The inspection took place on 6 April 2017 and was announced.

Swanton Community Support provides support to people living in their own homes, most of whom need support with a mental health need or learning disability. At the time of this inspection there were 24 people being supported in flats on the same site as the agency office. A number of others were being supported in their own homes in the community.

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.

There were enough suitably recruited, trained and supported staff to meet people needs in an individual manner. Staff had been inducted and had received appropriate support to prepare them for their role. Ongoing training was provided which had effectively provided staff with suitable skills and knowledge to support the people who used the service.

People’s needs had been regularly assessed and reviewed to ensure accurate support plans were in place. People had been involved in the planning of the support they received and staff demonstrated they knew people’s needs well. The service was flexible in meeting these.

Staff demonstrated a respectful and encouraging approach to providing support and understood the importance of people being in control of this. People’s independence was promoted and their privacy and dignity maintained. Staff had developed meaningful and trustful relationships with the people that used the service.

The CQC is required to monitor the Mental Capacity Act (MCA) 2005 Deprivation of Liberty Safeguards (DoLS) and report on what we find. We found that the service was compliant with this legislation and that staff had knowledge of its application. They understood the need for consent and regularly gave people information in order for them to make decisions.

The risks to those that used the service had been identified, managed and reviewed. Staff had a good understanding of how to safeguard people and reduce the risk of abuse. The provider had plans in place to manage any adverse incidents that may occur in order to ensure continuity of the service people received.

Accidents and incidents were recorded and appropriate actions taken. However, a more robust system was required in order to analyse these in order to mitigate future risk. The service had recognised this and was working towards achieving this.

People’s healthcare needs were met and staff supported people as necessary to access healthcare services. Staff supported people with meal preparation as required and gave people information in order for them to make decisions about their diet and associated health. Where support was required, staff administered people’s medicines safely and as prescribed.

Processes were in place to monitor and improve the quality of the service and feedback was sought on its implementation. People told us they felt able to express their views and that they would be listened to. People felt confident any concerns they may have would be actioned appropriately.

The culture of the service was open and positive. The management team were accessible and hands-on. They had a clear understanding of the service, its strengths and areas for improvement. An action plan was in place to drive improvement.

All the people we spoke with told us that they would recommend the service. They told us this was due to the success of the support their family members received, the kind and considerate approach of staff and the confidence they had in the management of the service.

The inspection took place on 23 March 2016 and was announced.

The service provides support people in their own homes. At the time of this inspection, twenty four people were supported in flats on the same site as the agency office. A further 15 were supported in their own homes in the community. Most of the people using the service need support with their mental health needs.

There was no registered manager in day to day charge of the service. The registered manager had been transferred elsewhere and this had become a permanent arrangement just before the inspection. 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. In the absence of the registered manager, the deputy manager was fulfilling the role of acting manager. It was the provider's intention that the acting manager would register in respect of the service.

People experienced a service that promoted their safety. They received assistance from sufficient numbers of staff to meet their needs safely. There were robust recruitment processes in operation, which contributed to protecting people from the employment of staff who were unsuitable to work in care. Staff were aware of their obligations to report any concerns that people may be being abused and people were supported with advice about risks to their personal safety.

Where people needed support to manage their medicines, staff did this in a safe way and people received their medicines as the prescriber intended.

The service was not wholly effective. Staff had not been properly trained and prepared to understand their obligations under the Mental Capacity Act 2005, about how to support people to make informed decisions where their capacity to do so may be in doubt. However, improvements in this area were in the process of being made to ensure staff were more aware of their responsibilities. Not all staff had received the provider’s core training so that they all had the skills and knowledge to meet people’s needs effectively. However, there were plans in place to improve this.

People were supported to eat and drink enough if this was a part of their care package. People were also supported to access health professionals if they could not do this independently or their health deteriorated.

People were supported by a staff team that was kind, compassionate and who treated people with dignity and respect. People were involved in making decisions about the care they wanted to receive.

Staff understood people's individual preferences for the way they wished their care to be delivered and respected these. They communicated well with one another about people's support and any changes that needed to be followed up. This helped to ensure people were supported in a way that focused on each person's needs.

People were confident that, if they needed to raise a complaint or concern, this would be dealt with properly and action taken to resolve issues as far as possible.

Changes in management arrangements, both within the provider's management team and within the service, compromised the ability of the service to demonstrate consistent, stable and appropriate leadership. The morale of the staff team was also affected. The new arrangements needed time to consolidate to ensure they were working appropriately, taking into account the views of people using and working in the service.

The care records of people who used the service included evidence that people were involved in decisions about their care. For example, each record contained an ‘enter and exit preferences’ form. This detailed the person’s wishes regarding how staff should enter their homes either on a routine visit or in case of emergency. This showed us that the provider was responsive to people's wishes regarding the ways in which their support was delivered.

The needs of each person had been assessed and their support plans had been developed based upon this assessment. Each record contained a set of risk assessments which was individualised for each person. For example, we read risk assessments relating to self-medication, choking risk, emergency evacuation, epileptic seizures and vulnerability to financial abuse. One person told us “I have one-to-one support every day. It’s very vital to have one-to-one.”

The provider had safeguarding training courses in place for all staff. One person said that their accommodation was “…very safe.” Staff members we spoke with showed a good understanding of safeguarding issues and of how to raise concerns.

Staff members we spoke with told us that they felt supported by the provider, managers and colleagues. One staff member said “I feel really well supported.” New staff received an induction course and were given named mentors to support them. The provider undertook a range of service reviews and audits to monitor the quality of the service.

People who use the service told us they felt involved in and treated with respect by the service. They told us that they were very happy with the care and support they received. One person referred to it as, "A nice set up". Each person said that the service provided was very flexible and organised around their own individual needs. They told us that the staff enabled them to be as independent as possible while offering support and care as needed.

The staff appeared enthusiastic and positive about their work. We saw examples of staff treating people with respect, ensuring that they obtained consent before delivering care and responding to people's requests in a positive manner.

The care plans that we reviewed were detailed and had been produced in co-operation with people who used the service and reviewed regularly. The service had clear policies in place for the management of medicines and for dealing with complaints. These policies were available to the people using this service and to staff.

We noted that there were sufficient staff, with the appropriate skills, qualifications and training, to meet the required care needs of the people using this service. The team was well-established and showed a good knowledge of the people who use the service.

You can see our judgements on the front page of this report.

Barchester Community Support is located on a site that includes a complex of flats named Treeview Court. The flats are owned by a company named Reside. People who use the service have a tenancy agreement with Reside, but receive support from Barchester Community Support. The agency also provides support to people living in their own homes away from the Treeview Court site.

People we spoke with told us they liked living at Treeview Court and they appreciated the support they received from Barchester Community Support. They said they could do as they pleased, when they pleased and were able to arrange the one to one support to fit in with their plans. One person referred to the support staff as “Little angels.”

One person we spoke with described the support they received with various tasks and chores. They described the staff as flexible and one person showed us the timetable they had put on their wall with the times and names of the support staff who were due to visit. They told us this changed each week so that they always knew who was due to call.

People told us they were satisfied with the service and said they knew who to speak to if they had concerns or became dissatisfied. People said the manager and staff were approachable and felt they would be listened to and action taken if necessary.