The inspection took place on 28 August 2018, The inspection was announced which means that we gave the provider 48 hours’ notice of the inspection to ensure key staff were available to speak with us.

Amity Supported Living is a domiciliary care agency. It provides personal care to people living in their own homes. The service supports people with learning disabilities, autistic spectrum disorder and mental health needs. Some of the people using the service lived in shared accommodation where staff from Amity Supported Living provided 24-hour support. Others lived alone or with family members. Not everyone using the service received a regulated activity. The Care Quality Commission (CQC) only inspects the service being received by people provided with 'personal care', that is, help with tasks related to personal hygiene and eating. Where they do we also consider any wider social care provided. At the time of our inspection, the service was providing a ‘personal care’ service to two people.

At our last inspection we rated the service good. At this inspection we found the evidence continued to support an overall rating of good and there was no evidence or information from our inspection and ongoing monitoring that demonstrated serious risks or concerns. This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection.

The service had a 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 and associated Regulations about how the service is run.

The registered manager was supported by a number of front line coordinators who had delegated day to day responsibility for managing the delivery of care within people’s homes. The registered manager was also one of the two registered providers. Both the registered manager and provider retained a high level of involvement in the day to day support and management of the service.

Staff who administered medicines had completed training and underwent competency assessments. Staff used medicine administration records (MARs) to document the administration of people’s medicines. These contained sufficient information to ensure the safe administration of medicines.

Staff had received training in safeguarding adults and the organisation had appropriate policies and procedures in place. This ensured staff had clear guidance about what they must do if they suspected abuse was taking place.

Individual risk assessments were in place which helped to ensure people were kept safe from harm.

Staffing levels were adequate and staff were well supported by an effective on call service.

People were protected from cross infection. Staff had completed infection control training and wore protective gloves and aprons when providing personal care.

People and their relatives felt the service provided effective care and support which made a real difference to people’s lives.

Staff had received training on the Mental Capacity Act 2005 and understood their responsibilities in relation to this and to respecting people’s choices and decisions. Action is being taken to ensure that records always include a mental capacity assessment to support best interests’ decision making.

New staff completed an induction and were required to complete a range of training which prepared them for their role.

People were supported to improve their health through good nutrition and to eat a well-balanced diet and make healthy eating choices.

Where necessary a range of healthcare professionals including GPs, and other community healthcare professionals, had been involved in planning peoples support to ensure their health care needs were met.

Amity Supported Living did not own the premises where people live

The inspection was carried out on the 11 January 2016. Forty-eight hours’ notice of the inspection was given to ensure the registered manager was available.

The service was last inspected in October 2013 and no concerns were identified.

Wessex House provides personal care and support to people living in their own homes, who may have a learning disability, physical disability or mental health needs. At the time of our inspection, one person was receiving personal care from this service however, they were looking to expand.

The service had a 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.

There were sufficient staff to support people effectively and staff were knowledgeable about how to identify signs of abuse and report it appropriately. People said the care and support they were receiving was safe. Medicines were managed safely and there was a robust competency assessment on all staff who administered them. Recruitment processes were safe and ensured all care and support staff were suitable prior to them commencing work.

People were asked for their consent before care and support was given. Staff and the registered manager knew about the Mental Capacity Act 2005, and how it could impact the person they provided care and support for.

People’s care plans and risk assessments were person centred and their preferences respected. Care plans were reviewed regularly and people were involved in deciding how their care was planned and delivered. People and their relatives were asked for feedback about the service they received and any concerns were addressed promptly.

Staff had completed training appropriate to their role. There was an on-going training plan in place as well as additional group training sessions and direct observations of their practice. People said the staff were kind and caring and treated them with dignity and respect. They were satisfied with the service they received.

Staff felt the service was well-led and they were supported in their roles. Procedures were in place to investigate any complains and learn from any accidents or incidents and there were clear actions recorded.

During our inspection we spoke with people and reviewed records. We saw that policies and procedures were in place that ensured people were supported by staff who were suitably qualified to carry out their duties.

People's needs were recorded in a plan of care that was kept under regular review. Risks to people's safety were assessed and plans to reduce and monitor risks to people using the service and members of staff had been recorded in detail. Care plans had been presented in written and pictorial presentation to enable people to express their needs and wishes.

Staff had received safeguarding training and members of the staff team we spoke with were aware of how and when to report any concerns. People using the service told us, " we never have any worries with our carers, they are all marvellous".

In order to protect people using the service we saw the provider carried out a rigorous staff recruitment process and staff received training and support suitable to their role.

We spoke with two people who used the service who were both very positive about the support they received. One of them told us they were,"very happy with the service" and another person told us, "they are all so kind".

Records we reviewed showed us there were processes in place to monitor accidents and incidents and the quality of service being provided. Comments we saw were positive.

We spoke with three people and two relatives. Communication records demonstrated that discussions took place regularly when arranging care sessions. We saw that one particular person wanted to facilitate their care sessions using email and text message. We spoke with a relative of this person who said "They are fantastic when organising my daughter's care."

We looked at a sample of records and saw that care plans were detailed and that they provided specific instructions for staff to follow when supporting people. Care plans were up to date and reflected people's care needs. One relative said "They assessed my relative’s needs very well. They came to see me and my daughter three times and asked lots of questions about her background and her health."

Records showed that risk assessments were carried out to protect people and to keep people and care staff safe when providing care. People we spoke with said that they trusted staff. One person said "They’re kind and I trust them." A relative said "The staff are fantastic at what they do, they are good people. They are experienced and suitably skilled to meet my family member's needs."

People were made aware of the complaints system. This was provided in a format that met their needs. All people we spoke with told us that they were pleased with the care they received and that they had no reason to complain. One professional said "Amity really do turn people's lives around."