The inspection took place on the 29 and 30 September 2016 at the agency office and was completed by contacting people using the service and staff with telephone interviews on 1 and 2 October 2016. The first day was announced. This was to enable the management team to make themselves available to participate in the inspection.

Affinity Supporting People is a domiciliary care service. The service provides flexible personalised care and support for people with learning disability who require additional support to live independently within the community. The agency's office is located in the centre of Accrington Lancashire.

At the last inspection on the 11 January 2014. The service was found to be meeting the regulations applicable at that time.

At the time of the inspection there was a registered manager at the service. 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.

Feedback we received from people using the service, their families and staff members was very positive, they indicated that staff were caring, supportive and understood people’s needs well. Family members told us they had seen positive changes in their relatives who appeared to have grown in confidence, independence and happiness as a result of being supported by the service.

The provider had robust processes in place to maintain a protected and suitable environment for all people using the service and visitors. Risk assessments were established to identify any risks associated with areas such as the storage of medicines, sharps and substances hazardous to health (COSHH).

Suitable training was offered to staff to ensure they were competent in recognising the signs of abuse and could appropriately and confidently respond to any safeguarding concerns and notify the relevant authorities when required.

The service had satisfactory staffing levels to support the operation of the service and provide people with safe and personalised support. Comments from people using the service, their relatives and staff supported this. Staff were expected to access a variety of training which ensured they were skilled and experienced in safely and effectively supporting all people using the service.

Recruitment procedures were thorough and robust. Appropriate steps were taken to verify new employee's character and fitness to work. People using the service and their relatives were very much a part of the recruitment of staff. Staff induction processes contained the correct amount of detail to provide them with the knowledge to carry out their support role effectively and an appropriate level of training was offered to all staff. This ensured staff were equipped with the correct knowledge to support people effectively. People spoken with and their relatives told us how staff knew their needs well. Staff shared their knowledge with us and demonstrated a good understanding of their role and how to support people based on individual need and in a person centred way.

The provider had appropriate processes in place for the safe administration of medicines this was in line with best practice guidance from the National Institute for Health and Care Excellence. Staff were adequately trained in the administration of medicines and all medicines were stored securely and safely.

People each had their own individual care file containing support plans and risk assessments individual to their own personal need. These documents gave clear information about people's needs, wishes, feelings and health conditions. Changes to people’s needs and requirements were communicated well which meant staff were kept up to date with these changes.

Staff spoken with were aware of the principles of the Mental Capacity Act

During this inspection we visited two of the homes where the service was provided to speak to people who used the service.

Care and treatment was planned and delivered in a way that was intended to ensure people’s safety and welfare. People who used the service told us they liked the staff who assisted them and they said they felt well cared for.

People we spoke with told us they were happy with the service they received and that staff were always helpful and kind.

Everyone we spoke with said that the staff explained what they were doing and involved them in decisions about their care, and in reviewing their care plans. People said they were given choices about how their care was delivered and that they felt safe and well cared for. One person said: “The staff help me do things like cleaning and cooking and are very respectful”, and another said: “The staff are all ok and they help me to do shopping”. These comments were reflective of the comments we received from the majority of people we spoke with.

The provider ensured that they spoke with and involved other health professionals in providing care for people. The staff understood how to keep people safe and understood their responsibilities for reporting concerns if necessary. The staff were supported by the management to understand how to support people through training and supervision, and there was a system in place to effectively respond to people’s concerns and complaints.