The Annex is a supported living service that can accommodate up to two people. Supported living is where people live independently in specifically designed or adapted accommodation, but need some help and assistance to do so. There were two people using the service at the time of this inspection. At the last Care Quality Commission (CQC) inspection in June 2015, the service was rated ‘Good’. At this inspection we found the service remained ‘Good’. The service demonstrated they met the regulations and fundamental standards.

The service is located on the same site as Hylton House, a care home which is also owned by the provider. It is owned by an individual provider who also manages the service. It therefore does not require a registered manager.

Since our last inspection, people continued to be safe. Staff knew how to protect people from the risk of abuse or harm. Risks posed to people due to their specific healthcare needs continued to be regularly reviewed by senior staff. This meant staff had access to up to date information about how to manage these risks to keep people safe. There were enough staff to keep people safe. People experienced continuity in the support they received as the provider ensured the same staff were available to assist them when needed. The provider maintained appropriate arrangements to check the suitability and fitness of new and existing staff to support people.

People had a current individualised support plan which set out how their care and support needs should be met. These also continued to be reviewed regularly. Staff received regular and relevant training so that they had the necessary skills to meet people’s needs effectively. Information about people’s communication needs and preferences were well maintained. This meant there was up to date information for staff on how to respond to people accordingly.

Staff continued to help people to maintain the skills they needed for independent living. People were supported to participate in activities and events of their choosing to meet their social and physical needs. They were also supported to maintain relationships with the people that mattered to them.

People were encouraged to eat and drink enough to meet their needs. They were supported to make healthy choices and helped to access healthcare services when they needed this. People promptly received the medicines prescribed to them.

Staff were kind and treated people with dignity and respect. They asked people for their consent before carrying out any care or support and respected their wishes and choices about how this was provided. Staff ensured people’s privacy was maintained particularly when being supported with their needs.

People and staff said the senior staff team were approachable and accessible. People and their relatives were happy with the quality of support received. They were encouraged to provide feedback about how the service could be improved. This was used to make changes and improvements that were required. Checks and reviews of the service continued to be made by senior staff and were used to improve working practices and processes so that people experienced good quality care and support. The provider maintained effective arrangements for dealing with complaints if people became unhappy or dissatisfied with the service.

Further information is in the detailed findings below.

There were two people using the service at the time of our inspection. We met with one person using the service and three relatives during our visit. We spoke with the registered manager and the supported living co-ordinator for the Annex.

Relatives told us they were pleased with the service and described the staff team as “very caring” and “lovely people.” One relative told us, “X (name of person) is happy and always wants to come back to the flat.”

Care records provided up to date information about people's needs which meant that staff understood how to support each person and provide consistent care. People were involved in writing their support plans and all decisions that were made about the Annex. Relatives told us that the staff understood their family member’s needs and encouraged people to be independent.

People received effective care and support because there were enough suitably trained staff. There were appropriate arrangements in place to manage medicines and for recruiting suitable staff.

The provider had effective systems in place to monitor the quality of the service and make improvements and changes where necessary. Feedback from people using the service and their relatives was used to improve the support they received.

There were two people using the service at the time of our inspection. We met with the supported living co-ordinator for the Annex, one of the people who used the service and one member of staff.

The person living at the Annex told us that staff treated them with respect and helped them to be as independent as possible. They told us they planned their weekly menu and activities and staff supported them with cooking, shopping and going to college four days a week. They said they liked the staff who supported them and someone was always available if they needed advice.

People using the service had support plans in place, which were current and outlined their agreed care arrangements. People were involved in writing their support plans and all decisions that were made about the home they lived in.

The care provider regularly assessed the supported living service they provided and consulted with the people who used it. This meant that the provider knew what was working well and what needed improving.

This inspection took place on 23 June 2015 and was unannounced. At the last inspection on 18 October 2013 we found the service was meeting the regulations we looked at.

The Annex is a supported living service that can accommodate up to two people. Supported living is where people live in their own home and receive personal care and/or support in order to promote their independence. People who use this service have their own tenancy agreement and staff are available 24 hours a day to provide them with support. At the time of our inspection there were two young male adults with a learning disability, using the service.

The service is located on the same site as Hylton House, a care home which is also owned by the provider. It is owned by an individual provider who also manages the service. It therefore does not require a registered manager. A registered manager is a person who has registered with the Care Quality Commission (CQC) 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 and associated Regulations about how the service is run.

People and their relatives told us the care and support provided by the service was safe. Staff knew how to protect people if they suspected they were at risk of abuse or harm. They had received training in safeguarding adults at risk and knew how and when to report their concerns if they suspected someone was at risk of abuse. The provider had a formal procedure in place for staff to follow to ensure concerns were reported to the appropriate person.

Risks to people’s health, safety and wellbeing had been assessed by managers. Staff were given appropriate guidance on how to minimise identified risks to keep people safe from harm or injury in their home and community.

There were enough suitable staff to care for and support people. Managers reviewed and planned staffing levels to ensure there were enough staff to meet the needs of people using the service. They carried out appropriate checks on staff to ensure they were suitable and fit to work. Staff received relevant training to help them in their roles. Managers ensured staff’s skills and knowledge were kept up to date. Staff were well supported by managers and were provided with opportunities to share their views and ideas about how people’s experiences could be improved.

People’s consent to care was sought and obtained before care and support was provided. People

were supported to make decisions and choices about their care and support needs. Their support

plans reflected their specific needs and preferences for how they wished to be cared for and supported in such a way as to retain as much control and independence over their lives. These were reviewed regularly with them by staff who checked for any changes to people’s needs.

People were encouraged to eat and drink sufficient amounts and maintain a healthy and balanced diet. Staff supported people to keep healthy and well and ensured people were able to promptly access other healthcare services when this was needed. Where this was relevant, staff ensured people received their prescribed medicines promptly. These were stored safely.

People and their relatives told us staff looked after them in a way which was kind, caring and respectful. People’s rights to privacy and dignity were respected. Staff spoke with people in a warm and respectful way and ensured information they wanted to communicate to people was done in a way that people could understand. Staff knew how to ensure that people received care and support in a dignified way and which maintained their privacy at all times. Staff also supported people to retain as much control and independence as possible, when carrying out activities and tasks. People were supported and encouraged to maintain social relationships that were important to them.

Relatives and visitors said they would feel comfortable raising any issues or concerns directly with staff. There were arrangements in place to deal with people's complaints, appropriately.

Managers encouraged an open and transparent culture and people, their relatives and staff were able to share their views and experiences of the service and how it could be improved. Managers demonstrated good leadership. They ensured staff were clear about their duties and responsibilities to the people they cared for and accountable for how they were meeting their needs.

There were systems in place to monitor the safety and quality of the service and managers took action if any shortfalls or issues were identified during routine checks and audits. Managers used learning to identify how the service people experienced could be improved.