This inspection was carried out on the 3 November 2016. The inspection was announced, and we gave the provider 48 hours’ notice to ensure there was a manager available to assist with the inspection process.

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

St. Christopher’s Trust is a domiciliary care service which supports people with a learning disability to live in the community, in houses and bungalows owned by the provider. At the time of our inspection, 26 people were receiving care and support from the provider.

The day-to-day management of the service and staff was carried out by the registered manager, who was supported by a management team. The registered manager and management team had worked at the service for many years and had a sound knowledge about the people who used the service. The service was focused on the needs of individuals and there was a commitment by the registered manager and the staff, to ensure people received the care and support they wanted and needed.

The service was focused on each person and accounted for personal likes, dislikes, needs and preferences. Staff encouraged people to make their own day to day decisions and staff respected those decisions whilst ensuring and being aware of people’s safety.

Staff were aware of the need to keep people safe and to protect them from the risk of avoidable harm. Staff and the registered manager understood procedures in relation to safeguarding and ensured any allegation of abuse was recorded and reported in the appropriate manner.

People were cared for by staff who had demonstrated their suitability for their respective role. Recruitment procedures were safe and included Disclosure and Barring service (DBS) checks.

People’s medicines were managed safely and in accordance with current regulations and guidance. There were auditing systems in place to ensure medicines records were completed; staff were trained in medicines administration and competency assessments were carried out.

Staff cared for each person in a supportive manner and were aware of promoting people’s independence. People were encouraged and supported to take part in activities of their choice.

Staff participated in training and supervision; they understood their roles and responsibilities in relation to the Mental Capacity Act 2005 (MCA). Capacity assessments and best interest decisions were available in people’s care plans.

People’s right to privacy and dignity was respected by the staff. Staff were kind, caring and compassionate; they promoted and supported people to remain as independent as possible.

Staff received training to ensure they were providing appropriate and effective care and support for people. People were involved in the assessment and planning of their care and care plans; we saw information was provided to people in different formats, to ensure they were included.

Staff felt they were supported by the management team and there was good team work being carried out. The registered manager had effective auditing systems in place to assess and monitor the quality of the service. People who used the service were asked for their opinions and views.

During our inspection we spoke with 12 people who used the service, six members of staff, three managers and three relatives.

People we spoke with said that they were highly satisfied with the service. A person using the service told us, "I like living here with my friends. We go to lots of places. There is nothing that I don't like." A relative told us, "X is very happy. The place is marvellous for (them). We have no complaints."

We saw that people were given choices in everyday life. Assessments of capacity had been reviewed regularly. Best interest meetings had been arranged where needed. A relative said, "I am kept well informed. I have been involved in best interest meetings. I am included in all discussions."

The format for care records, risk assessments and health action plans had been changed and reviewed to accurately reflect people's personal and health care needs as stated in the provider's action plan received following the last inspection.

Medicines were stored in people's bedrooms, giving them privacy and choice in the way they received their medicines.

Staff had received all required training and were well supported with regular supervision, appraisals and team meetings. There was access to senior staff at all times for advice. Staff told us they felt well supported by senior staff.

The provider had a system in place to regularly review the quality of the service provided.

People we spoke with told us that they received good support from St. Christopher's Trust. One person said, "We choose our own things for the house, and I have even got a job."

We found that people were consulted about their care, and that they were treated with dignity and respect by their staff team. Staff were knowledgeable and trained in relevant subjects to their role, and said they were well supported by managers. Procedures for recruitment enable St. Christopher's Trust to get the right kind of people to work at the service.

We saw that complaints were dealt with effectively, and staff were aware of how to safeguard people from abuse.

We found that although care files were very personalised, and many areas were detailed, some important information was missing and not all risks were adequately assessed. This meant that a risk was present to the care and welfare of people using the service.