Tru Care Limited provides care and support to people living in seven ‘supported living’ settings, so that they can live as independently as possible. People’s care and housing are provided under separate contractual agreements. CQC does not regulate premises used for supported living; this inspection looked at people’s personal care and support. Tru Care Limited is also a domiciliary care agency. It provides personal care to people living in their own houses and flats.

At the time of this announced inspection of 15 and 16 November 2017 there were 34 people who used the service. Twenty three people were living in ‘supported living’ settings and eleven people received domiciliary care in their own homes. The provider was given up to 48 hours’ notice because it is a small service and we wanted to be certain the registered manager and key staff would be available on the day of our inspection. We also wanted to give them sufficient time to make arrangements with people so that we could visit them in their homes to find out their experience of the service. This service was registered with CQC on 19 January 2011.

At the last inspection of 5 February 2015 the service was rated Good. At this inspection we found that the service remained Good.

The provider’s nominated individual was also the 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.

The service continued to provide a safe service to people. This included systems intended to minimise the risks to people, including from abuse, mobility, accessing the community, nutrition and with their medicines. Support workers understood their roles and responsibilities in keeping people safe.

Recruitment checks were carried out with sufficient numbers of support workers employed who had the knowledge and skills through regular supervision and training to meet people’s needs.

People and their relatives were complimentary about the care provided and the approach of the support workers and management team. People told us that they felt safe and well cared for. Support workers and the management team had developed good relationships with people.

People were able to express their views and support workers listened to what they said and took action to ensure their decisions were acted on. Support workers consistently protected people’s privacy and dignity.

People were supported to eat and drink enough to maintain a balanced diet. They were also supported to maintain good health and access healthcare services. Where people required assistance to take their medicines there were arrangements in place to provide this support safely.

People received care that was personalised and responsive to their needs. People’s care records were detailed and accurate. They reflected how people were involved in making decisions about their ongoing care and support. This ensured they received care and support which was planned and delivered to meet their specific needs in accordance with their wishes.

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

The service listened to people’s experiences, concerns and complaints and took action where needed. People, relatives and staff told us the registered manager was accessible, supportive and had good leadership skills. The service had a quality assurance system and shortfalls were identified and addressed. As a result the quality of the service continued to progress.

We conducted this unannounced inspection on 5 February 2015.

Tru Care Limited provides personal care support to people living in their own homes. The service leases a total of six properties to people on long term secure tenancies. There were 20 people using the service at the time of our inspection

There was a registered manager in post who is also the provider of the service. 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.

There were procedures in place which safeguarded the people who used the service from the potential risk of abuse. Care workers understood the various types of abuse and knew who to report any concerns to.

There were procedures and processes in place to ensure the safety of the people who used the service. These included risk assessments which identified how the risks to people were minimised.

Where people required assistance to take their medicines there were appropriate arrangements in place to provide this support safely.

There were sufficient numbers of care workers who were trained and supported to meet the needs of the people who used the service.

People, or their representatives, were involved in making decisions about their care and support. People’s care plans had been tailored to the individual and contained information about how they communicated and their ability to make decisions.

Care workers had good relationships with people who used the service and were attentive to their needs.

Where care workers had identified concerns in people’s wellbeing there were systems in place to contact health and social care professionals to make sure they received appropriate care and treatment.

Care workers understood their roles and responsibilities in providing safe and good quality care to the people who used the service. The service had systems for monitoring the quality of care and support provided and shortfalls were addressed promptly. As a result the quality of the service continued to improve.

As part of this inspection we spoke with the registered manager, three people who used the service and two members of staff.

We found that the provider had systems in place to maintain the safety and welfare of service users. All three care plans examined were person specific and were individualised to each person and their care needs. One person told us that they "Felt safe living at Byways House and that staff were very kind to them."

We observed that people were treated with dignity and respect and the care plans examined confirmed that people were treated as individuals and were involved in the planning of their care. We saw that people were supported to access a wide range of activities, both within their own homes and within the local community.

We also found that medication was managed effectively and safely and that the staffing levels provided were appropriate to meet the individual needs of each person who used the service.

Staff considered the registered manager to be both effective and responsive in supporting them to promote and maintain people’s independence and well-being.

We spoke with three people who use the service, three members of staff and a local authority social worker. We also spoke with two relatives of people who use the service and examined the content and results of a relatives questionnaire.

People who used the service were happy with the quality of care and the way it was delivered. One person said, "We get on very well together - like a happy family."

A relative of a person who used the service said, "(XX) thinks of it as her home. There's wonderful interaction with the local community."

We tracked the care records of three people who used the service and found that they experienced care, treatment and support that met their needs and protected their rights. We saw evidence that care planning was used safely through clear assessments and plans to meet assessed needs. A social worker said, "Communication is brilliant, tenants are encouraged to be independent."

People who use the service were protected from the risk of abuse.

People were cared for by staff who were supported to deliver care and treatment safely and to an appropriate standard. We spoke with three people who use the service. One said, "The staff here are very kind." Another said, "They help out, but not too much because it's my house."

The provider had an effective system to regularly assess and monitor the quality of service that people receive.