St Anne’s Community Services (Sunderland) is a domiciliary care agency which provides personal care to six people in three shared houses. Other organisations managed the tenancies for the three houses. People who used the service had learning disabilities, autism spectrum disorders and/or physical disabilities. People who used the service were supported with personal care, medicines, cooking, shopping, activities and other day to day tasks.

At the last inspection on 13 and 14 January 2015, the service was rated Good. At this inspection we found the service remained Good.

Staff had received training to ensure they knew how to recognise and report potential abuse. Risks to people were identified and plans were in place to help manage and minimise risks. Medicines were managed in a safe way and checks were made to ensure staff were competent to administer people's medicines. There were enough staff to meet people's needs.

People were assisted to have maximum choice and control of their lives and staff supported them in the least restrictive way possible. People were supported to have enough to eat and drink in line with their needs and preferences. Staff were provided with effective training, support and development opportunities to enable them to meet people's needs.

Staff supported people to do the things they enjoyed and also encouraged independence with daily living. Staff were caring and respectful to people who used the service. Staff knew what was important to people.

Detailed support plans were in place which were specific to the needs of individuals. Support plans contained information about how people wanted and needed to be supported. People knew how to make a complaint but no complaints had been received since the last inspection.

The service had a registered manager. Staff told us there was a positive culture and they felt supported. Systems were in place to assess the quality of care people received. People's feedback was sought regularly and acted upon. Staff told us they could approach the management team at any time.

We visited two of the people who received care in their own home. We spoke with one person via their care worker, who signed for us as the person was deaf. They made us coffee and told us they liked their care workers, they helped them and they liked cooking. The person was cooking tea with the assistance of their care worker when we visited them at home. They also told us that they could get up what time they wanted, they usually had a lie in when they were not at work. They felt that staff listened to them and kept them safe.

Another person we spoke with told us how it was their birthday soon and they were really excited because they were going to have a big chocolate cake to celebrate and staff were arranging for them to go out for an Indian meal with their family. They also showed us a symbol book which they used to communicate with staff.

We found people were given care, treatment and support that met their needs. People who used the service were also protected from the risk of abuse, because the provider had taken reasonable steps to identify the possibility of abuse and prevent abuse from happening.

The provider could demonstrate that staff were supported to deliver care and treatment to an appropriate standard. There was an effective system in place to assess and monitor the quality of service.

This inspection took place over two days, 13 and 14 January 2015. The provider was given one days notice of our visit.

The last inspection of the service was carried out on 2 August 2013. The service met the regulations we inspected against at that time.

St Anne’s Community Care – Sunderland provided personal care, which is a regulated activity, to six people who lived in three separate tenancies. The tenancies were managed by a separate organisation. The amount of personal care provided by St Anne’s Community Care – Sunderland, varied according to the individual needs of each person. For instance, some people received around 20 hours support each week, while others needed up to 112 hours. Each person had learning disabilities. Some people used non-verbal communication methods to tell us their views.

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 2008 and associated Regulations about how the service is run.

People told us or communicated that they felt safe. They told us the service was “perfect” and “It’s alright here.” We observed people were happy and relaxed and had good relationships with the staff caring for them. The registered manager had successfully used a number of methods to raise staff awareness about protecting people from harm. This meant staff knew how to recognise potential abuse and what to do about it. Risks to individuals and the service were identified and managed effectively so that people were kept safe, without compromising their independence.

There were enough staff to meet people’s needs. Staff support was provided at the times people needed it and managed flexibly so people’s individual wishes could be accommodated. Staff had been thoroughly vetted before they were employed and effective measures were in place to cover any unexpected staff absences.

People’s medicines were managed effectively so that they received them safely. People told us they got their medicines at the right times they needed them.

The provider had ensured the staff were trained to provide the care people needed. This included basic training in the fundamentals of care, as well as more specialised training. For instance, staff had been trained to use British Sign Language as this was some people’s main method of communication. Constructive supervision and appraisal systems meant staff felt well supported to carry out their roles.

The registered manager understood the requirements of the Mental Capacity Act 2005 and had taken action where necessary when concerns were identified about people’s capacity to make their own decisions. She had also used effective measures to help staff understand the implications of this legislation for their practice.

Staff provided the support people needed to have a balanced diet. Any risks to individuals around eating and drinking had been identified and expert advice sought when necessary. Staff were well informed about any risks to people as well as their individual preferences about food and drink.

People got the support they needed to maintain good health and obtain medical advice and routine check-ups when needed. There were effective audit systems in place to monitor people’s health and wellbeing.

Staff were kind and considerate when providing care and support to people. They supported people to express their views and were skilled at listening and communicating with people who used non-verbal means of communication. It was apparent people got on well with their care workers. They told us, “I like the workers. They help wash and cook, and they drive the car,” and “I know all the staff. I like them all.” The staff clearly understood the importance of promoting people’s privacy and dignity when they provided care to them.

Detailed support plans were in place to guide staff as to how their care should be provided. It was clear from our communication with people, that they had been involved in drawing up their plan of care. As a consequence, the support provided to people reflected their wishes and aims. This meant people got the support they needed and wanted. For instance, people were able to get out into the community and enjoy their preferred social activities or go to work. This showed the service provided the personalised care people wanted.

People understood how to make a complaint or raise any concerns about their care. The registered manager had checked to make sure people understood how to do this. Documents about making a complaint used pictorial symbols to help people understand how to make a complaint.

The registered manager provided good leadership to the staff team and managed the service well. She was well known to people who used the service, which meant they had a good relationship with her.

The provider and registered manager had promoted a positive culture, which meant both people using the service and staff had ample opportunities to discuss their views about the service. People’s views were taken into account which meant the service was provided in a flexible way to meet people’s needs and wishes. For instance, the service had reduced the number of care workers providing support to one person, which had helped reduce his anxiety.

There were effective systems in place to check on the quality of care being delivered including regular meetings with people who used the service and staff, visits by management to people and regular auditing of each aspect of people’s care. We found these methods were used to improve the quality of care people received.