This inspection took place on 16 June 2016 and was unannounced.

Cambridge Supported Living Services is a supported living service that is registered to provide personal care to people living in their own homes. Their office is based on the outskirts of Cambridge city. The service provided included that for people with a learning or physical disability. At the time of our inspection there were five people who received the regulated activity of personal care.

The service had a registered manager. A registered manager is a person who has registered with the Care Quality Commission (CQC) 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 was a robust process in place to help ensure that only suitably qualified and staff who were appropriate for their role were offered and accepted for employment.

People’s assessed health and care needs were identified and then met at the times they required this support. Staff were trained and deemed competent to provide the care people needed or that they had requested.

Staff had a thorough understanding about how to identify any potential harm and who the most appropriate authorities were to report this to if ever this was required.

Medicines management and administration was undertaken in a safe way. This was by trained staff whose competency to do this safely was regularly assessed.

The registered manager was aware of the process to be followed should any person lack mental capacity and thus have a need to be lawfully deprived of their liberty. They and their staff were knowledgeable about the situations where people required some support with their decision making. The service was working within the principles of the Mental Capacity Act 2005 (MCA) and Deprivation of Liberty Safeguards (DoLS) codes of practice.

People were supported by staff who knew each person’s individual care and support needs well. People were supported and cared for in a way which respected and encouraged independent living skills. People received care in private that was respectful, dignified and compassionate.

Risk assessments had been implemented and these were regularly reviewed to help ensure that risks to people and the risk they took were minimized as far as reasonably practicable.

People were involved in their care needs assessment. People were provided with a wide range of opportunities and occasions to help them maintain close links with those people and communities that were important to them.

People’s nutritional and health care needs were identified and met in a safe way to maintain their health and wellbeing. People were supported by, and had access to, a range of health care professionals including occupational therapists, GPs and community nurses.

Staff were supported with an effective induction and training programme that helped them develop the care skills they needed. Staff were mentored and supervised in the roles they performed and undertook.

People were provided with information in an appropriate format according to their needs as to how to make and raise any suggestions they may have had to improve their care. Action was taken promptly to resolve any concerns that people raised to their satisfaction.

Audit and quality assurance procedures were in place and these were effective. The provider had processes in place, which had been used, to ensure that the CQC was notified about events that they are required, by law, to do so.

Our inspection team was made up of one inspector who answered our five questions; is the service caring? Is the service safe? Is the service effective? Is the service responsive? Is the service well led?

Below is a summary of what we found. The summary is based on our conversations with four people who used the service, the manager, and four staff and from looking at records. Where it was not possible to communicate with some people we used our observations to gather information.

Is the service caring?

People were supported by kind and attentive staff. We saw that staff showed patience and gave encouragement when supporting people. People commented, “The staff are good.” One person said, “Staff helps me to look after myself.”

People’s preferences, interests, aspirations and diverse needs had been recorded and care and support had been provided in accordance with people’s wishes.

Is the service safe?

People were cared for in an environment that was safe, clean and hygienic. Staff had received appropriate training and guidance to use the equipment safely.

Records contained detailed assessments of people's needs that had been carried out prior to them moving to the home. Any training needed for staff to support people safely was identified and provided prior to the person moving to the service and if their needs changed. This ensured that the staff had the relevant skills and knowledge required to meet the individual’s identified needs.

Systems were in place to make sure that managers and staff learned from events such as accidents and incidents, complaints, concerns, whistleblowing and investigations. This reduced the risks to people and helped the service to continually improve.

Is the service effective?

Where people were able they told us that they were happy with the care they received and felt their needs had been met. It was clear from what we saw and from speaking with staff that they understood people’s care and support needs and that they knew the people well.

People’s health and care needs were assessed with them, and they were involved in writing their plans of care. Specialist dietary needs had been identified in care plans where required. People’s preferences, interests, aspirations and diverse needs had been recorded and care and support had been provided in accordance with people’s wishes.

The training that staff had received equipped them to meet the needs of the people who used the service.

Is the service responsive?

There was information on how to make a complaint if people were unhappy. This was in a variety of formats that met people’s individual communication needs. Monthly keyworker meetings took place where people had an opportunity to provide feedback on the service.

Where shortfalls or concerns were raised these were addressed.

Is the service well led?

The service worked well with other agencies and services to make sure people received their care in a joined up way.

The service had a quality assurance system. Records seen by us showed that identified shortfalls were addressed promptly. As a result, the quality of the service was continuously improving.

Staff told us they were clear about their roles and responsibilities and that they received excellent support and supervision from the manager. Staff had a good understanding of the ethos of the service. This helped to ensure that people received a good quality service at all times.

People that we spoke with were positive about the care and support they received from care staff and told us that: “The carers are kind and help me with what I need.” People told us that they received care and support in a respectful and dignified way.

We saw that peoples’ preferences were recorded in care plans regarding the way they wanted their care to be provided and planned. Care and support was appropriately assessed with detailed guidelines for staff regarding the care and support the person required.

Records showed staff were trained and monitored regarding the administration of medication. Staff were aware of their responsibilities when recording medication that they had given or prompted people to take.

There were induction programmes and mandatory training in place to ensure that staff were competent to deliver care. Supervision was regularly provided for staff to monitor their work performance and development needs.

The service had an effective procedure in place to deal with concerns and complaints. Complaints were responded to efficiently and people told us that they knew who to contact if they wished to raise any concerns about their care.

People that we spoke with were positive about the care and support they received and commented that, “I am very happy with the help I receive from staff and we go on holidays and trips to the pub” and, “The staff are helpful and help me with cooking and shopping”. People told us that they were involved in their care and support and that their views and concerns were listened to by staff and properly dealt with.

Care and support was well delivered and coordinated for people but improvements to care plans regarding signing and dating of some documents was needed. There was evidence of people’s involvement in the reviewing and planning of their care and support.

Staff were trained in safeguarding people from harm and information regarding how to report allegations of abuse to the local authority safeguarding team had been made available to staff

The agency had effective recruitment procedures in place to ensure that only people who were suitable to work with vulnerable adults were employed.

The agency had an effective system to monitor and audit the quality of the services that were provided to people.