This inspection was carried out on the 18 and 19 January 2017. Welmede Housing Association Limited offers person centred support services to people with a learning disability living in their own homes. At the time of our inspection the service provided personal care to approximately 329 people spread over a large geographical area. Some people shared accommodation with others whilst some people lived on their own. There were other people who used the service that were not receiving personal care.

There was a registered manager in post at the time of the inspection. A registered manager is a person who has registered with the Care Quality Commission (CQC) 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. We were supported on the inspection by the registered manager and the senior management team.

People’s feedback about the safety of the service showed that there was a high level of understanding from staff of the need to make sure people were safe. People were supported to be safe whilst maintaining their independence.

The service used innovative ways to manage people’s risk and keep people safe, whilst ensuring they had a full and meaningful life. Staff had received training in how to recognise and report

abuse and were confident any allegations would be taken seriously and investigated to help ensure people were protected.

There were sufficient staff at the service to provide care and support to people. Appropriate recruitment checks were undertaken before staff started work. People's medicines were managed in a safe way people supported to manage their own medicines.

People received support from staff that knew them really well, and had the knowledge and skills to meet their needs. People and their relatives spoke highly of the staff and the support provided. The staff made people feel that they mattered and that they were contributing to their own care. People were supported by staff that had undergone a thorough induction programme which gave them the skills to care for people effectively. Comprehensive and detailed training was provided to staff to help them understand the specific needs of people.

People had detailed care plans in place which provided guidance for staff about how people liked their care provided. People and families were fully involved in making sure they planned care which suited their needs. People told us staff always respected the way they liked things done and respected their home. Staff received appropriate supervision to provide effective care to people.

All staff had a clear understanding of the Mental Capacity Act 2005 and how to make sure people who did not have the mental capacity to make decisions for themselves had their legal rights protected. Staff were aware of when someone may need to receive a mental capacity assessment and who to report this to.

Staff supported people's nutritional and hydration needs and people were supported to access any health care they needed. Staff supported people to stay well and they followed the guidance given by health care professionals.

Staff and management were committed to a supportive approach to caring and found ways to make sure that every person using the service were happy and comfortable. People were treated as individuals whose life and experiences mattered to the staff. The manager team and staff went out of their way to ensure that people and their relatives were comforted and looked after in a kind and compassionate manner and treated with dignity and respect. It was clear that staff understood people's needs and how to communicate with people. Staff had supported people to use information which helped them communicate more easily. People and relatives were at the centre of decision making about their care.

Care records were pe

During our inspection we spoke with eight members of staff as well as the registered manager. An expert by experience spoke to twelve people who used the service to gain their views. We sent out sixty questionnaires to people who used the service and their relatives and friends. We received twenty one responses which were mostly very positive.

Most people told us that they were happy with the care and support they received from the staff. One person told us that staff “Are brilliant”. However, one person told us that their care needs had changed and they felt that they needed more support now.

People told us that staff asked them for their consent before providing any care or support. One person told us “Staff always check with me first before walking around my home to do things”.

We saw records that showed staff had received regular supervision and appraisal and had completed training in essential areas such as health and safety. Staff we spoke with confirmed this. People told us that they thought staff were well trained.

We looked at other records held by the provider and saw that these were not all up to date. We spoke to the provider about this. They told us that these records were available and sent most of them to us following our inspection.

We visited Welmede Housing Association on 7 January and 14 January 2014 to follow up on some concerns that we had identified at our previous inspection in August 2013. At our previous inspection we had found that the provider had not maintained people’s records in a way that ensured they were accurate and fit for purpose.

During our visit on 7 January 2014 we found that the provider had put in place a new system for maintaining people’s records at the registered office. However, we found that these records were still not all accurate and complete. We also looked at some records from people’s own homes. We found that these records were well maintained. We decided to look at more records from people’s own homes to check that the information that staff worked from was accurate and fit for purpose.

We asked the provider to get more records ready for us from people’s own homes and re-visited on 14 January 2014 to check these. We found that these records were well maintained, accurate and fit for purpose.