This inspection took place on 16 and 21 December 2016. It was an announced visit to the service.

We previously inspected the service on 11 October 2013. The service was meeting the requirements of the regulations at that time.

CCS Homecare Services Limited provides domiciliary support to people in supported living properties. Twenty three people were receiving support with personal care at the time of our inspection. People using the service were mostly adults under the age of 65 with learning disabilities or mental health needs. Support was being provided in the Slough, Hillingdon, Surrey and West Berkshire areas.

The service had a registered manager 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.

We received positive feedback about the service. Comments from people included “Happy with staff” and “Nice people.” One person said their keyworker was “Brilliant.” A relative told us the house manager where their family member lived was “Clearly very committed to her job and interested in the individuals.” They considered their relative was “Provided with all that he needs” and added “The staff have created an environment where he is happy and settled and wants to stay.” Another relative said “I feel very reassured that my (family member) is in such safe hands. I cannot praise the whole lot of them highly enough.” They added “I have only good things to say about Comfort Care Services. They are a wonderful service provider who very much live up to their name.” A social care professional told us “The manager and all CCS staff are extremely approachable, responsive and deal with any issues or concerns that we may raise with them. The management team are open to discussion about improvements or changes and work with the council to deliver high quality services.” They added “CCS endeavour to always put the service user first and at the centre of any support they provide.”

There were safeguarding procedures and training on abuse to provide staff with the skills and knowledge to recognise and respond to safeguarding concerns. Risk was managed well at the service so that people could be as independent as possible. Risk assessments had been written to reduce the likelihood of injury or harm to people during the provision of their care.

We found there were sufficient staff to meet people’s needs. They were recruited using robust procedures to make sure people were supported by staff with the right skills and attributes. Staff received appropriate support through a structured induction, regular supervision and appraisal of their performance. There was an on-going training programme to provide and update staff on safe ways of working.

People told us they were treated with dignity and respect. They were involved in decisions about their care and support and their independence was promoted.

Care plans were centred around the needs of the person and documented how they wished to be supported. Care plans had been kept up to date to reflect changes in people’s needs. People were supported with their healthcare needs and medicines where necessary.

The service was managed well. Staff told us they felt supported and would be confident in raising any concerns about people’s care with the manager or provider. The provider regularly checked the quality of care through visits and audits. Records were maintained to a good standard and staff had access to policies and procedures to guide their practice.

During our visit we spoke with six people and four staff members. People we spoke with told us staff always sought their consent before supporting them. One person said “Staff always ask me first before they help me.” Another person said “They (staff) always ask for my permission first.”

We found there were effective recruitment and selection processes in place. We reviewed four recruitment personnel files. We saw required recruitment checks had been completed and recorded.

People told us care staff were understanding and knew how to help them maintain their independence. One person told us “Staff take good care of me.” Another person said “I am fine here ...staff are helpful.” We found arrangements were in place to ensure staff working at the service were properly trained, and supported to provide appropriate care to people.

People we spoke with told us that they were regularly asked for their feedback, to make sure the service was meeting their needs appropriately. They said they felt comfortable approaching the manager with any concerns. Systems were in place to monitor the quality of the service provided, and ensure people had their views listened to.

People expressed their views and were involved in making decisions about their care and treatment. All the people who used the service were initially assessed by the manager to establish their needs.

The care plans and risk assessments provided detailed information about people's needs. The emphasis was on the individual and things that were important to them such as routines, interests and family. Assessments undertaken included risk of falls, mobility and whether a person could administer their own medication. Care plans were up to date and reviewed regularly.

The home had procedures to protect people from the risk of harm and abuse. Staff had received training in safeguarding vulnerable adults and had an understanding of their roles and responsibilities. We spoke with people who told us they were safe. The service had recruitment processes in place which included ensuring that all relevant checks were carried out before a person could start work.

There was a system in place to listen to any complaints people had. We spoke with people and they told us "I have no complaints at all" and "I talk to staff if I am not happy". However one person told us that they had a complaint which they had expressed to a staff member but were not happy with the response.