their job.

We asked if people knew how to complain, people using the service told us they did and they felt confident that it would be dealt with. We were shown an example of where this happened and it was fully investigated.