Teamcare Support is a supported living and domiciliary care service providing support to 22 people experiencing severe and enduring mental health conditions. People lived in supported living accommodation owned and managed by the provider of Teamcare Support and used the service to support them with activities, attending appointments and regaining independent living skills. These aspects of support are not regulated activities so did not form part of this inspection. Of the 22 people using the service, only one person received the regulated activity of personal care and therefore this inspection focused on this person’s experience of care and support.

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 a legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

We carried out a previous inspection of this service on 29 January 2014 where we found the service was meeting the requirements in the areas we looked at.

This inspection took place on 23 November 2016. The provider was given short notice of the inspection date as the service provides personal care to only one person and we needed to ensure that person, staff and the registered manager would be able to speak to us. The provider of the service was also the registered manager and will be referred to as the registered manager throughout this report.

The person whose care we reviewed spoke highly of the way staff treated them and made comments such as “They are caring” and “The staff are very considerate to me”. We observed staff displaying physical affection towards this person and treating them with respect and kindness.

This person told us they felt safe when receiving care. Staff knew how to recognise possible signs of abuse which helped protect people. Staff had received training in safeguarding and had access to information, guidance and relevant contact numbers should they have any concerns about people’s safety or wellbeing. Where requested and appropriate, staff supported people to take their medicines safely, had received training and had their competencies checked. Records relating to the person whose care we reviewed demonstrated they had received their medicines as prescribed by their doctor.

Staffing numbers at the service were sufficient to meet people’s needs and provide them with the number of support hours they needed. Staff had the competencies, qualifications, training and information they required in order to meet people’s individual needs. Staff received regular supervision and appraisal. Recruitment procedures were in place to ensure only people of good character were employed by the home. Staff underwent Disclosure and Barring Service (police record) checks before they started work in order to ensure they were suitable to work with people who were vulnerable.

Staff had a good understanding of the Mental Capacity Act 2005 (MCA) and put it into practice. They had a good understanding of the times and circumstances in which the person we reviewed was unable to make certain decisions and what they would do in these situations.

The service sought regular feedback from people, relatives, staff and healthcare professionals. They conducted an annual survey and the most recent survey analysis reflected some highly positive feedback being received. The majority of people said they were very satisfied with the service.

People were supported to work towards independent living and recovery. Skilled professionals were involved in planning people’s care and support plans which focused on their development, their skills, their wellbeing and their independence. The person whose care we reviewed was supported to progress in a number of areas, including cooking. Staff involved this person in co

At the time of our inspection the service was providing care and support to 16 people in their own homes (Shared living). We spoke with four people who used the service who told us that they were happy with the care and support they received. They felt that the service was “Good and staff were kind.”

One of the relatives that we talked with told us that “My relative is very happy and staff are supportive.” The relative mentioned that they had asked to see the care plans of their relative but staff told them that it was locked and the manager had the key to the cupboard. The relative told us they did not follow that through with the manager but would like to look at the care plans of their relatives and also be kept informed with meetings that take place in relation to professional input. Another relative that we spoke with told us “ We are fully involved in the care plans of our relative and if they we had any concerns we would contact the manager, my relative seems pretty happy and staff are nice.”

People were protected against the risks associated with medicines because the provider did have appropriate arrangements in place to manage medicines.

People were protected from the risks of unsafe or inappropriate care and treatment because accurate and appropriate records were maintained.

The agency had a robust recruitment procedure in place. This meant that people were cared by people who had been checked to work with vulnerable people.

We found that the service gained regular feedback from people and had robust quality and assurance procedures in place to monitor the effectiveness and safety of the care and support provided.

People who used the service told us that they were "very happy" and that "the staff are very friendly".

We found that whilst the provider had identified those service users who were at particular risk of harm or neglect, the provider had not planned or delivered care which would ensure the welfare and safety of service users.

We saw that there were appropriately trained staff available to provide care to people using the service.

There were systems in place for ensuring that the views and opinions of people using the service and their representatives such as care managers, advocates and family members were taken into consideration and acted upon where necessary to improve the service.