About the service: The Grange Supported Living service provides support to people on and off site with a range of disabilities. At the time of the inspection the service was supporting 40 people on site, eight of which received regulated care. The majority of people who use this service live in properties around the Grange Centre. CQC does not regulate the premises used for supported living; this inspection only looked at people’s personal care and support.

People’s experience of using this service:

People were supported to live as independently as possible at a service which encouraged and inspired people to live full lives. One relative told us, “ I think it’s a caring service. Its very responsive. If there’s anything they can do then they will do it.” In one day people could complete classes in cookery, gardening, textiles, flower arranging and/or work alongside staff at the centre for work experience. People’s properties were respected by staff as private dwellings which enabled them to have dignity and privacy whilst receiving support.

The management team ensured that they worked in line with ‘Registering the Right Support’ and other best practice guidance. These values include choice, promotion of independence and inclusion to ensure that people with learning disabilities or autism can live as ordinary a life as any citizen.

Risks to people were assessed and managed in a way which balanced their safety and right to lead a non-restricted life. There were enough well trained staff to ensure people were supported safely at all times. Staff ensured that people’s needs were consistently met and assessed to enable improvements and progress in their lives.

People, relatives and staff were engaged by the service via meetings, forums, questionnaires and projects so that everyone could contribute to the development of the service. There was a credible strategy in place with plans for multiple new improvements and updates at the service. This was being implemented by the registered manager who was pro-active in considering how the service could be improved. People, staff and relatives spoke positively about the registered manager and senior team who led the service well.

People were supported to communicate with their relatives and the managers when they were not happy or wanted to change their support. Staff cared about the people they supported and wanted to help them do what they wanted with their lives.

Rating at last inspection:

Good (2 June 2016)

Why we inspected:

This was a scheduled comprehensive inspection. We inspect all services rated as 'Good' within 30 months to ensure that we regularly monitor and review the quality and safety of the service people receive.

The Grange supported living service provides support to people with a learning difficulty. The majority (61 people) are tenants in accommodation owned by The Grange, however a further 10 people live in other housing association or privately rented accommodation.

There are 42 people living on site at present, with capacity for 43. Off site the service supports a further 29 people in a mixture of shared housing and single flats. The support people receive was for tasks such as cooking, shopping, managing finances and personal correspondence. There are two people currently who receive support with their personal care (the regulated activity).

The service was run by a registered manager, who was present on the day of the inspection 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 and associated Regulations about how the service is run.

People were protected from avoidable harm. Staff received training in safeguarding adults and were able to demonstrate that they knew the procedures to follow should they have any concerns.

There were sufficient staff to keep people safe. There were robust recruitment practises in place to ensure that staff were safe to work with people.

Staff had written information about risks to people and how to manage these. Risk assessments were in place for a variety of tasks like personal care, activities and the environment and were updated frequently.

People’s human rights were protected as the registered manager ensured that the requirements of the Mental Capacity Act 2005 was followed. Staff assumed capacity for people to make decisions regarding their care, unless proven otherwise.

People had sufficient to eat and drink. People were supported to prepare, menu plan and cook healthy meals. There was also an on-site kitchen where some meals were prepared.

People were supported to maintain their health and well-being. People had regular access to health and social care professionals.

Staff were trained and had sufficient skills and knowledge to support people effectively. There was a training programme in place and training to meet people’s needs. Staff received regular supervision.

Positive and caring relationships had been established. Staff interacted with people in a kind and caring manner.

People, their relatives and other professionals were involved in planning peoples care. People’s choices and views were respected by staff. People’s privacy and dignity was respected.

People received a personalised service. Staff knew people’s preferences and wishes and they were adhered to. People were supported to develop with living skills to gain more independence.

The service listened to people, staff and relative’s views. The management welcomed feedback from people and acted upon this if necessary. The management promoted an open and person centred culture.

Staff told us they felt supported by the registered manager. Relatives told us they felt that the management was approachable and responsive.

There were robust procedures in place to monitor, evaluate and improve the quality of care provided. Staff were motivated and aware of their responsibilities. The registered manager understood the requirements of CQC and sent appropriate notifications.

We visited The Grange supported living to look at the care and welfare of people who used the service. We were able to speak to eight people who used the service and four staff as well as the registered manager. We also spoke with three relatives.

All the people that we spoke with said they liked living at The Grange. People appeared relaxed and happy and we observed staff interacting well with people during activities or as people were preparing to go out. One person we spoke with told us “The best thing about living here is being independent.”

We saw that systems were in place that ensured staff worked with the consent of people who used the service. Staff were able to give us good examples of how they ensured they gained a person’s consent. One person told us “They involve me in things.”

We saw that risks had been identified to protect the welfare and safety of people and we heard how people were involved in developing a care package appropriate to them.

We saw that there were systems in place that protected people from abuse and that staff had received appropriate training.

We saw that the provider carried out appropriate checks when they employed staff. This ensured staff were of good character and had the necessary skills and experience to do the job.

The provider had a complaints policy which they made available to people who used the service as well as their relatives.

We had discussions with four people who used the service, four members of staff, an assistant manager and the registered manager.

People who used the service told us that they were treated with respect by the staff. They told us that staff always respected their privacy and dignity. One person told us, “Staff always knock on my door and wait for me to answer.” Another person told us, “The staff are always pleasant and they always respect me.”

People also told us that they made decisions about their care, treatment and support. They told us that they had an assessment of their needs undertaken and they had a care plan. They told us that they always felt safe with the staff who attended to them.

People told us that they were very happy with the care they received from the agency.

Staff were provided with training that enabled them to deliver the care and treatment to people safely and to an appropriate standard.