This inspection took place on 19 and 21 March 2018 and was announced. This was to ensure someone would be available to speak with us and show us records.

St Anne's Community Services - North Tyneside DCA is a domiciliary care agency. It provides personal care to adults living in their own houses in the community. On the day of our inspection there were nine people using the service.

The care service has been developed and designed in line with the values that underpin the Registering the Right Support and other best practice guidance. These values include choice, promotion of independence and inclusion. People with learning disabilities and autism using the service can live as ordinary a life as any citizen.

This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection.

The service had a registered manager in place. A registered manager is a person who has registered with the Care Quality Commission (CQC) to manage the service. Like 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.

We last inspected the service in February 2016 and rated the service as ‘Good.’ At this inspection we found the service remained ‘Good’ and met all the fundamental standards we inspected against.

The service provided exceptionally person-centred care. Person-centred means the person is at the centre of any care or support plans and their individual wishes, needs and choices are taken into account.

People were involved in the running of the service. The registered manager told us, “Clients are at the centre of everything we do and they lead the services that we provide.”

The service was exceptional at supporting people to maintain their independence and staff treated people with dignity and respect.

People had ‘Accessible information’ support plans in place. The accessible information standard was introduced in 2016 to ensure anyone with a disability, impairment or sensory loss is given information they can easily read or understand. The plans described how people communicated, what their preferences were and how staff could support them with their communication needs.

Accidents and incidents were appropriately recorded and risk assessments were in place. The registered manager understood their responsibilities with regard to safeguarding, procedures had been followed and staff had been trained in safeguarding vulnerable adults.

Appropriate arrangements were in place for the safe administration and storage of medicines.

There were sufficient numbers of staff on duty in order to meet the needs of people who used the service. The provider had an effective recruitment and selection procedure in place and carried out relevant vetting checks when they employed staff. Staff were suitably trained and received regular supervisions and appraisals.

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.

Care records showed that people’s needs were assessed before they started using the service. People were protected from the risk of poor nutrition and staff were aware of people’s nutritional needs. Care records contained evidence of people being supported during visits to and from external health care specialists.

Activities and holidays were arranged for people who used the service based on their likes and interests and to help meet their social needs.

People who used the service and family members were aware of how to make a complaint.

The provider had an effective quality assurance process in place. Staff said they felt supported by the registered manager. People who used the service, family members and staff were regularly consulted about the quality of the

St Anne’s Community Services in North Tyneside provide personal care and support to people living in their own homes. At the time of our inspection there were 14 people using the service.

This inspection took place on 9 and 11 February 2016 and was announced. We last inspected this service in January 2014, at which time we found them to be compliant against all the regulations that we inspected.

The service had a registered manager in post. 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 told us they felt safe living at home with support from the staff. Staff understood their responsibilities to report any safeguarding concerns to the registered manager. People and staff told us they felt there were enough staff employed at the service to provide a consistent service and we confirmed this through records.

Policies and procedures were in place to support the smooth running of the service. Personal emergency evacuation plans were in place and regular checks on the safety of people’s homes were carried out.

Medicines were managed safely and in line with safe working practices and records were well maintained and accurate.

Accidents and incidents were recorded and monitored and where appropriate, care records showed that risks associated with individual care needs had been assessed and were monitored. There was evidence to demonstrate that regular reviews were carried out and the information was passed onto the support workers and other health and social care professionals where appropriate. Annual surveys were used to gather feedback from people about the service they received.

Evidence showed the registered manager and staff had an understanding of the Mental Capacity Act (MCA) and their own responsibilities. The service had assessed people’s mental capacity and reviewed it. Care records showed that wherever possible people had been involved in making some decisions, but significant decisions regarding people’s care were made in people’s best interests and had been appropriately taken with other professionals and relatives involved.

People told us they were supported by staff to maintain a well-balanced healthy diet. We found staff were trained and received induction, supervision and annual appraisal from the management team.

People were respected and their dignity was maintained. Staff displayed kind and caring attitudes and treated people as individuals. People’s care needs were detailed, recorded and reviewed by staff with input from people, their families and healthcare professionals. The registered manager told us they were in the process of updating people’s care records with the new wellbeing and outcome based documentation which had been recently introduced.

Staff offered people a choice in all aspects of daily life and people participated in a wide range of activities. Staff promoted social inclusion and supported people to maintain links with family and friends. People and their relatives told us they knew how to complain and would feel confident to do so if necessary.

Staff told us they worked well as a team. They felt supported by the registered manager and deputies who staff said were approachable and made them feel valued.

The registered manager held a comprehensive set of records which showed the monitoring of quality and safety of the service. Audits took place to ensure staff were undertaking their job competently.

We were not able to speak to all of the people who received the support of the service because of the nature of their condition. We gathered evidence of people's experiences by observation. We spoke with staff and observed their practices in order to determine

how this care and support was carried out.

We found members of staff were very attentive to people's needs. People looked well cared for and at ease with the staff members who were supporting them. People's needs were assessed and care and support was planned and delivered in line with their individual support plan.

Person centred care plans were in place, which included pictorial information to help with people's communication needs. These were regularly updated and contained clear information about individuals' care. People or their relatives had been involved.

People were protected against the risks associated with medicines because the provider had appropriate arrangements in place to manage medicines.

People were cared for by staff who were supported to deliver care and support safely and to an appropriate standard.

People's personal records were accurate, fit for purpose and held securely. Staff records were kept in an appropriate form.