This inspection took place on 29 November 2017 and was announced. The provider was given short notice of our intention to inspect the service. This is in line with our current methodology for inspecting domiciliary care agencies to make sure the registered manager would be available.

Supported Living Service provides care and support to people living in 12 ‘supported living’ settings, so that they can live in their own home as independently as possible. People’s care and housing are provided under separate contractual agreements. CQC does not regulate premises used for supported living; this inspection looked at people’s personal care and support.

There were 25 people receiving personal care and support when we inspected.

At our last inspection on 12 and 13 October 2016 we rated the service as ‘Requires Improvement’ and identified one breach related to staffing. Following the last inspection, we asked the provider to complete an action plan to show what they would do and by when to improve the key questions ‘Safe’ and ‘Well-Led’ to at least good. We found action had been taken to make improvements.

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.

Staffing had improved since the last inspection as the provider had filled many of the staff vacancies and there was an ongoing recruitment drive. Staff recruitment procedures ensured staff were suitable to work in the care service. Staffing levels were flexible to meet people’s needs.

Staff received the training and support they required to carry out their roles and meet people’s needs. All staff had received refresher training in first aid which had been overdue for some staff at the last inspection.

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.

We saw staff knew people well and understood how to manage risks without limiting people’s freedom unduly. Staff understood safeguarding procedures and how to report any concerns. Medicines were managed safely and people received their medicines when they needed them.

Staff supported people to access healthcare services. People were involved in planning their care and support which was delivered to meet their needs and preferences. Staff supported people to lead active lives of their choosing and to keep in contact with family and friends. There were systems in place to manage complaints.

Relatives praised the staff for their kindness and caring manner. Staff we spoke with knew people well and had developed positive relationships with them. They were compassionate, considerate and respectful in their interactions with people and were skilled in communicating and responding to their needs.

Relatives and staff were complimentary about the management team and leadership of the service. The registered manager led by example and promoted person-centred care. Effective quality audit systems were in place.

We inspected the Supported living Service on 12 & 13 October 2016. The provider was given 48 hours’ notice of our intention to inspect the service. This is in line with our current methodology for inspecting domiciliary care agencies to make sure the registered manager would be available.

The last full inspection took place on 13 September 2013, when we found the service was meeting the regulations we looked at.

Supported Living Service is a domiciliary care agency which provides care services to people in their own homes. They are currently providing a domiciliary care service to 32 people in their own homes. At the time of our visit 17 people were receiving a personal care service. It is the ‘personal care’ element of the service we regulate. The agency can provide a service to adults, older people, people living with dementia, people with physical disabilities, learning disabilities or autistic spectrum disorder, sensory impairment and people living with mental health issues.

There was 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.

We found that people were provided with care and support by staff who had the appropriate knowledge and training to effectively meet their needs. The skills mix of staff was good, however the provider had not recruited any new staff for two years. There were 12 vacancies for care workers across the scheme. Existing staff and pool staff were covering the vacant posts because of their dedication to people who used the service. If at any time they decided to just work their contracted hours the service would become potentially unsafe.

Staff had opportunities for on-going development and the registered manager ensured they received supervision, annual appraisals and training relevant to their role. However, the provider had not responded to the registered managers request to update everyone’s first aid training.

People who used the service told us they felt safe with the care they received. We found there were appropriate systems in place to protect people from risk of harm.

There were policies and procedures in place in relation to the Mental Capacity Act 2005 and staff had received relevant training.

People told us staff were kind, helpful, compassionate, caring and understood people’s needs. The staff we spoke with were able to describe how individual people preferred their care and support to be delivered and the importance of treating people with respect in their own homes.

Care plans were in place and available in people’s own homes for staff to follow. These clearly detailed what care and support people needed from staff and what they could do independently.

Medicines management systems were in place to ensure people received their medicines at the right times. When necessary staff offered appropriate support to make sure people’s healthcare and dietary needs were met.

There was a complaints procedure available which enabled people to raise any concerns or complaints about the care or support they received.

People using the service, relatives and staff we spoke with were very positive about the registered manager and told us they would recommend the service.

A range of audits and checks were undertaken by the registered manager and assistant managers to help ensure the service worked to a consistently high standard.

We found one breach of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see what action we told the provider to take at the back of the full version of the report.

We spoke with the manager of the service, five staff and five people who used the service. We also contacted two relatives of people who used the service by telephone to gain their views.

We visited people in their homes to speak with them and observed how they were being supported.

We saw people who used the service were happy and they spoke highly of the staff. People told us they liked being independent and said staff helped them do things for themselves.

Relatives we spoke with very happy and told us their family members were well cared for and supported. One relative told us the staff “absolutely bend over backwards to help” and said “we can’t believe how lucky we are”. Another said staff knew their family member well and provided “superb care and support”.

We spoke with staff who explained how they kept people safe and the procedure they followed to report any safeguarding concerns. People who used the service told us they felt safe.

We saw there were systems in place which effectively monitored the quality of the service. We looked at records which showed how the service was run and how staff recruited and supported to do their work.