This was an announced comprehensive inspection which took place on 13 and 14 November. At the previous inspection which took place on 10 and 11 February 2016, the service was rated as "good" in all five key areas (safe, effective, caring, responsive and well-led.)

Blackburn with Darwen and East Lancashire Domiciliary and Supported Living Scheme is part of Creative Support Ltd. The service is registered to provide 24-hour care and support to adults who have learning or physical disabilities or mental health needs. People using the service are tenants who live mainly in a variety of shared houses across East Lancashire that are staffed on a 24-hour basis. People's care and housing are provided under separate contractual agreements. The care quality commission does not regulate premises for supported living. This inspection looked at people's care and support. The service has been developed and designed in line with the values that underpin Registering the Right Support. These values include choice, promotion of impendence and inclusion. People with learning disabilities and autism using the service can live as ordinary life as any citizen.

At the time of this inspection there were a total of 47 people using the service.

The service had a registered manager in place. 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 service had built on their previous success and sustained the good model of support provided to people living within the service. Significant improvements since last inspection had been made and an outstanding rating in effective had been achieved. This was achieved by improving outcomes for individuals. The person-centred vision and the values of the service had been further developed and embedded into the culture of the service.

People told us they received personalised support which was responsive to their needs. Care plans were well written in a person-centred manner detailing how people wished to be supported. People's independence and choice was promoted. People who used the service were involved in regular person-centred reviews, in a format enabling them to be as fully involved as possible.

All staff we spoke with told us they loved their job, felt part of a good team and felt valued by their managers. The service had implemented Achieve Q awards which recognise and reward staff achievement. Staff told us they felt able to raise any issues of concern.

Comprehensive information and training was in place to guide staff in the most effective approaches which included positive behaviour support.(PBS) The service had supported people effectively and the number of people who required PBS interventions had reduced.

People who used the service had health action plans, hospital passports and dental passports in place. Records we reviewed showed that people were supported to attend health appointments where necessary. Staff were confident in challenging professionals if they felt people's health needs were not being met.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible. Staff had followed the code of practice in relation to the Mental Capacity Act 2005. (MCA)

People who used the service told us they felt safe with the staff who supported them. People told us there were always staff available to support them.

Systems were in place to record safeguarding concerns, accidents and incidents and appropriate action was taken when required.

Recruitment processes were robust and were carried out to ensure suitable people were employed to work at the service. The service made sure that people being supported were included in the interview

This was an announced inspection which took place on 10 and 11 February 2016. The service was last inspected in April 2014 when it was found to be meeting all the regulations we reviewed.

Blackburn with Darwen and East Lancashire Domiciliary and Supported Living Scheme is part of Creative Support Ltd. The service is registered to provide 24 hour care and support to adults who have learning or physical disabilities or mental health needs. People using the service are tenants who live mainly in a variety of shared houses across East Lancashire that are staffed on a 24 hour basis. At the time of this inspection there were a total of 54 people using the service.

The service had a registered manager in place. 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 who used the service told us they felt safe with the staff who supported them. They told us there were always staff available to support them to participate in the activities which were important to them. Recruitment processes were robust and should help protect people who used the service from the risk of staff who were unsuitable to work with vulnerable adults.

We saw that risks to people’s safety and well-being were regularly assessed. Care records included information for staff to follow to ensure all identified risks were appropriately managed. Support plans we looked at were personalised and included good information for staff about the goals people wished to achieve as well as how they wished their support to be provided.

Staff had received training in the safe administration of medicines. The competence of staff to administer medicines safely was regularly assessed.

Systems were in place to ensure the safety and cleanliness of all the premises where people who used the service lived.

Staff told us they had received the training and support they needed to carry out their role effectively. New staff received a comprehensive induction to the service. There were systems in place to track the training and supervision staff had received.

All the staff we spoke with told us they enjoyed working in the service and felt valued by their managers. Staff felt able to raise any issues of concern in supervision or in staff meetings.

Most staff we spoke with had a good understanding of the Mental Capacity Act 2005; this legislation is designed to protect the rights of individuals to make their own decisions wherever possible. The registered manager was aware of the action to take to protect the rights of people who were unable to consent to their care and support.

People who used the service had health action plans in place. Records we reviewed showed that people were supported to attend health appointments where necessary. Systems were also in place to ensure that people’s nutritional needs were monitored and met.

We observed positive interactions between staff and people who used the service. People told us the staff who supported them were kind and caring and enabled them to maintain their independence as much as possible. Staff demonstrated a commitment to providing care which would improve the quality of life of the people they were supporting. Records we reviewed showed staff were regularly reminded in supervision and team meetings about the requirement to treat people who used the service with dignity and respect.

All the people we spoke with told us they would feel able to raise any concerns with the managers in the service and were confident they would be listened to. We noted all compliments and complaints were recorded and any concerns had been investigated.

The service was based on a set of values which were well understood by staff. There were a number of quality monit

The inspection team included two inspectors and an expert by experience. The team gathered evidence against the outcomes we inspected to help us answer our five key questions; Is the service safe? Is the service effective? Is the service caring? Is the service responsive? Is the service well led?

