The Papworth Trust Centre Waveney is a domiciliary care agency. It provides personal care to people who live in their own houses or flats. Support is provided to adults with autism and other learning difficulties. People’s care and housing were provided under separate contractual agreements. At the time of our inspection support was being provided to 12 people.

At our last inspection we rated the service as Good. At this inspection we found the evidence continued to support the rating of good and there was no evidence or information from our inspection and ongoing monitoring that demonstrated serious risks or concerns. This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection.

At this inspection we found the service remained Good.

The service has been developed in line with the values that underpin the Registering the Right Support and other best practice guidance. These values include choice, promotion of independence and inclusion. By following these principles, services can support people with learning disabilities and autism to live a fulfilled and meaningful life.

Systems were in place to help safeguard people from abuse. Staff knew how to identify signs of abuse and what action to take to protect people they supported. Risk assessments had been completed to show how people should be supported with everyday tasks, while promoting their independence. Recruitment checks had been carried out to ensure staff were suitable to work with vulnerable people. People were looked after by small teams of staff who were committed to providing support in a person-centred and caring way.

Staff had undergone training to ensure they had the knowledge and skills to support people safely. All staff received regular supervision. This gave them the opportunity to discuss their work, reflect on what was working well for the person they supported and plan any changes that were needed.

Medicines were managed safely. Staff had undergone training and received regular competency checks. Regular audits were carried out to ensure medicines were being administered correctly.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice.

Staff worked with health and social care professionals to ensure people were supported to maintain good health and remain as independent as possible. People's support plans contained detailed information about their preferred routines, likes and dislikes and how they wished to be supported. People and their families and advocates, where appropriate, were involved with planning and reviewing their care. This ensured it was tailored to meet their needs.

The service was well-managed. The manager provided good leadership of the service and was committed to maintaining and improving standards. Audits and quality checks were undertaken on a regular basis and any issues or concerns addressed with appropriate actions. The manager had also developed an action plan to support improvement.

Further information is in the detailed findings below

This inspection took place on 6 November 2015 and was unannounced.

The Papworth Trust Centre Waveney provides personal care support to approximately 25 people living in their own homes.

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.

People told us they felt safe and secure when care staff visited them. There were systems in place to reduce the risks to people and protect them from avoidable harm.

The service had in place robust recruitment procedures which ensured that staff had the appropriate skills, background and qualifications for the role. There were enough suitably trained and supported staff available to meet the needs of the people using the service.

Staff told us they felt supported by the management of the service and that the training they received provided them with a good understanding of topics such as the Mental Capacity Act 2005 (MCA). People spoke highly of the staff team and felt able to raise concerns or issues.

The service was complying with the requirements of the Mental Capacity Act (2005) and appropriate assessments of people’s capacity had been undertaken where required. Staff understood consent and people told us that staff did not infringe upon their rights and enabled them to make their own choices.

People spoke positively about the care and support they received from the service. People and their relatives had input into the planning of their care and support. Care staff demonstrated that they knew the people they were caring for well, and people benefitted from having the same care staff support them.

There were systems in place to monitor the quality of the service and to identify shortfalls or areas for improvement. There was an open culture at the service. People using the service, their relatives and care staff were given the opportunity to express their views and these were acted on by the service. There was a complaints procedure in place and people told us they knew how to make a complaint if they weren’t happy.

The Papworth Trust Waveney provides a supported living and home care service to people living within the local community. During our inspection, we spoke with six people who used the service, four relatives of people who used the serviced, four staff members and the manager.

The people and relatives were happy with the care that was being provided. One person told us, “They are very friendly, treat me really well.” Another person said, “They (the staff) are very very nice, no problems with any of them.” A relative told us, “The staff always turn up on time and I am very satisfied.” Another relative said, “They have bent over backwards to provide us with continuity of care which is very important for X.”

We saw that people had access to information before they started to use the service detailing what care could be provided. Care plans were in place that showed the service had completed a detailed assessment of people’s needs. Risk assessments had been completed to ensure that the care people were provided with was safe.

Staff were able to demonstrate that they could identify the signs of abuse and that they would report any concerns to an appropriate authority who would investigate into the matter.

Staff received regular supervision and training to ensure that they had sufficient support, skills and knowledge to perform their role.

Systems were in place to monitor the quality of the service provided to ensure that it was effectively managed.

We spoke with five people who used the service. We looked at the care records for nine people using the service. Other records viewed included staff training records and quality assurance records. We considered our inspection findings to answer questions we always ask; Is the service safe? Is the service effective? Is the service caring? Is the service responsive? Is the service well-led?

This is a summary of what we found;

Is the service safe?

People using the service told us they felt safe when carers visited their homes.

Risk assessments for five of the nine people whose records we looked at had not been updated and reviewed appropriately. This meant that the service had not considered whether or not all risks to people were still being appropriately managed.

Is the service effective?

People told us that they felt that they were provided with a service that met their needs. One person told us, "The carers are great. I can't complain about the service." Another person told us, "Some are better than others. They all help me out enough though."

Five of the nine care records which we looked at were out of date and had not been reviewed for some time. Three of the five people we spoke with told us that they had not had a review of their care needs in the 12 months prior to our inspection. This meant there was a risk that people could receive inappropriate or unsafe care as the service had not assessed whether their needs had changed.

Is the service caring?

We reviewed the responses to a survey of people's views carried out in 2013. We also reviewed the contents of some responses which had been received for the 2014 survey, which was in progress at the time of our inspection. We found that there was evidence that the service had addressed some of the trends in negative feedback in the 2013 survey. However, the responses received as part of the 2014 survey indicated that comments people had raised in 2013 regarding not having reviews of their care had not been addressed by the management of the service.

Is the service responsive?

People we spoke with told us that they knew how to make a complaint if they were unhappy. We saw that where people had raised concerns appropriate action had been taken to address them.

The management of the service had responded appropriately to accidents and incidents and learned from these.

Is the service well-led?

The system in place to monitor the quality of the service was not robust enough to identify issues in service provision. Some audits we reviewed identified issues, and there was evidence to support that appropriate action was taken by the management of the service to rectify these issues. However, other audits failed to identify that the care records for people were out of date. This meant that we were not assured that the service was well-led.