Augusta Care Limited is a domiciliary care agency. It provides personal care to people living in their own houses and flats and supported living houses; it provides a service to older adults and younger adults.

This service provides personal care and support to people living in 42 supported living settings so that they can live as independently as possible. People’s care and housing are provided under separate contractual agreements. The Care Quality Commission (CQC) does not regulate premises used for supported living; this inspection looked at people’s personal care and support.

Not everyone using Augusta Care Limited receives the regulated activity; CQC inspects the service being received by people provided with ‘personal care’, help with tasks related to personal hygiene and eating. Where they do we also take into account any wider social care provided.

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 or independence and inclusion. People with learning disabilities and autism using the service can live as ordinary a life as any citizen.

This announced inspection took place on 12 and 16 March 2018. This was the first inspection of this service since their CQC registration changed in 30 September 2016. There were 73 people, who live with a learning disability and who may also have mental and physical health needs, receiving the regulated activity of personal care at the time of this 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 2008 and associated Regulations about how the service is run.

Staff had an understanding of the Mental Capacity Act 2005 (MCA). People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible. Staff knew how and where to report any suspicions of harm and poor care practice.

People were assisted to take their medication as prescribed.

Processes were in place and followed by staff members to make sure that infection prevention and control was promoted and the risk of cross contamination was reduced as far as possible when supporting people.

Staff assisted people in a caring, patient and respectful way. People’s dignity and privacy was promoted and maintained by the staff members supporting them.

People, their relatives, and advocates were given the opportunity where appropriate to be involved in the setting up and review of people’s individual support and care plans. People were supported by staff to have enough to eat and drink.

People were assisted to access a range of external health care professionals and were supported by staff to maintain their health and well-being. Staff and external health care professionals, would, when required, support people at the end of their life, to have a comfortable and as dignified a death as possible.

People had individualised care and support plans in situ which documented their needs. These plans informed staff on how a person would like their care and support to be given, and how it was to be given in line with external health and social care professional guidance. However, some people’s care, support plans and risk assessments lacked detailed information as guidance for staff on how to mitigate people’s known risks.

There were enough staff to meet people’s individual care and support needs. Individual risks to people were identified and monitored by staff. Plans were put into place as guidance to staff to minimise people’s risks as far as possible to allow them to live as safe and independent a life as practicable.

Accident and incidents that occurred at