This inspection took place on 25 November and 6 December 2016 and was unannounced. At our previous inspection of The Orpheus Centre in August 2013 we found that the service was meeting the requirements of the outcomes that we assessed. These were: Treating people with respect and involving them in their care; providing care, treatment and support that meets people’s needs; caring for people safely and protecting them from harm; staffing; quality and suitability of management.

The Orpheus Centre domiciliary service provides personal care and support to tenants who live in 29 independent living flats located in the grounds of The Orpheus Centre, a residential performing arts college for young disabled adults situated in Godstone, Surrey. People who use the service are younger adults with a variety of disabilities that include sensory, physical, learning disabilities or autistic spectrum conditions and have a declared interest in the performing arts. At the time of our inspection 28 people were using the service.

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

People who used the service were protected from the risk of abuse. Staff members had received training in safeguarding, and were able to demonstrate their understanding of what this meant for the people they were supporting. They were also knowledgeable about their role in ensuring that people were safe and that concerns were reported appropriately.

Medicines were well managed by the service. People’s medicines were managed and given to them appropriately. Records of medicines were well maintained.

We saw that staff at the service supported people in a caring and respectful way and responded promptly to meet their needs and requests. There were enough staff members on duty to meet the needs of the people using the service.

Staff members received regular relevant training and were knowledgeable about their roles and responsibilities and the needs of the people whom they supported. Appropriate checks took place as part of the recruitment process to ensure that staff members were suitable for the work that they would be undertaking. All staff members received regular supervision from a manager, and those whom we spoke with told us that they felt well supported.

The service was meeting the requirements of The Mental Capacity Act 2005 (MCA). People who used the service were assessed as having capacity to make decisions. We were told by people that they were involved in agreeing their support plans and risk assessments.

Care plans and risk assessments were person centred and provided detailed guidance for staff around meeting people’s needs. These were up to date and had been amended where there had been changes in need. Systems for supporting and monitoring people’s needs and behaviours were effectively used and monitored. Personalised support tools had been designed with people to help them to manage their behaviours.

People were enabled to participate in a range of activities supported by staff. Their cultural, religious and relationship needs were supported by the service and detailed information about these was contained in people’s care plans.

People were supported to make healthy choices about the foods that they ate. Staff members provided support with menu planning and food shopping.

The service had a complaints procedure and we saw that complaints were managed effectively. People told us that knew how to complain if they were unhappy about the support they received

Arrangements were in place to ensure that people were supported to be healthy. People had health action plans and these showed that their health needs were met by the servi

As part of our inspection we spoke with five people who used the service and their relatives about the care and support they received. We also spoke with the Registered Manager, the Services Manager, staff in the office and five support staff. During the visit we saw people speaking with the Registered Manager and staff members. We noted that the interactions were positive. People seemed at ease with staff and it was clear that strong professional relationships had been formed.

People told us they were involved in their care and were happy with the support provided by the service. Comments included "It's awesome", "They provide a very high standard of care" and "I always know what's happening".

We saw that staff respected the privacy and dignity of people by knocking on their front doors and speaking appropriately to them. People told us that staff were "Nice" and made them feel "Safe". Relatives of people also spoke highly of staff and described them as "Very good".

We found that people were supported by regular staff who understood their health and social needs.

People said that they found the management of the service to be very approachable and open to feedback. They said the manager had responded appropriately to any concerns they had raised.

We saw that the service had good quality assurance systems in place to ensure that the care and support provide was effective and people received a high quality of care.

We spoke with the service manager, domiciliary manager and her deputy at the agency office. We did not speak to people who used the service on the day of our visit. We spoke with some of the carers of people who used the service the next day. They told us that their relatives care and support needs had been assessed prior to them moving to the independent living scheme. The manager told us that copies of care plans were available in people's flats and the records of what staff had done for them during each visit. We looked at care plans that were personalised and included details of people's individual needs and preferences. People told us that care staff generally stayed long enough to do everything they needed. One carer said that the time slot allocated for support calls was too short on occasions, although some staff managed tasks required better than others within the given timeframe. We saw that care staff had received induction and training in how to manage peoples care needs. A relative commented that the service was always, “nothing if not brilliant, and it continued to be so.” Another relative said that there had been some significant challenges when the service changed from residential care to supported living, but things were now settling down and they were much more comfortable with the service. An experienced domiciliary manager had been appointed by the provider since our last visit to further develop the service.

People who use the service and their relatives told us they were involved in making decisions about the care and support they received and felt they were very well supported by the agency. They said that agency staff listened closely to their opinions and requests and acted upon them. People using the service evidenced high levels of satisfaction with support staff and said they were patient and kind in their approach and consistently encouraged them to do what they could for themselves. They felt safe and secure and told us they were very happy with the personal care that staff provided. They also felt their privacy and dignity was respected at all times. Carers of people using the service told us about the range of activities that their relatives were supported to take part in, and how staff were helping them develop their daily living skills. Relatives and advocates said they had developed good working relationships with both the management and support staff at the agency, which clearly benefited the people using the service. One relative commented that the service was, “very special and totally reliable”. Another said that being involved with the service was simply, “a life affirming experience”