This unannounced comprehensive inspection took place on 4 and 8 May 2018 and was carried out by one adult social care inspector.

Vivo Care Choices Specialist Autism Service is a supported living service providing care and support to adults who live in their own homes so that they can live in their own home as independently as possible. The service currently supports 22 people who live in shared housing which is situated close to each other. 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.

The care service has been developed and designed 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. People with learning disabilities and autism using the service can live as ordinary a life as any citizen.

The service had a registered manager but they were away from the service at the time of our inspection. The service had appointed an interim manager who began managing the service in February 2018. 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.

In November 2017 the local authority’s quality assurance team inspected the service and found that overall it was non-complaint with their quality standards. The local authority’s report identified a number of areas requiring improvement, ranging from shortcomings in person-centred care planning and record keeping to a lack of up-to-date training and supervision for staff. The service committed to an improvement action plan, which the local authority shared with us prior to our inspection. Overall, during our inspection we saw that the service was making progress against its improvement action plan. The new management team at the service were actively addressing the shortcomings that had been identified and they will require further time to make all of the necessary improvements.

Since the local authority’s visit the service had put in place clear safeguarding and whistleblowing policies and procedures. The staff we spoke with were clear and confident about managing any safeguarding concerns if they arose. Most staff had received training on safeguarding vulnerable adults but around a quarter of staff’s training had expired. We also found that the service had not always notified CQC of any safeguarding incidents that had occurred as is required.

We saw that documentation about accidents and incidents was not always fully completed and there was a lack of evidence to demonstrate what, if any, follow-up action had been taken following any accidents and incidents.

Staff training had not been kept up-to-date since our last inspection and a significant number of staff were not up-to-date in both the service’s mandatory and specific training. We noted that the service had sourced a new training provider and staff training was scheduled to take place shortly after our inspection.

Staff had not been supported with regular supervisions, appraisals and performance management since our last inspection. However, we saw that the new management team had made improvements in this area in the last few months. For example, we saw that staff supervisions were now being held on a regular basis, were recorded and meaningful discussions such as performance management issues were taking place.

People had personal emergency evacuation plans (PEEPs) and the content of these documents was helpful and gave clear guidance about what level of support people would need in an emergency. However, not all of these documents had been signed and dated so it was unclear

We visited this service on 15th and 17th September 2015 and we gave short notice to the provider prior to our visit. This service was registered with the Care Quality Commission in July 2014 and this was the first inspection.

The agency is managed by VIVO Care Choices Limited to provide care and support to adults who have a learning disability and who live in their own homes. The agency is an Autism specialist and move on service and their aim is to promote people’s independence, develop confidence and increase skills. The agency currently supports 22 people. People live in shared bungalows and a house which are situated close to each other. People had individual tenancies with the property owners.

There was a registered manager employed to work at 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.

People told us staff were kind, caring and supported them well. Relatives said they were happy with the support provided and that the staff were very kind and patient with people. Comments included “Staff make [name] life as fulfilling as possible”, “Staff are very good”, “There has been significant improvement in [name].”

There were robust staff recruitment processes in place which meant that people were protected from staff who were unsuitable to work with people who may be deemed vulnerable. Staff had undertaken an induction and had access to supervision sessions, staff meetings and training relevant to their job role. Staff commented that there was a wide range of training available.

Support plans were person centred and gave good information about the individual needs of each person. They contained comprehensive information and included a range of risk assessments tailored to each person’s particular requirements. Some people were supported with their medications and these were well managed by the staff team. Some risk assessments had not been reviewed and these were brought to the attention of the manager.

There was usually were enough staff on duty, however occasionally there were not enough staff for people to go out with staff on a one to one basis.

People had access to information about the service that included a statement of purpose and service users guide. These were written in large print and included pictures to make it easier to understand the information enclosed. These documents could also be produced in a DVD format.

A complaints policy was available and processes were in place should a complaint be received. The registered provider had not received any complaints and CQC had also not received any complaints about this service.

People and relatives said they were safe in the support of the staff. Staff were aware of safeguarding policies and procedures and had undertaken safeguarding awareness training. The manager understood the principles of the Mental Capacity Act (MCA) 2005 and the implications of that on people who used the service. Staff had an awareness of the MCA through the induction process and safeguarding training.

Quality assurance processes were in place which included meetings held with people who used the service and relatives. There were also a range of audits undertaken in relation to the service provided that monitored its safety and effectiveness.