The inspection took place on 19 April 2017 and was announced. The service provides a domiciliary care service supporting people in two properties over 24 hours. There were three people living at one property and six at the other. Staff supported people to live as independently as possible in the shared houses which were rented by people through Boothferry Housing Association. There were tenancy agreements in place for each person.

At the last inspection the service was rated Good. At this inspection we found that the service remained Good.

There was a person registered with the Care Quality Commission at the time of the inspection. We were told they were retiring but another person held a manager role and had been trained by the outgoing 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.

Care was planned in partnership with people and they received the care and support they needed to meet their individual needs. The managers and staff were committed to working in a person-centred way and treated people with kind-heartedness and consideration. People, including those who had difficulties communicating or who could become upset, responded positively to the way in which staff approached them. Staff were professional but kind in their approach.

People were protected from abuse because staff could identify the different types of abuse and knew what actions to take to report abuse. It was clear from our observations that people felt safe around the staff.

Improvements were identified through meetings, reviews and surveys. As well as consulting with people there were systems in place to monitor the quality and safety of the service and bring about any improvements that were needed. The home worked in partnership with other organisations to make sure they were providing high quality care.

The service had a clear management structure. Managers worked closely with staff, frequently observing and providing care. People were confident in the leadership of the service. They were encouraged to raise any areas of concern, which were taken seriously and the appropriate action was taken.

Staff demonstrated good communication skills when engaging with people. The staff were familiar with the needs of people. There was plenty of communal space available to people, including outside space.

Risks to people were monitored and people were encouraged to maintain a safe level of independence. Staff supported people in a positive way and were able to recognise when people may require additional support. We saw that people were cared for and supported by qualified and competent staff who were regularly supervised. Staff told us they felt extremely well supported by managers and the registered provider through training and meetings where their views were listened to.

The service was organised to meet people's individual needs. They were supported by staff that were kind and treated them with dignity and respect. Without exception, people we spoke with were complementary and positive about the staff that supported them.

People were supported to buy, prepare and cook their own food.

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

The premises were safely maintained by the housing provider but checks of the environment were carried out by staff. Staff were recruited safely and during this inspection we saw there was sufficient staff available to provide support to people.

This inspection took place on 9 January 2015 and was unannounced. At the previous inspection, which took place on 5 December 2013 the service was compliant with all of the standards we assessed.

Wolds & Coast Domiciliary Agency (Goole), which is owned by East Yorkshire Housing Association, provides ‘personal care’ and support services to people in their own homes who may have learning difficulties. Most of the people who receive support from the agency reside in two shared properties that are owned and managed by Boothferry Housing Association. People rent the property as tenants. These properties are on the outskirts of the town but close enough to the town centre to enable people to access local facilities. The aim of the service is to promote each person's independence. The service is a small one which currently provides support to twelve people.

The service has 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 2008 and associated Regulations about how the service is run.

We found that the service was safe in its delivery of care, recruitment practices, providing sufficient staff to meet people’s needs, dealing with accidents, supporting people with medication and managing good hygiene practices.

People that used the service told us they felt safe when being cared for by the staff that supported them. They said, “I like living here. The staff are kind and if I was worried about anything I could tell them or tell my sister”, “The house is safe. The staff know what to do if I am worried” and “My money is kept safe and there are only staff who come here to care for me.” We found that staff understood their responsibilities regarding protecting people from harm or abuse, promoting people’s human rights and following risk assessment processes.

We found that the two properties used by people were safe and appropriately maintained as part of the tenancy agreements that people had with Boothferry Housing Association. Staff followed procedures for dealing with accidents, incidents and whistle blowing and therefore ensured people were safe. We found that staffing levels were appropriate to meet the needs of people, the recruitment practices used by the service were robust and met the requirements of The Health and Social Care Act 2008 (Regulated Activities) Regulations 2010, and that medication handling systems were appropriate for supporting people with their medication. We found that staff had good infection control management systems in use.

We found that the service was effective in ensuring staff were trained and competent to do the job, were well supported by the management team, followed the procedures for supporting people who lacked capacity, obtained consent to provide care and support, encouraged people to ensure they had good nutritional diets and encouraged people to look after their health.

