The inspection visit took place on 06 November 2017 and was announced.

A Chance for Life Ltd is a service for adults and children whose lives have been changed by injury or serious illness. The service provides case management and rehabilitation. It also provides personal care to people living in their own houses and flats in the community. People’s care and housing are provided under separate contractual agreements. CQC does not regulate premises used for people supported in their own homes; this inspection looked at people’s personal care and support.

At the time of the visit there were 63 people who used the service.

At the last inspection in November 2014 the service was rated 'Good'. At this inspection we found the service remained 'Good'. Following this inspection in November 2017, we found the key question ‘is the service effective?’ to be outstanding.

The registered manager had systems in place to record safeguarding concerns, accidents and incidents and take appropriate action when required. Recruitment checks were carried out to ensure suitable people were employed to work at the service.

Staff skills knowledge, training and support demonstrated an excellent commitment to providing outstanding care which was embedded into the practices of the staff and the management team. The service put people's views at the forefront of the service and designed the service around their needs.

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

Risk assessments had been developed to minimise the potential risk of harm to people who used the service. These had been kept under review and were relevant to the care and support people required.

Care plans were in place detailing how people wished to be supported. People who received support, or where appropriate their relatives, were involved in decisions and consented to their care. People’s independence and choice was promoted.

Staff responsible for assisting people with their medicines had received training to ensure they had the competency and skills required.

We found people had been assisted to have access to healthcare professionals and their healthcare needs were met.

People who used the service and their relatives knew how to raise a concern or to make a complaint. The complaints procedure was available and people said they were encouraged to raise concerns.

The registered manager used a variety of methods to assess and monitor the quality of service provided to people. These included regular internal audits of the service, surveys and staff and relatives meetings to seek the views of people about the quality of care being provided.

People we spoke with told us their relative received the support they needed and said they had been included in developing the plan of the care to be provided by the service. They confirmed that there was a copy of the care plans in their homes and said they felt the care plans gave staff good information about the care needed and how this was to be provided. We were told that their care plans were reviewed regularly and were changed if the support they needed had changed.

We looked at the recruitment process undertaken by the provider. We found the provider recruited staff in line with legislation.

There was a case file kept in the person’s home and a duplicate copy was kept at the office. Each day a support worker provided care and support they recorded this on a daily log. These were kept in the file in the home for two weeks before being returned to the office. When we spoke with staff they confirmed that the team leader visited the home on a regular basis and reviewed and updated care plans.

People we spoke with told us they received the support they needed and said they had been included in developing the plan of the care to be provided by the service. People said they were confident the support workers who visited them were well trained and competent to carry out their duties. One person said, “The staff are all very good, you couldn’t ask for better.”

We were told that their care plans were reviewed regularly and were changed if the support they needed had changed. All the people we spoke with said they knew their case manager very well and would speak to them if they had any concerns at all about the service provided. One person said: “It is great to have so much support at the end of the phone. The service they are providing is taking a lot a pressure off me in caring for my child.”

The support workers we spoke with told us they were aware of the actions they had to take to protect themselves and people using the service because this was clearly identified in risk assessments held in the records in individuals’ homes. Support workers told us they were able to identify if the risk assessments needed updating and could do this and inform the office of any changes so the risk assessments were always up to date.

This announced inspection took place over two days the 12 and 16 June 2015. The provider was given 48 hours’ notice of the first visit because the location provides support and personal care to people living in their own homes.

A Chance For Life Ltd is a service for adults and children whose lives have been changed by injury or serious illness. Who may have complex health issues requiring collaboration and coordination of services that they need to access. The service provides case management and rehabilitation. It employs specialised healthcare professionals to help people make informed decisions about their care and support needs.

During our previous inspection visit in December 2013 we found the service met all five of the essential standards we looked at. Since then there had been no incidents or concerns raised that needed investigation.

There was a registered manager in post on the day of our inspection visit. 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 this service the registered manager is also the registered provider.

We found that people who used this service were safe. The staff knew how to protect people from harm. Staff had completed training in the safety of vulnerable adults and knew the signs to look for and how to report any incidents of concern. There were good systems in place to ensure people knew the staff that supported them.

We saw that recruitment procedures were robust this ensured only suitable people worked in the service. We saw that staffing levels were good throughout all areas of the service. Staff training was up to date. We saw that staff were supported by the management team through regular staff supervision and appraisals.

We found that the service worked very well with a variety of external agencies such as social services, other care providers and mental health professionals to provide appropriate care to meet people’s physical and emotional needs.

We saw that medicines were administered safety and records were up dated regularly. Staff who were responsible for the administration of medications had completed the appropriate training.

Observations during our inspection evidenced people were given choices about how they wanted to be supported and how to live their lives. Support was given in a manner to people to promote their independence for example supporting them to join in with activities in the community

The service followed the requirements of the Mental Capacity Act 2005 Code of practice. This helped to protect the rights of people who were not able to make important decisions themselves. Best interest meetings were held to assist people who were not always able to make difficult decisions for themselves and where relevant independent advocacy was arranged.

People received support from a regular team of staff who they knew and who understood the care and support they required. We saw that people were treated with kindness and respect and they made positive comments about the staff who visited their homes.