This inspection took place on 5 and 6 October 2016. It was an announced visit to the service. This meant the service was given 24 hour notice of our inspection. This was to ensure staff were available to facilitate the inspection.

The service is registered as a domiciliary care service. It provides care and support to people living in supported living schemes and in their own homes. It specialises in providing support to people in the community with epilepsy. At the time of the inspection they were providing support to 29 people.

There was a registered manager in post as required. 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.

We previously inspected the service on the 11 January 2013. At that inspection the service was found to be non- compliant in supporting staff. We carried out a follow up visit in November 2013. We found the service had addressed those concerns and was fully compliant with regulations in place at that time.

At this inspection we found the service was providing safe, effective, caring, responsive and well-led care to people. People and their relatives were happy with the care provided. They described staff as kind, caring, patient and enabling.

Systems were in place to safeguard people. Risks to people were identified and managed which promoted people’s independence. People had support plans in place and they were involved in their care. The support plans outlined the schedule of visits and the support required at each call. The support plans were updated and reviewed in response to people’s changing needs.

Medicines were safely managed with people supported and enabled to self-medicate.

People were provided with staff at the time they required. The service was flexible too and was able to provide person centred care to people in response to their seizures as well as support with interests, hobbies and health appointments.

People’s privacy and dignity was promoted. Staff were respectful of the person’s home and their environment.

Staff were suitably recruited, inducted, trained, supervised and supported. This enabled them to have the right skills and training to support people effectively. People were supported by an established staff team who worked well together to benefit people.

People and their relatives were aware of the complaints procedure and knew how to raise concerns. They confirmed issues raised were addressed. People were asked for feedback on the service to improve practice. The registered manager and the provider audited the service to satisfy themselves the service was running effectively. Where issues were identified action was taken to make improvements.

The management team were accessible, approachable and supportive. People who used the service and relatives were positive about the management team. People described the registered manager as “Fantastic boss, good at what they do, caring, helpful and someone they can have a laugh and chat with”. Staff felt management listened and valued them which promoted a happy working environment.

When we visited the service on 11 January 2013, we found staff had not been supported through regular supervision and appraisal. We set a compliance action for the provider to improve practice. At this inspection we found the service had addressed these concerns. Staff we spoke with told us they felt supported by the manager and colleagues and they had regular supervision and an annual appraisal. One person told us "The staff here are well trained." Another person told us "The staff know their job well and support me when I need them."

We found peoples care and support needs were met by suitably qualified, skilled and experienced staff. One member of staff told us “I didn’t expect the recruitment process to be so thorough and detailed.”

We found the provider had an effective system to regularly assess and monitor the quality of service that people received. People we spoke with told us that regular resident meetings took place for people to raise any concerns or issues. One person told us “They do ask us for feedback and I let them know what I think.” Another person told us “I attend the resident meetings which take place here, these give me the opportunity to say what they (Service) are doing well and tell them areas they can improve on.”

People told us they were happy with the care provided and were involved with their care and support needs. Everyone we spoke with told us their dignity was respected and confidentiality was always maintained. One person told us "I make my own decisions here", and another person told us "staff treat me with respect and dignity."

People's needs were assessed and care and treatment was planned and delivered in line with their individual care plan. Care plans were person centred, detailed and informative. People told us "I am happy with my care plan" and "my care plan meets my needs and requirements". People who use the service were protected from the risk of abuse, because the provider had taken reasonable steps to identify the possibility of abuse and prevent abuse from happening. People told us "I am very safe here", "I feel safe living here and going out with the staff."

Staff members had received up-to-date essential training including safeguarding and epilepsy awareness. However there was the potential for people to be placed at risk as staff were not supported through supervision and appraisal.

People were made aware of the complaints system. People were given support by the provider to make a comment or complaint where they needed assistance. The service had a complaint's policy and procedure. People told us "I know how to make a complaint" and "no concerns and no complaints at all."