About the service: Steps to Independence Limited is a small Care at Home service supporting people to live independently in their own homes. At the time of inspection, the service was providing personal care and support to five people with complex learning or physical disabilities in their own homes.

People’s experience of using this service: The registered managers and staff successfully ensured people received high quality, person-centred care. They ensured people received a high quality of care from staff who knew them well.

The registered managers had been in place for several years and were supported by a small team of dedicated staff who were well trained and understood their roles. People’s relatives spoke highly of the registered managers, as did staff. They had backgrounds and experience relevant to the service.

Staff turnover was low and morale high. Staff had developed strong bonds with people and confirmed they were able to spend time getting to know people rather than focussing on tasks. All staff shared the provider’s vision of enabling independence for people in their own homes.

Staff received a range of relevant training, specific to people’s needs. They were supported by regular discussions with their manager and more informal support.

Records were accurate, up to date and person-centred. Oversight of these records and processes was strong and consistent. The registered managers demonstrated sound management of the service and clear plans in place to monitor and continually improve service provision.

People were supported to attend or take part in a range of activities and to try new things. Staff proactively encouraged people to live full lives and to maintain and develop their independence.

Medicines administration was safe and staff had the appropriate skills and knowledge. People were kept safe and staff were suitably trained in safeguarding principles and practice.

People’s capacity was assumed and staff acted in line with the Mental Capacity Act 2005. 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. Appropriate training was in place.

The registered managers responded to any concerns or complaints and had appropriate policies and procedures in place.

Staff at all levels worked in line with the company ethos of promoting independence wherever possible.

The care service was managed in line with the values that underpin 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.

Rating at last inspection: We last inspected the service in June 2016 and rated the service good.

Why we inspected: We inspected the service in line with our scheduled programme of inspections.

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

We carried out this inspection on 23 June 2016. We told the provider we were coming 48 hours before the visit so they could arrange for staff to be available to talk with us about the service.

Steps to Independence Limited is a domiciliary care service which provides personal care support to people with complex learning or physical disabilities in their own homes. At the time of our visit three people used the service. One person was supported by staff with 24 hour care.

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. A registered manager had been in place since January 2014.

Relatives told us people felt safe using the service because staff were skilled and knowledgeable, and knew how to care for them. Care workers had a good understanding of what constituted abuse and safeguarding concerns were raised with the local authority.

Checks were carried out prior to care workers starting work to ensure their suitability to work with people who used the service. Care workers received an induction to the organisation, and a programme of training to support them in meeting people’s needs effectively.

Staff understood the principles of the Mental Capacity Act (2005), and had received training in this.

People who required support had enough to eat and drink during the day and were assisted to manage their health needs. Care workers referred people to other professionals for further support if they had any concerns. People and families had regular opportunities to meet with staff to review their care.

People had care workers they were familiar with, who arrived at the expected time and completed the required tasks. There were enough care workers to care for the people they supported.

Relatives told us care workers were kind and caring and had the right skills and experience to provide the care their family members required. People were supported with dignity and respect. Care workers encouraged people to be independent where possible and to further develop their life skills.

Care plans contained relevant information for care workers to help them provide personalised care including processes to minimise risks to people’s safety. People received their medicines when required from staff trained to administer them.

People knew how to complain and could share their views and opinions about the service they received. Care workers were confident they could raise any concerns with the registered manager and provider, knowing they would be listened to and acted on.

The management team gave staff formal opportunities to discuss any issues with them. There were processes to monitor the quality of the service provided and understand the experiences of people who used the service. This was through regular communication with people and staff. Other checks and audits ensured care workers worked in line with policies and procedures.