This inspection took place on the 30 May 2018 and 5 June 2018 it was announced. The service was last inspected in April 2015 and rated Good overall.

TLC Care homes Limited (Summer House) provides personal care to people in supported living settings in Westcliffe, Great Dunmow, Saffron Walden, Earls Colne, Basildon, Halstead and Colchester. People using the service have a learning disability and may have a mental health diagnosis. There are two registered managers for this service. At the time of our inspection the service was supporting 21 people.

The service had two registered managers in post, with one covering services in the Mid Essex region and the other covering services in the South Essex region. The registered manager for the South Essex region was also an area manager. We were unable to speak to the registered manager for the Mid Essex region as they were away during our inspection, in their absence the area manager (Mid Essex) and Director of Operations were managing and monitoring service in that region. ‘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 a legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

The service was not consistently Well Led. The quality assurance system was not effective because it had not identified the areas of concern. There were no plans in place to demonstrate what action the provider / registered managers were going to take to mitigate risks in relation to the health, safety and welfare of people using the service. Further improvements were required to ensure that the management team had a complete oversight of the management of people’s finances.

There were sufficient numbers of staff on duty to meet the needs of people and keep them safe from potential harm or abuse. People’s health and wellbeing needs were assessed and reviewed to minimise risk to health and wellbeing. The provider had a good management and monitoring structure in place for medication.

People were cared for and supported by staff who had received training to meet their needs. The registered manager had a good understanding of their responsibilities in relation to the Mental Capacity Act 2005 and the Deprivation of Liberty Safeguards. People were supported to eat and drink enough as to ensure they maintained a balanced diet and referrals to health and social care services were made when required.

Staff cared for people in an empathetic and kind manner. Staff had a good understanding of people’s preferences. Staff always worked hard to promote people’s independence through encouraging and supporting people to make informed decisions.

People and their relatives were involved in the planning and review of their care. Care plans were reviewed on a regular basis and when there was a change in people’s care needs. People were supported to follow their interests and participate in social activities. Complaints were responded to in a timely manner.

The inspection took place over two days on the 29 and 30 April 2015. The inspection was announced.

The service provides support with personal care to people in their own homes. People using the service have a learning disability and may have a mental health diagnosis. There are two registered managers for this service They cover different geographical locations. 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 were supported according to their needs and wishes and there were enough staff to do this.

Staff were aware of how to promote people’s safety and people had risk assessments in place where risks were identified. Assessment showed how the risk should be reduced. Staff recognised people could be at risk or harm and, or abuse and received training to help them know how to protect people as far as possible. Staff knew how to escalate concerns if required.

People were assisted with their prescribed medicines by staff who were trained to give medicines. There were systems in place to regularly check that people had access to the medicines they needed and they were stored correctly.

There were thorough recruitment procedures to ensure only staff considered suitable to work in this setting were employed. We found staff were appropriately supported through induction, and regular supervision. Staff received the necessary training which was updated when required.

Staff understood how to work lawfully with people in terms of decision making and consent. Most people were able to make their own decisions and staff asked people for their consent before assisting them with their care needs.

Most people were independent but staff monitored people’s health and supported people to access appropriate health care when necessary. Where a person was at risk of unintentional weight loss this was monitored.

People had a plan of support tailored around their individual needs and interests. People were consulted about their needs and staff facilitated people’s independence and respected their choices. People had varied lives and participated in a wide range of activities.

People knew how to complain and there was a process in place to do so. People were regularly consulted and staff responded appropriately. People were routinely asked for their views and improvements were made as a result of people’s feedback.

Staff were mindful of people’s individual needs and had received training to help them understand how to appropriately support people. People felt respected and were encouraged to be as independent as they were able to be. Parents and family members had confidence in the staff providing the support to their family member.

The service was well led, with a strong ethos and clear leadership. Staff were supported in their roles and people they supported felt confident. There were systems in place to evaluate the level of service provision and people’s satisfaction with it. This meant the service knew where it was doing well and where it needed to improve.

There were good links with the communities and professionals working within them to ensure people were appropriately support. Support was extended to family members