We carried out this announced inspection on 26, 27 and 28 June 2017.

Head Office is registered to provide personal care and support for people who live in the community. The service is registered to provide support for adults of all ages who have a learning disability and/or who need help due sensory disabilities and/or who need assistance managing their mental health. Some of the people who received support at the time of our inspection lived with their relatives. However, most of them had their own homes. Most people received at least one visit a week lasting several hours. Some people had longer visits and one person who needed extra assistance had members of staff living in their home.

The service covers the whole of Lincolnshire but at the time of our inspection all of the 30 people who used the service lived in the south of the county. The service's main office was in Moulton Chapel.

Head Office is operated by a company called Training, Employment Support Solutions CIC. The company was owned by two directors one of whom was also the 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. In this report when we speak about both the company and the registered manager, we refer to them as being, 'the registered persons'.

The registered persons told us that the service emphasised the importance of enabling people to be as independent as possible. As a result everyone involved with the service referred to the care staff who provided support for people as being ‘personal coaches’. Therefore, we also use this term in our report.

Personal coaches knew how to respond to any concerns that might arise so that people were kept safe from abuse. People had been supported to take reasonable risks while at the same time avoiding preventable accidents. Although people had been helped to safely manage their medicines additional records and checks needed to be completed to ensure that this remained the case. There were enough personal coaches to provide people with the support they needed and background checks had been completed before new staff had been appointed.

Personal coaches had received training and guidance and they knew how to support people in the right way. People had been assisted to plan and prepare their own meals and they had been supported to receive all of the healthcare assistance they needed.

Personal coaches had ensured that people's rights were respected by helping them to make decisions for themselves. The Care Quality Commission is required by law to monitor how registered persons apply the Deprivation of Liberty Safeguards under the Mental Capacity Act 2005 and to report on what we find. These safeguards protect people when they are not able to make decisions for themselves and it is necessary to deprive them of their liberty in order to keep them safe. In relation to this, the registered persons had worked with the local authority to ensure that people only received lawful care that respected their rights.

People were treated with kindness, compassion and respect. Personal coaches recognised people's right to privacy and promoted their dignity. There were arrangements for people to be supported by lay advocates and confidential information was kept private.

People had been consulted about the support they wanted to receive and they had been given all of the encouragement they needed to be as independent as possible. People had been supported to pursue work commitments, hobbies and interests. There was a system for quickly and fairly resolving complaints.

People had not been fully consulted about the development of the service. Some quality checks had not been completed in the right way and this had increas