Cartref Homes Supported Living Service provides a specialist care and support service to people with learning disabilities, autism and physical disabilities. At the time of the inspection it was providing support for four people living in two ‘supported living’ settings, so that they could 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. Cartref Homes Supported Living Service also supported people who did not receive 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.

There had not been a registered manager at since October 2017. The manager of the service had started the process to become the registered manager in April 2018 and their application was being processed at the time of this inspection. 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.

At the last inspection on 27 April 2016 we rated the service as Good. At this inspection on 21 June 2018 we found two breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.

Quality assurance processes were not effective. The provider’s training programme did not ensure that staff had the essential training they required for their roles. New staff had not received all the training they required to safely carry out their roles before supporting people alone in the community. Existing staff had not had their training refreshed at frequency outlined by the provider, to make sure they continued to have the skills and knowledge they required to support people. There were shortfalls in health and safety, fire, infection control, food hygiene, moving and handling and first aid.

People were protected against the risk of abuse. Staff and the management team knew how to recognise and report any safeguarding concerns and were confident in doing so. People knew how to raise a concern or complaint and there were processes in place to respond to these.

Risk assessments were detailed and gave staff guidance about any action staff needed to take to make sure people were protected from harm. When people presented behaviours that may challenge themselves or others, effective strategies were in place which had been developed in consultation with a clinical psychologist.

Effective recruitment processes were in place. There were suitable numbers of staff available so that people’s individual needs were met at the times that they required support.

People understood the importance of keeping their home clean and were supported by staff to do so.

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 supported to maintain their health, access health services and were given information about how to eat healthily.

People told us staff were kind and caring and helped them to be independent. Staff supported people to take practical steps towards achieving their goals.

The provider was effective in responding to people’s changing needs. People's view and experiences were sought and acted on so that people felt that they were really listened to.

Feedback from people, relatives and professionals was that the service was well managed and that staff and managers were approachable.

The provider worked alongside other agencies to continuously improve the quality of

We inspected the service on the 27 April 2016. This inspection was unannounced.

Cartref Supported Living Scheme provides services for younger adults, including people with learning, autism and physical disabilities. They provide personal care to people in their own home and also support people to access the community. The service provides care for people in and around the Sittingbourne area. There were four people receiving support to meet their personal care although most only needed minimal support. The service also supported people to access the community and there were a further five people who they provided services to who did not require personal care.

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.

People were protected against the risk of abuse. All staff were trained and recognised the signs of abuse what to look out for. Both the registered manager and staff understood their role and responsibilities to report any safeguarding concerns and were confident in doing so.

Risk assessments were detailed and gave staff guidance about any action staff needed to take to make sure people were protected from harm.

Effective recruitment processes were in place and followed by the registered manager. Staff had received training relevant to their roles. Staff had the opportunity to discuss their performance during one to one supervision meetings and had an annual appraisal that discussed their future development and possible further vocational training.

There were suitable numbers of staff available to meet people’s needs. People’s planned care was allocated to members of staff at appropriate times.

Staff were trained to assist people with their medication, with some people being able with minimal support to self-medicate. We found some issues with the way medication was being recorded and have made a recommendation about that.

People were supported to access the community regularly. People were also supported and helped to maintain their health and to access health services if they needed them.

People told us staff were kind, caring and communicated well with them. People’s information was treated confidentially. Paper records were stored securely in locked office.

Procedures, training and guidance in relation to the Mental Capacity Act 2005 (MCA) was in place which included steps that staff should take to comply with legal requirements.

People’s view and experiences were sought through review meetings and through surveys. People’s views about the service they received were positive.

People were supported to be as independent as possible. People told us that the service was well run. Staff were positive about the support they received from the registered manager. They felt they could raise concerns and they would be listened to.

Audit systems were in place to ensure that care and support met people’s needs.

Communication between staff within the service was good. They were made aware of significant events and any changes in people’s support needs.