.The inspection was unannounced, and the inspection visit was carried out on 5 June 2018. The home was previously inspected in March 2017, where concerns were identified in relation to medicines management and governance. At that inspection the home was rated “Requires Improvement.”

This service provides care and support to people living in a ‘supported living’ setting, 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. People using the service lived in six neighbouring houses, with office accommodation on the same site.

Care services for people with learning disabilities should 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.

At the time of the inspection the service had a 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 and associated Regulations about how the service is run.

Staff did not always ensure that people were engaged with when at home, meaning that people were at risk of social isolation. However, we found that people were supported to engage in activities in the community.

Care plans were not always personalised to people’s individual needs, and risk assessments were not always adhered with.

We found that the way that medicines were managed at the service required improvement so that people received their medicines as prescribed.

The provider did not always comply with the Mental Capacity Act in relation to consent and making decisions in people’s best interests.

The provider ensured that when people’s needs changed appropriate referrals were made to external healthcare professionals, and people’s needs were met in relation to nutrition and hydration.

There was a comprehensive programme of audits within the service, however, they had not identified shortfalls or concerns within service provision.

The inspection took place on the 14 March 2017 and was unannounced. This meant the people who lived at Wensley Street and the staff who worked there did not know we were coming. This was the first time the service had been inspected.

Wensley street had been a care home accommodating up to 30 people. In August 2016 they changed their registration status to provide supported living. Supported living means that people are supported to live in a way that they want and that people are given more choice and control.

The service did not meet all the regulations we inspected and were given requirement actions for not following their own recruitment practices. You can see what action we told the provider to take at the back of the full version of the report.

There was a manager at the service who was registered with CQC. 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.

Arrangements were in place to ensure medicines were safely administered but there had been a number of medicine administration errors. The registered manager told us they were working with the pharmacist to improve the medicines administration and to ensure all staff were competent in the process.

We have made a recommendation about the safe management of medicines.

Recruitment practices ensured that the staff employed were suitable to work with people but there were some gaps in staff personnel files. The registered manager was reviewing staff files to make sure all the required documentation was there. Staff received training and support to deliver a good quality of care to people.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the registered provider’s policies and systems supported this practice.

People were involved in menu planning, shopping and meal preparation. We saw people were able to choose what they wanted to eat and there was no set times. There was plenty choice of food and snacks were available.

Staff respected people’s privacy and dignity and spoke to people with understanding, warmth and respect. There was a friendly, homely atmosphere and staff supported people in a kind and caring way that took account of their individual needs and preferences. People’s needs had been identified, and from our observations, we found people’s needs were met by staff who knew them well.

Care records detailed people’s needs and were regularly reviewed.

There were systems in place for monitoring quality, which were effective. Where improvements were needed, these were addressed and followed up to ensure continuous improvement. The registered manager was aware of how to respond to complaints. Information on how to report complaints was clearly displayed in the service.