The inspection took place on 14 and 16 June 2017. We gave 48 hours-notice to the provider as we needed to be sure someone would be available to facilitate our inspection. The last inspection took place on the 20 and 25 February 2015 and we rated the service as ‘Good.’ Every previous CQC inspection has found the service to be compliant with the regulations

The Integration Trust Limited is a domiciliary care service that supports three people living with a learning disability and physical disabilities. The three people using the service all share a house together and support is provided 24 hours a day, seven days a week. The service was set up 24 years ago with three families who wanted to ensure their relatives had a good quality of life, could lead an ordinary life and be socially included in their community forming part of the steering group that set the Trust up. It was one of the first such services, in the North East for people with a learning disability.

The service works in partnership with the local authority, NHS services and a local housing association. The Integration Trust Limited trustees worked with a social worker to identify suitable accommodation for people and found a large bungalow in the Brandon area. Over the 24 years the trustees have worked with the housing association to make sure the building was modernised and adapted so it remained suitable for the people who used the service.

There was a registered manager in post at the time of our inspection who had worked at the service since the early 1990s. 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.

The most striking aspect of this vibrant service was the strong sense of commitment and drive to deliver a service which improves people lives in fulfilling and creative ways. The culture embedded in the service was an absolute commitment to deliver a totally person-centred service, which relatives described as a safe haven. We found that the manager had encouraged staff to constantly think about improvements. We found that the management style had led to people who use the service and staff feeling that they were an integral and essential partner in the operation and enhancement of the service.

We found the staff worked above and beyond what would be expected of a domiciliary care agency or even supported care. We found that the staff had embraced the diversity of people’s interests and views. The understated and tireless nature of the staff actions to ensure people experienced equity in access to the community had led to the people being fully integrated members of the local community.

Staff were devoted to ensuring each individual found their lives were enriched. We found staff empowered people to voice their wants and aspirations for their lives and then supported them to achieve these goals. It was evident that people’s voices were heard. Following feedback from people, decisions were made about who was employed to work with them in their home, activities, holidays and trips were scheduled, and the environment was updated.

Over time as people’s needs changed The Integration Trust Limited had worked collaboratively with people to assist them to ensure their voices were heard by their housing association. This meant the housing association had listened to people and had taken action to ensure their bungalow remained suitable for their needs. Corridors in the bungalow had been widened and rooms converted to create larger usable spaces to accommodate people and their wheelchairs. Most recently, the housing association had devolved the day to day maintenance of the service to the people using it. This meant staff at The Integration Trust had been able to support peopl

We saw people being asked for their consent before they were given care. Relatives were involved in decision making.

Staff had a clear understanding of the care and welfare needs of people living in the home. A relative described the care as 'very good'.

We saw the equipment in the home was appropriately checked and maintained.

Staff had been recruited using the necessary checks to ensure they were suitable to work with people requiring care.

A complaints process was in place and it had been followed appropriately when a complaint was made

We carried out an inspection looking at domiciliary care services. We visited three people in their own home as part of this review and spoke with them and their relatives about their experiences of the support they have received.

We spoke with the manager at the time of our visit to the office and also spoke with two care workers.

We spoke over the telephone with the relatives of one person who received a service from this agency. Everyone spoke positively about their care workers and felt that they fully supported their care needs.

People told us they were happy with the care and support they were receiving. One person said "I am happy here”. Another person told us he went to a day centre during the week where he enjoyed lots of different activities. He explained that he was a keen football supporter so staff often took him to watch cricket matches.

This inspection took place on the 20 and 25 February 2015 and was announced. We gave 24 hours’ notice to the provider as the service is small and we needed to be sure someone was in to facilitate our inspection.

We carried out our last inspection in December 2013 and found the provider was complaint with our regulations.

The service provides 24 hour support to three people who live in their own adapted bungalow in the community. People living in the bungalow rented the property from a local housing association.

At the time of our inspection there was a registered manager in place. 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.

We found safety to be a key feature of the day to day work of the service in their care planning, risk assessments, staff training, working with other professionals and premises management.

We looked at people’s medicines and found they were safely administered.

We reviewed the staff training and saw staff had received sufficient training to be able to care for people in their own home. This included recent training on the use of a defibrillator.

We saw people who were cared for by the service were supported to continue to keep in touch with family members and friends for example; they were supported to send birthday cards to family members and friends.

We found a board member reported to the board their findings of care provided by the agency and acted as ‘next friend’ to represent people’s views at board level. We saw this was delivered in a report to the board.

We reviewed people’s care plans and found them to be personalised along with risk assessments. Staff were aware of the risks to people and how to mitigate those risks.

The registered manager demonstrated by example the determination to ensure people lived comfortably and were kept safe in their home.

The service had in place a number of different systems to ensure the service met the needs of people.

We found the service worked in partnership with a range of different health and social care organisations to respond to, and meet people’s needs.

The provider told us their ethos was to provide a client led service, meeting client’s physical and emotional needs’. We found the service was meeting their overarching goal.