The inspection took place on 5 and 6 October 2017 and was announced.

The service’s office is based on the main road of Herne Bay town centre and offers support and care to people within the geographical areas of Herne Bay, Canterbury and surrounding areas. Aiding Independence is registered to provide personal care to people who have learning disabilities. The service provided a supported living service for people in their own homes. Some people lived on their own in rented flats, others lived in shared houses. Each person had a tenancy agreement. Other people lived with their families. People were able to tell us about the care and support that they received. At the time of the inspection 63 people were receiving support from the service but only nine people were receiving the regulated activity ‘personal care’.

We last inspected this service in October 2015 and the service was rated as ‘outstanding’ in the caring and responsive domains. The provider continued to provide outstanding responsive care; they had developed this to enhance people’s well-being and self-esteem.

There was a wide age range of people using the service and their needs varied greatly. For some people the routine was that staff would go into their homes in the morning to assist, support or guide them with their personal care and breakfast to help them get ready for the day. The staff then returned in the evening to offer assistance and support. For others, staff were available throughout the whole day and night. Staff supported some people to participate in activities in the community while other people were able to do this independently. The service worked to give people the care and support they wanted and needed to develop their skills to reach their full potential and to be as independent as possible.

There was a registered manager working 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. The registered manager, one of directors and the newly appointed deputy manager supported us

throughout the inspection.

The culture within the service was transparent, personalised and open. People were at the heart of the service. The management team engaged with people, relatives and staff consistently. People, their relatives and staff could drop in at the office at any time to discuss any issues or concerns.

The registered manager was aware that they had to inform CQC of significant events in a timely way and had done this on most occasions. At the inspection we identified two minor incidences involving people that had been reported to the local safeguarding team. The registered manager had not notified us about these two incidents when they happened but did so after the inspection. Action was taken at the time to keep people safe. The registered manager took action to make sure they informed us of significant events in the future.

Staff were clear about their roles and responsibilities and felt confident to approach senior staff if they needed advice or guidance. They told us they were listened to and their opinions counted. The registered manager had sought feedback from people, their relatives and other stakeholders about the service. Their opinions had been captured, and analysed to promote and drive improvements within the service. Informal feedback from people, their relatives and healthcare professionals was encouraged and acted on whenever possible. People were able to express their opinions and views and they were encouraged and supported to have their voices heard within their local and wider community. They were enabled to promote links within the community that improved their own lives and the lives of the wider community of people with disabili

People who used the service told us they were satisfied with the care and support being provided. They said they were encouraged to express their views and participated in making decisions relating to their care and treatment.

We found that individual personalised care plans were in place to make sure people were receiving the care they needed. People told us they felt respected by the staff and were involved in the running of the service. People who used the service told us that staff arrived on time and stayed for the full duration of the call.

Staff recruitment records showed that new staff had been checked to make sure they were suitable to work with vulnerable people. We found that the provider took appropriate action to safeguard people from abuse. Systems were in place to monitor the service that people received to ensure that the service was satisfactory and safe.

The inspection visit took place at the Aiding Independence office on 7 and 9 October. On the 12 October 2015 we spoke with relatives and visiting professional by telephone.

The service’s office is based on the main road of Herne Bay town centre and offers support and care to people within the geographical areas of Herne Bay, Canterbury and surrounding areas. Aiding Independence is registered to provide personal care to people who have learning disabilities. The service provided a supported living service for people in their own homes. Some people lived in their own in rented flats, others lived in shared houses. Each person had a tenancy agreement. Some people lived with their families. People were able to tell us about the care and support that they received.

There was a wide age range of people using the service and their needs varied greatly. For some people the routine was that staff would go into their homes in the morning to assist, support or guide them with their personal care and breakfast to help them get ready for the day. The staff then returned in the evening to offer assistance and support. For others, staff were available throughout the whole day. Staff supported some people to participate in activities in the community while other people were able to do this independently. The service worked to give people the care and support they wanted and needed to develop their skills and to reach their full potential and to be as independent as possible.

There was a registered manager working 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. The registered manager, and two directors, supported us throughout the inspection. The management team visions and values were imaginative and person-centred and made sure people were at the heart of the service. They were developed and reviewed with people and staff and were owned by all. The management team demonstrated strong values and a desire to learn about and implement best practice throughout the service. The management team made sure the staff were supported and guided to provide outstanding care and support to people enabling them to live fulfilled and meaningful lives. The ethos of the service was a ‘hands off approach’, so that people could be as independent as possible. Staff were positive about the support they received from their managers. They were encouraged to strive to improve. Staff were very motivated and proud of the service. One comment people, their relatives and professionals consistently said to us was, ‘The service changes people’s lives’.

