We carried out this announced inspection on 23, 24 and 25 May 2018. Between these dates and 8 June 2018, we also received feedback from professionals working for the local authorities that commissioned the service.

This service is a domiciliary care agency. It provides care and support to people living in 11 'supported living' settings (schemes) and in flats, so that they can live in their own home 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. The service supported people with physical disabilities, learning disabilities and/or autistic spectrum conditions. At the time of the inspection, 81 people were being supported by the service.

The care service has been 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.

There was a registered manager in post. 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.

Constant changes to staff meant that one person did not always receive care that was safe or consistent. This put them at risk of harm. We found the provider needed to make further improvements in how they managed this person's care.

There were risk assessments in place that gave guidance to staff on how risks to people could be minimised. There were systems in place to safeguard people from risk of possible harm and action was taken to review incidents so that systems could be put in place to prevent them from happening again. People’s medicines were being managed safely.

The provider had safe recruitment processes in place. They had not used agency staff for a few months prior to the inspection as they now had sufficient permanent staff. Staff had received regular supervision and support, and they had been trained to meet people’s individual needs.

People’s needs had been assessed and their care plans took account of their individual needs, preferences, and choices. People enjoyed happy and fulfilled lives because they had been supported to pursue their hobbies and interests. They had also been supported to maintain close relationships with their family members and friends.

Staff understood their roles and responsibilities to seek people’s consent prior to care being provided. Where people did not have capacity to consent to their care or make decisions about some aspects of their care, this had been managed in line with the requirements of the Mental Capacity Act 2005 (MCA).

People were supported by kind, caring and respectful staff. They were supported to make choices about how they lived their lives. People’s health and wellbeing was promoted, and they were supported to access other health and care services when required.

The provider managed people's complaints and concerns well. They encouraged feedback from people, relatives, staff and other stakeholders. They acted on the comments received to improve the quality of the service.

The provider’s quality monitoring processes had been used effectively to drive improvements. People and staff we spoke with were happy with the quality of the service.

We carried out an announced inspection on 13 April 2016. Between this date and 5 May 2016, we contacted the relatives of four people by telephone, but we were unable to speak with any of them. This was because three of them did not answer the phone despite us trying at different times of the day and the other relative was busy.

The service provides care and support to people with physical disabilities, learning disabilities and/or autistic spectrum conditions who live in ‘supported living’ premises. At the time of the inspection, there were 27 people being supported by the service, within three premises.

There was a registered manager in post. 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.

There were risk assessments in place that gave guidance to staff on how risks to people could be minimised. There were systems in place to safeguard people from risk of possible harm and suitable equipment was in place so that people were supported safely. People’s medicines were now being managed safely.

The provider had safe recruitment processes in place. Although they had an ongoing recruitment plan, they had not been able to recruit sufficient permanent staff. This meant that they used a group of regular agency staff to ensure that there was always sufficient numbers of staff to support people safely. Staff had received regular supervision and support, and they had been trained to meet people’s individual needs.

Staff understood their roles and responsibilities to seek people’s consent prior to care being provided. Where people did not have capacity to consent to their care or make decisions about some aspects of their care, this had been managed in line with the requirements of the Mental Capacity Act 2005 (MCA).

People were supported by kind, caring and respectful staff. They were supported to make choices about how they lived their lives. People’s health and wellbeing was promoted, and they were supported to access other health and care services when required.

People’s needs had been assessed and their care plans took account of their individual needs, preferences, and choices. They enjoyed happy and fulfilled lives because they had been given opportunities to pursue their hobbies and interests. They had also been supported to maintain close relationships with their family members and friends.

The provider had a formal process for handling complaints and concerns. They encouraged feedback from people who used the service, people’s relatives, staff and health professionals. They acted on the comments received to improve the quality of the service.

The provider’s quality monitoring processes had been used effectively to drive improvements. People and staff we spoke with described the service as ‘good’.