Avalon Northallerton Services provides personal care and support to people who have a learning disability. Some of the people who use the service are also living with dementia. Some people who receive support live in small supported living services which are staffed according to assessed needs. This service provides care and support to people so that they can live 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.

Other people lived in a family setting with a main carer. This is called shared lives. At the time of our inspection the service provided personal care to 11 people in supported living and three people in shared lives. For the purposes of this report the term ‘staff’ refers to supported living workers as well as shared lives carers.

Not everyone using Avalon Northallerton Services received a regulated activity; CQC only 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 service did not have a registered manager. The previous registered manager left in October 2017. The manager in charge of the service had applied to become registered.

At the last inspection the service was rated good. At this inspection we found the service remained good.

People were protected from unnecessary harm by staff who knew how to recognise signs of abuse and how to report concerns. Individual risks were assessed and medicines were administered safely to those who required this support. There were safe recruitment procedures in place and enough staff to ensure people received the care and support they needed. Staff were trained and supervised to ensure that they had the knowledge and skills to support people effectively.

When people required assistance to eat and drink, the provider ensured their preferences and assessed needs were met. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice.

People were treated with kindness, compassion and respect by staff who knew them well. People liked the staff who supported them and had developed good relationships. Care was planned and reviewed with people and the provider ensured that people's choices were followed and their independence was promoted.

People had care records that included information about how they wanted to be supported and this was reviewed to reflect any changing needs. There was a complaints procedure in place and people knew how to complain if they wanted to.

People's views about their care were listened to and acted upon. Staff felt well supported by the manager. The quality of care was assessed and monitored to ensure standards were met and maintained. The manager promoted an open culture which put people at the heart of the service.

Further information is in the detailed findings below.

This inspection took place on 15 October 2015 and was announced. The last inspection took place in July 2013 when the service was found to be meeting the Regulations.

Avalon Northallerton Services provides personal care and support people who have a learning disability. Some of the people who use the service are also living with dementia. There are two aspects of the service. Some people who receive support live in small supported living services which are staffed according to assessed needs. Other people live in a family setting with a main carer. This is called shared lives. The aim of the service is to support people to live independently. The service currently provides personal care to 12 people in supported living and three people in shared lives. For the purposes of this report the term ‘staff’ refers to supported living workers as well as shared lives carers.

A registered manager was 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.

People told us they felt safe at the service. Staff were confident about how to protect people from harm and what they would do if they had any safeguarding concerns. There were good systems in place to make sure that people were supported to take medicines safely and as prescribed.

Risks to people had been assessed and plans put in place to keep risks to a minimum. An ‘out of hours’ service was in place so that people could contact a member of staff in an emergency.

There were enough staff on duty to make sure people’s needs were met. The provider had robust recruitment procedures to make sure staff had the required skills and were of suitable character and background.

Staff told us they enjoyed working at the service and that there was good team work. Staff were supported through training, regular supervisions and team meetings to help them carry out their roles effectively. Staff were supported by an open and accessible management team.

The manager and staff were aware of the requirements of the Mental Capacity Act 2005 (MCA) and Deprivation of Liberty Safeguards (DoLS). DoLS are put in place to protect people where their freedom of movement is restricted. The registered manager had taken appropriate action for those people for whom restricted movement was a concern. Best interest meetings were held where people had limited capacity to make decisions for themselves.

People told us that staff were caring and that their privacy and dignity were respected. Care plans were person centred and showed that individual preferences were taken into account. Care plans gave clear directions to staff about the support people required to have their needs met. People were supported to maintain their health and to access health services if needed.

People received personalised care. There were some inconsistencies with the recording of care plan information. However, people received support which was regularly reviewed and met their current needs. People had opportunities to make comments about the service and how it could be improved.

There were effective management arrangements in place. The registered manager had a good oversight of the service and was aware of areas of practice that needed to be improved. There were systems in place to look at the quality of the service provided and action was taken where shortfalls were identified.

We visited the Avalon service in Northallerton and spoke with people who used the service. One person who used the service told us "We are really happy and now we can be independent". A carer we spoke with told us "I really enjoy being able to provide support to people". We saw that support plans were detailed and very individualised. Overall people were satisfied with the support they received.

There were systems in place for the recruitment and induction of staff and these were followed appropriately by the service. Staff had training and supervision on a regular basis and were able to access extra training when they wished. Staff felt well supported. There were extensive quality assurance systems in place that were used on a local and regional level. This ensured that managers were able to identify and review areas for development. People were able to give feedback and be involved in further development of the service.

There was a complaints system in place although the use of this required further work to ensure that people felt able to access it and rely on it appropriately. Records were found to be accurate and up to date although some issues were highlighted with data protection and confidentiality.

We used a number of different methods to help us understand the experiences of people who used the service. We talked to four people who used the service, one carer who used the service, a healthcare professional who worked with the provider, and several staff about the care and well being of people who used the service. We also gathered evidence of people’s experiences of the service by reviewing care records and other documentation.

One person told us " There is nothing they could do better, I am happy with the way things are".

Another told us “They are good. They help people, it’s a good service”.

A carer told us "There is always someone to give a second opinion, who is experienced, I feel supported ". A healthcare professional told us "I am always happy with the service provided, I feel comfortable that they are doing a good job".

People said they felt comfortable, happy and safe with the support they were receiving and talked highly about the level of care and communication. They felt that they were listened to and the provider was active in finding ways to continually improve the support provided.