The inspection took place from 13, 16 and 24 August 2018. The visit to the provider’s office took place on 13 August 2018 and was unannounced. Further inspection activity included a visit to meet people who used the service and telephone calls to staff and relatives.

At the last inspection in September 2017 we found the provider had breached Regulation 19 Fit and Proper Person. The provider did not have robust checks in place in relation to the recruitment suitability of prospective staff members. 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 of Safe and Well led to at least good.

We found improvements had been made to the recruitment processes to meet the relevant regulation.

This service provides care and support to people living in the community and in a ‘supported living’ setting, 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. The service was supporting three people at the time of the inspection. Two people who shared one property and another in their own home.

The property was a three-bedroom house which had been adapted so each person had their own lounge area and bedroom with private bathroom facilities. The property had a communal dining and kitchen area. As people required staff to be available over a 24 hour period one bedroom was utilised as a sleepover room.

“The care service has been developed and designed in line with the values that underpin the 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.”

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.’

The provider had policies and procedures in place to keep people safe. Staff were trained in safeguarding.

The registered manager maintained a log of all incidents and ensured lessons learnt were disseminated to staff. People had access to easy read information about how to recognise and report abuse.

Risks to people were assessed with control measures in place for staff support and guidance. The environment was checked for safety. Electrical and gas safety certificates were in place. Fire detection systems were monitored regularly.

Medicines were managed safely by trained staff whose competency to administer medicines was checked regularly.

The provider ensured staffing levels met the needs of people who used the service. Staff were appropriately trained and received regular supervisions and appraisals.

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.

Staff supported people with their nutritional needs to maintain a healthy and varied diet. People had access to health care professionals when necessary.

Staff treated people with dignity and respect and helped to maintain people’s independence by encouraging them to care for themselves where possible. Staff supported people with privacy.

Care records were written in a person-centred way. People’s individual wishes, needs and choices were considered. People’s care and support was reviewed on a regular basis.

Activities were arranged for people who used the service based on their likes and interests and to help meet their socia

This unannounced inspection visit took place on 19 September 2017 and we also spoke with people via telephone on 25 September 2017.

The service currently provides personal care for five people who have a learning disability and who may be on the autistic spectrum. Some people lived in small groups in a house whilst other people may live with family or carers.

The service had a registered manager in place who was on leave at the time of our visit. 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. The registered manager worked across another of the provider’s services. On a day to day basis the service was managed by a full time manager and deputy manager as well as a team leader. We were told that the full time manager would take over the registered manager’s role in their own right once the registered office had moved to a new location.

We undertook this visit following safeguarding concerns that were raised to the local authority safeguarding team regarding care plans and a staffing issue. This safeguarding concern has now been investigated and closed by the local authority following the completion of an action plan by the provider.

We found the service had not undertaken robust recruitment checks to ensure prospective staff members had the relevant background to work in the service. In the five staff files we viewed not all staff had appropriate references, application forms, interview records or evidence of identity. We asked the deputy manager who was on duty on the day of the inspection to address these deficits straight away.

There were systems and processes in place to protect people who used the service from the risk of harm. Staff were aware of different types of abuse, what constituted poor practice and action to take if abuse was suspected. Appropriate checks in were in place in relation to the health and safety of people and staff.

Risk assessments were in place for people using the service and for staff members. Staff members told us of the systems they followed in case of an emergency as they sometimes worked alone.

Staff told us that they felt supported. There was a regular programme of staff supervision. Records of supervision were detailed and showed the service manager worked with staff to identify their personal and professional development areas. We spoke with one new member of staff who spoke highly of their induction and support.

Staff had been trained and had the skills and knowledge to provide support to the people using the service. There were enough staff on duty to provide support and ensure people’s needs were met. Staff were aware of the requirements of the Mental Capacity Act [2005] and the Deprivation of Liberty Safeguards [DoLS] which meant they were working within the law to support people who may lack capacity.

Appropriate systems were in place for the management of medicines so that people received their medicines safely.

There were positive interactions between people who used the service and staff. We saw that staff treated people with dignity and respect. Staff were attentive, showed compassion, were patient and gave encouragement to people.

People’s nutritional needs were met, with them being involved in shopping and decisions about meals.

People were supported to maintain good health and had access to healthcare professionals and services. We saw they were supported and encouraged to have regular health checks and were accompanied by staff to appointments.

Assessments were undertaken to identify people’s support needs. People had [where possible] been involved in the development of their person centred plan.

Staff encouraged and supported people to access activities within the com