Before people decided to use the service their support needs were assessed by the registered manager to make sure the service would be able to offer them the care that they needed. People and their relatives were fully involved in the assessment and had a say. Their opinions were taken seriously and acted on. The care and support needs of each person were different and unique and this was reflected throughout their care plans. People were involved in developing and writing their plans. They told staff what they needed and wanted. When people requested what could not be achieved there were boundaries in place so people knew what was attainable and achievable and what was not. This was explained to people in a way they could understand and accept.

People, relatives and professionals like care managers, who were involved with people, told us that they were very happy with the service provided. They said that the management team and staff were very proactive and they did not give up. If a plan did not work they looked at other innovative ways of supporting people to develop. The details in the care plans contained the information needed to support people in the way they preferred and suited them best and that they had chosen. People, relatives and staff said the communication between them and the office made sure that they were up to date with people’s changing needs. They said that support and care was flexible depending on what people wanted and needed and any specific time.

People were supported to make choices and to take ‘risks’ in their daily lives. Potential risks to people were identified and assessed. There was guidance in place for staff on how to care for people effectively and safely and without restricting their activities or their lifestyles. Staff were able to tell us what they would do if an incident did occur, but in some cases, further detail was needed in the risk assessments so that staff had full written guidance of how to keep risks to a minimum.

Safeguarding procedures were in place to keep people safe from harm. People felt safe using the service; and if they had any concerns, they were confident these would be addressed quickly by the management team. The staff understood their responsibility to recognise and report safeguarding concerns and to use the whistle blowing procedures. They had received training in how to keep people safe and demonstrated a good understanding of what constituted abuse and how to report any concerns.

People were able to make decisions about their care and support. Staff had received training in the Mental Capacity Act 2005 and they were able to explain current guidance to support people to make decisions. They told us about the importance that everyone should be deemed to have capacity to make decisions about their lives. The Mental Capacity Act 2005 provides the legal framework to assess people’s capacity to make certain decisions, at a certain time. The registered manager told us about occasions when people had been referred to health and social care professionals to make big decisions about their care and support. Best interest meetings had been held to collectively decide what action should be taken to act in the person’s best interest.

Some people were able to take their medicines independently and required no support or intervention from staff. Other people did need support, prompting and supervision to take their medicines. People received their medicines safely and on time but the systems and records being used did not accurately record the medicines people were being supported or prompted to take. People were monitored for any side effects of their medicines and if there were any concerns their doctor was immediately contacted. The staff made appropriate referrals and worked jointly with health care professionals, such as community nurses, doctors and specialist services to ensure that people received the health care support they needed.

Staff supported, prompted and supervised people to prepare meals to make sure they had a range of nutritious food and drink. People told us that they had increased their cooking skills because of the support from staff. When people were at risk of not drinking enough this was monitored by staff on a daily basis to make sure they were drinking enough.

There were sufficient numbers of staff available to make sure people’s needs were met. Staff had permanent regular schedules of calls so that people received care from a consistent team. People and staff had strong bonds and relationships. There was mutual respect and friendship. Staff were caring and treated people with dignity and respect. Staff responded on a daily basis to peoples changing needs. People were able to express their opinions and views and they were encouraged and supported to have their voices heard within their local and wider community. They played an active role in the running of the service and the organisation. They were enabled to promote links within the community that improved their own lives and the lives of the wider community of people with disabilities. People took an active role in the District Partnership Group where there was involvement from local community services like the police and health professionals. There was also a weekly ‘drop in’ centre where everyone met up to chat, do activities and plan events. The ‘drop in’ service was also visited by other people who did not receive a service from Aiding Independence, everyone was welcomed.

Relatives told us that the staff arrived on time and stayed for the duration of their call. Staff supported people to go out during the day and in the evening to attend various activities in the local community. People were supported to go where ever they wanted to. The activities varied depending on what the person liked and enjoyed. People were coached, supported and encouraged to do things independently like travelling on public transport, shopping and visiting family and friends.

People were protected by robust recruitment procedures and new staff had induction training which included shadowing experienced staff, until they were competent to work on their own. Staff had core training and more specialist training, so they had the skills and knowledge to meet people’s needs. The registered manager was looking at ways to develop the training systems to make sure staff were getting all the training that they needed. Staff fully understood their roles and responsibilities as well as the values of the service.

People and staff were supported by an out of hours on call system. They told us told us that the management staff were always responsive and any queries raised were sorted out promptly.

People, relatives and staff felt confident in complaining, but did not have any concerns. People had opportunities to provide feedback informally and formally. The feedback received had been positive.

The culture within the service was transparent, personalised and open. People, their relatives and staff could drop in at the office at any time to discuss any issues or concerns. There was a clear management structure in place and staff told us they were all part of the team. They said they felt comfortable talking to the management about their concerns and ideas for improvements. There were systems in place to monitor the safety and quality of the service being provided. The service looked at new ways of working to continuously improve.