People we spoke with told us they thought staff were well trained and skilled to do their jobs. They said, “The staff are good and know how to help me”, “I think the staff are really nice. They advise me in most things” and “I’ve known the staff for many years and they know what to do to support me.” One person said, “I like some of the staff better than others because they have more in common with me, being of similar ages.”

We found that there were sufficient numbers of skilled and knowledgeable staff employed to meet people’s needs, that staff were well supported by the service and people without capacity were protected from the risks of exploitation and receiving poor care. We found that people ate well, had their health monitored, were encouraged to live well and that they lived in properties that were effectively maintained to a good standard.

We found that the staff at Wolds & Coast were caring when they delivered the service to people. Staff had a pleasant and considerate approach to people, ensured people’s privacy and dignity were maintained at all times, encouraged people to be autonomous, respected people and maintained confidentiality in all matters.

People said, “I am happy with the care and support I receive, as staff are friendly”, “Everyone is caring and I like the staff that look after me” and “I get on well with staff and they care about me very much.” They said, “My key worker helps me to understand my choices and to make my own decisions” and “I had involvement with setting and reviewing my care plan.”

Staff said, “I assist people to attend health care appointments. I make sure I respect people’s privacy and dignity when they use the bathroom or spend time in their bedroom, and I uphold confidentiality when it comes to information about their care and personal details” and “I’ve known people a long time and the care they get is person-centred. I am a key worker to one person and together we go in to town shopping or for a coffee, which is what they like doing. My enjoyment comes from just being with people. I think the staff here are very committed to caring well for people. Staff continually ask people about their needs and preferences so that their quality of life is the best it can be.”

We found that the service was responsive to people’s needs. People we spoke with told us they had clear care plans in place for staff to assist them with their needs. They said, “I have a care plan that I was involved in putting together and it is reviewed whenever any changes occur. I get good support from the staff to keep to my plan” and “I like to go to day services, but don’t really like doing chores here at home. We have a rota and I don’t like it when it is my turn to wash up, but staff are good and motivate me to do what I have to do.”

We saw that care plans and risk assessments supported people to lead fulfilling and independent lives of their choosing. These involved work and educational choices. People were able to make complaints and concerns known to the service in the confidence they would be dealt with appropriately and satisfactorily.

We found that the service was well-led through the use of a healthy culture of care, an approachable management style and effective quality monitoring system.

People told us they thought they could speak to anyone about anything and said the staff were very supportive. When we asked the staff about the culture of the service they described it as open and transparent. They said, “We have a good atmosphere in the two properties. They are happy places to work. I think people that live there are happy with the support we give them” and “People are free to do as they wish. We help them to be independent and we offer a nurturing environment for them.”

We found that people were given the opportunity to make their views and opinions of the service known through satisfaction surveys, meetings and daily discussions. There were audits in place, but these were informally recorded and did not show any analysis of information at a local level.

We recommend that quality assurance systems are further developed.

At the time of our visit Wolds and Coast Domiciliary Agency was providing support to 12 people residing in two shared tenancy houses.

People’s consent was obtained before care and support was provided. Where people did not have capacity to consent to care or treatment best interest decisions were made that involved the relevant people involved in the person’s care.

Care plans provided clear guidance to support staff to ensure people’s needs were safely met. People we spoke with confirmed they were satisfied with their support.

People were supported to take their prescribed medication in accordance with their care plan.

Staff received regular supervision and training to ensure they had the support necessary to enable them to undertake their role appropriately.

The provider had effective systems in place to check on the quality and safety of the service people received.

People told us that they could choose how to spend their day and what activities to take part in. Two people showed us their bedrooms and told us how their bedrooms had been divided so that they all had a single room.

People told us that they felt safe in their home. They told us that they could speak to staff if they had any worries or concerns and that they felt staff would help them if they could. One person said that they trusted all of the staff at the home and said, "I am really happy living here". People said that they attended tenant's meetings and that they could raise any issues at these meetings.

We observed good rapport between people who used the service and staff and it was clear that staff had a good understanding of each person's individual level of independence and need for support. People were encouraged to undertake household chores and to take part in activities within the local community, and spent one to one time with their key worker. People enjoyed telling us about their holidays and their active social lives.