We inspected Affinity Trust – Domiciliary Care Agency – North on 16, 17 and 22 August 2016. This was an announced inspection because we wanted to ensure someone would be present at the service on the days of the inspection to provide us with the information we needed.

The service is registered to provide personal care to people living in their own homes and to people who required support to access the community. At the time of our visit the service provided personal care to 27 people with learning disabilities and/or autistic spectrum disorder across the city of Leeds.

The service had an operations manager in post who had applied to become the 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.

Systems were in place for the safe management of medicines so people received their medicines safely. Some improvement was needed around the consistent use of ‘as and when ‘required protocols and those for creams and lotions.

The medication audit was not fully effective as it had not identified medication errors we found. However, the registered provider had already identified this and taken appropriate action.

There were systems in place to monitor and improve the quality of the service provided. Staff told us the service had an open, inclusive and positive culture.

Assessments were undertaken to identify people’s support needs. Support plans reviewed contained information about the person's likes, dislikes and personal choices and preferences.

There were risk assessments in place for people who used the service. The risk assessments and support plans had been reviewed and updated on a regular basis. Risk assessments covered areas such as mobility, medicines and independent access to the community. This meant staff had the written guidance they needed to help people to remain safe.

There were enough staff employed to provide support and ensure people’s needs were met. The rota system was flexible to ensure people could access activities of their choice at different times of the day.

Staff told us the managers were supportive. Staff received regular supervision sessions and an annual appraisal. The majority of staff were up to date with training and the registered provider had a system to monitor compliance in this area. Staff told us they had received training which had provided them with relevant knowledge and skills to provide care and support.

There were systems and processes in place to protect people from the risk of harm. Staff were aware of the different types of abuse and what would constitute poor practice.

Effective recruitment and selection procedures were in place and we saw appropriate checks had been undertaken before staff began work.

The operations manager and staff we spoke with had an understanding of the principles and responsibilities in accordance with the Mental Capacity Act (MCA) 2005. MCA is legislation to protect and empower people who may not be able to make their own decisions, particularly about their health care, welfare or finances.

People and their families told us staff treated people with dignity and respect. Staff were attentive, showed compassion, were patient and gave encouragement to people. People told us they were supported to access a wide range of activities which helped them to build and maintain relationships.

People were provided with their choice of food and drinks which helped to ensure their nutritional needs were met. Staff at the service worked with other healthcare professionals to support people’s health and wellbeing.

The registered provider had a system in place for responding to people’s concerns and complaints. The procedure was available in an accessibl

We visited one of the supported living services as part of this inspection and spoke with people who lived there and observed the support people received. One person told us how much they enjoyed living in their home with the staff providing their support and said staff treated them well. They said, “I like them all, I have a keyworker, I go on holiday with staff and they help me.”

Other people smiled and said “OK” when asked if they were treated well and got on with the staff who supported them.

We also spoke on the telephone with people who received the service in their own home. They spoke very highly of the service received. Their comments included:

“They are very good, I would have cancelled them if they weren’t.”

“Very kind, nice and respect my home and privacy.”

“I am quite happy, have a great team, they turn up on time and we all get on so well.”

People who used the service spoke highly of the staff. People told us they felt safe and were pleased with staff’s professionalism. Their comments included:

“They are well trained and very professional.”

“I trust them 100%.”

There were quality monitoring systems in place, which included people giving feedback on their care and support.

We used a number of different methods to help us understand the experiences of people using the service including visiting and speaking with four people who lived in a shared house. They told us that they had been included in decisions about what care and support they received and when this would be available. People told us that they knew which care staff would be providing support and when. People told us that they were included in their care reviews to make sure it was meeting their needs and they were happy with the care they received. People said if they had any concerns they knew who to contact and had confidence in the service.

One person said; “The staff are fantastic, I am very happy with the support I get.”

Another person said;” I am very happy with the care I get.”

We observed staff being friendly and warm towards people. We observed that staff and service users had positive relationships and that people appeared relaxed and comfortable with their surroundings, with staff and the activities they were engaged in. We saw that staff supported people to make choices about their daily living.

We spoke with four members of staff who told us that the agency was very supportive, particularly with emergency out of office support, and provided good opportunities for training.

We did not gain views directly from people who use the service at 2 Stockshill, Methley. However we did spend some time with people in the lounge and found the atmosphere to be pleasent and calm. Staff interactions were frequent and friendly and people appeared content and engaged with their surroundings.