The inspection took place on 23 November 2013 and was unannounced.

The service provided care for people as part of a supported living arrangement at two locations in Sleaford. There were 10 people using the service on the day we inspected.

At the time of our inspection the service did not have a registered manager. However, we had received an application for a new manager to be registered and the appropriate checks to ensure the person had the appropriate knowledge and skills were being undertaken. 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 Care Quality Commission is required by law to monitor how a provider applies the Mental Capacity Act 2005 (MCA) and to report on what we find. The registered manager and staff had understood their responsibilities under the Mental Capacity Act. People’s abilities to make decisions had been assessed and appropriate support had been provided to ensure that their views were taken into account when making decisions.

There were enough staff to meet people’s needs. Staff training and the ongoing support staff received from the manager meant that the care provide was calmly delivered, safe and effective. Staff knew how to safeguard people from situations and people where they could be abused. Safe recruitment practices ensure that staff were safe to work with people using the service.

Care plans contained information on the care people needed and the risks they faced. However, at times the information did not always reflect the latest care people needed. However, staff we spoke with were up to date regarding people’s care needs. People had been supported to access healthcare professionals when needed and their care and communication needs were communicated to those looking after them if they had to go into hospital.

Medicines were safely stored and administered. However, recording of when medicines had been administered was not consistently completed. People received person centred support to make choices about their food. Staff knew about people’s nutritional needs and ensured that the food provided was presented in a way which was safe for people to eat.

There was a good relationship between people using the service and staff. Staff supported people to be involved in their care and to make choices about how they spent their time. Wherever possible staff encouraged people’s independence and supported them to access the local community.

The manager was approachable and took action when any concerns were raised. They had gathered the views of people using the service, their families, healthcare professionals and staff. Systems used to monitor the quality of care provided were effective and the provider and manager kept up to date with changes in legislation and best practice.

In this report the name of a registered manager appears who was not in post and not managing the regulatory activities at this location at the time. Their name appears as they were still on our register at the time.

When we visited the service we spoke with three people who lived there. Two other people we observed could not communicate with us verbally, however we observed how staff cared for them and we saw by their non-verbal form of communication they were happy and well cared for.

Most of the people lived in a self contained bungalows where staff provided support and care to them. Two of the bungalows accommodated two people. They had their own bedrooms and shared the lounge, kitchen and bathroom. One person lived in a rented property in the community and staff provided domiciliary care.

One person we spoke with told us they really liked living there and said the staff provide good support and care whilst promoting their independence. Another person told us staff treated them with dignity and respect. We spoke with a relative who told us, "The care is excellent, the staff act on everything we say. I have no complaints, people are definitely safe there."

Care and support levels were worked out according to people's needs and abilities. Some people had staff supporting them 24 hours a day. People were given choices about their day to day lives within a risk managed environment.

We spoke with the registered manager, deputy manager, two members of staff, one person who used the service, three relatives, two healthcare professionals and observed two people who used the service who were not able to communicate verbally.

We spoke with a relative of a person who used the service. They told us, “The staff are always respectful. Whenever the staff come into the bungalow, they always knock on the door because it is (name) home. The staff are lovely and very caring.”

We asked the staff if Ancaster Mews were responsive to the needs of the people who used the service. One member of staff told us, “Yes I think we are but I would like to take them out more. I think sometimes we let them down in not being able to get them out enough.”

One person who used the service told us, “I feel safe because I can ring the bell at night for emergencies and the staff come to help me.”

We spoke with one person who used the service and their relatives and asked them whether they thought the food and drink provided met their or their family member’s needs. A person who used the service told us, "The food is nice, my favourite is fish and chips with mushy peas.”

Staff confirmed they had received regular supervision and told us they felt well supported by their manager. We saw records of regular supervision in the three staff files we looked at. Supervision provides a formal way for staff and their manager to discuss any concerns they may have, request training and support and discuss how to carry out their roles.

People who used the service, their representatives and staff were asked for their views through a survey and where possible they were acted upon. The meetings for the people who used the service were called ’One Voice Meetings’ and were held monthly. Records of these meetings showed that people were asked about issues affecting their daily lives such as leisure activities, day trips, holidays, key workers, menus and shopping. They were also asked if they had any concerns or problems with the service provided.