Below is a summary of what we found. The summary is based on our observations during the inspection, a review of records, discussions with five people who used the service and telephone interviews with 12 relatives. We also spoke with the registered manager, the unit business manager and a total of 16 members of staff drawn from 10 projects in the service.

Is the service safe?

People who used the service told us they were happy with the care and support they received. They told us, “I feel like I’ve got more skills and self-confidence since being here” and “I feel safe living here; it’s nice and good and calm”.

People’s care records contained sufficient information to enable staff to provide safe and appropriate care. Appropriate arrangements were in place to support the safe administration of medicines.

Policies and procedures were in place for staff to follow should they have any concerns about the care and support people received. We found a protection plan had been developed to help ensure the safety of people who lived in a project where safeguarding issues had been raised.

Systems were in place to help ensure the manager and staff learnt from events such as accidents and complaints.

Is the service effective?

An assessment was completed before people started to use the service to ensure their individual needs could be met. People were involved in the development of their care plans.

Staff told us they knew people well and were able to deliver effective support which promoted independence and choice. One staff member told us, “I feel we are encouraged to support people to meet their needs and wishes”.

Is the service caring?

People who used the service were positive about the staff who supported them. They told us, “I like all of the staff” and “I like being here, the staff are nice”.

Relatives we spoke with told us they mostly felt staff were good and caring. They told us, “New staff are brilliant” and “Staff are great, my relative is coming on leaps and bounds”.

People’s care records showed that their preferences, likes and dislikes had been clearly documented and their care and support had been provided in accordance with their wishes. The staff we spoke with showed they had a good understanding of the needs of the people they were supporting.

Is the service responsive?

Information in the care records showed that the staff involved other healthcare professionals in the care and support of people who used the service.

The provider had a clear procedure in place with regards to responding to any complaints and concerns made.

Is the service well led?

The service had a manager who was registered with the Care Quality Commission and was qualified to undertake the role.

Most staff told us they felt well supported. We saw staff had access to training relevant to their role.

We spoke with a person who lived in a shared tenancy house. They told us they were happy with the care and support they received. Comments included, “It's really nice here; I'm comfortable", "The staff are kind to us”.

People told us they enjoyed the food. Comments included, "The food is nice here. The staff cook for us".

We found that people's medicines were managed safely. Regular medicines accuracy checks minimise the risk of errors.

All of the care staff had achieved a recognised qualification in care, which would help them to look after people properly. We saw staff interacting with people in a pleasant and friendly manner and being respectful of people's choices and opinions.

People told us there were sufficient staff to look after them. People made positive comments about the staff team. One person said, “The staff are lovely. They look after us well”.

We found records that were required to be kept to protect the safety and wellbeing of people who used the service were accurate and up to date to ensure people's needs were fully met.

People told us they were happy with the care and support they received and were treated well by staff. Comments included, "The staff are really good” and “I like all the staff, they’re like friends”. People told us they were able to express their views and opinions and could influence the way their care was delivered. They said they could raise any concerns with the manager or the team leaders and were confident they would be listened to

People using the Creative Support services told us that in general they were happy in the shared homes. One person said, ”The houses and bedrooms are lovely. We can keep our own furniture”.

We spoke with six people who use the services and they told us they were satisfied with the meals provided and they are always consulted about the choice of menu which they could help plan and prepare. “There is always a choice of food and we can snack at anytime”. They told us that they had a hire car which was used to go shopping, for outings to places of interest and to take them to their planned activities.

The people using the services told us they felt they had satisfactory choices in their daily lives such as in rising and retiring times. One of the people we asked about this told us, “I can go to bed when I want to and get up when I want to”. They also told us there were varied and interesting activities to suit individual preferences like computer courses, cooking classes, a gardening group and visits to the pub in the evening.

In general the people we spoke with spoke positively about the staff and felt they were treated properly and looked after in a way that respected their privacy, dignity and independence.

They told us they felt their views were listened to and that they knew who to speak to if they were not happy with something.

People using the Creative Support services told us that in general they were happy in the shared homes. One person said, ”The houses and bedrooms are lovely. We can keep our own furniture”.

We spoke to six people who use the services at Creative Support and they told us they were satisfied with the meals provided and they are always consulted about the choice of menu which they can help plan and prepare. “There is always a choice of food and we can snack at anytime”. They told us that they have a hire car which is used to go shopping, for outings to places of interest and to take them to their planned activities.

The people using the services told us that they felt they had satisfactory choices in their daily lives such as in rising and retiring times. One of the people we asked about this told us, “I can go to bed when I want to and get up when I want to”. They also told us there were varied and interesting activities to suit individual preferences like computer courses, cooking classes, a gardening group and visits to the pub in the evening.

In general the people we asked spoke positively about the staff and felt they treated them properly and looked after them in a way that respected their privacy, dignity and independence.

They told us they felt their views were listened to and that they knew who to speak to if they were not happy with something.