About the service: Community Support Services is a domiciliary care agency (DCA). The service provides personal care for adults who have a learning disabilities or autistic spectrum disorder living in their own home in the community. At the time of our inspection the service supported 19 people who received personal care support.

The service had been developed and designed in line with the principles and values that underpin Registering the Right Support and other best practice guidance. This ensures that people who use the service can live as full a life as possible and achieve the best possible outcomes. The principles reflect the need for people with learning disabilities and autism to live meaningful lives that include control, choice and independence. People using the service receive planned and co-ordinated person-centred support that is appropriate and inclusive for them.

People’s experience of using this service: People were at the heart of their care and involved in the planning of their support. Their preferences were always considered and each person was treated as an individual. Their physical, social, emotional and spiritual needs were always valued and respected by staff.

Strong community links were established. Staff worked with people to promote inclusion with community groups with the goal of achieving the best possible outcomes for people. Their choices and wishes were recognised and people were actively encouraged to share their views and give feedback regarding their support.

People and their relatives consistently told us staff were caring and always showed kindness and compassion.

People were truly placed at the centre of the service and were consulted on every level. Staff worked in respectful ways to maintain people’s privacy and dignity. Staff were motivated and demonstrated a clear commitment to providing dignified and compassionate support.

People using the service received exceptional care from a well-led service. There was a truly holistic approach to assessing and delivering care and support. Support plans were personalised and recorded specific information about what was important to each individual.

The registered manager demonstrated a strong and supportive leadership style. They led by example and promoted a culture of team work and inclusion for all. Staff felt valued and demonstrated the provider’s values.

The service was outstanding in supporting people to ensure they were safe within their own homes.

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.

More information is contained in the detailed findings below.

Rating at last inspection: At the last inspection in July 2016 the service was rated good.

Why we inspected: This was a planned inspection based on the rating at the last inspection.

Follow up: We will continue to monitor intelligence we receive about the service until we return to visit as per our re-inspection programme. If any concerning information is received we may inspect sooner.

Community Support Services provides assistance and personal care to people who experience needs mainly related to learning disabilities and who live in their own homes. People receive varying amounts of support depending on their particular needs. The service has its office close to the centre of Mablethorpe and it covers the surrounding towns and villages.

We carried out this announced inspection on 20 and 21 July 2016. At the time of our inspection 54 people received care under the regulated activity of personal care.

There was an established 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.

People were involved in making decisions about how they wanted to be supported and how they spent their time. Staff were caring, compassionate and positive working relationships had been developed between staff and the people who used the service. These relationships were being consistently maintained and people were treated with kindness, compassion and respect.

New staff were recruited safely and staff had all of the knowledge and skills they needed in order to care for people in the right way. The registered persons had consistently provided staff with the guidance and training they needed and there were enough staff available who were deployed in the right way to meet people’s care needs.

Staff had a good understanding of how to manage risks and protect people from avoidable harm. They also knew how they would report and follow up on any concerns they identified regarding people’s safety.

The registered manager had ensured there were clear arrangements in place for ordering, storing, administering and disposing of the medication people needed. Staff’s competency to safely support people to take their medicines was regularly checked.

People had been consulted about the care they wanted to receive. In addition, care was

always assessed, planned and delivered in a consistent way.

The registered persons and staff were following the Mental Capacity Act 2005 (MCA). This measure is intended to ensure that people are supported to make decisions for themselves. When this is not possible the Act requires that decisions are taken in people's best interests.

People were supported to share their views and opinions and were involved in planning and reviewing the arrangements for the care they received. People and their relatives also understood how to raise any complaints or issues they had and were confident the right actions would be taken to resolve them.

Arrangements were also in place to enable staff to share any ideas they had regarding the development of the service and to raise any concerns they had direct with the provider so these could be responded to in the right way.

The provider had completed regular quality checks together with the registered manager to make sure that people received the care they needed in a consistent way. These checks included a range of effective audit systems which ensured the service was continually monitored. This was so that any changes or improvements needed could be identified quickly and acted upon in order to keep improving the quality of the services they provided.

We spoke with seven people who used the service and with four relatives. Everyone gave us positive feedback. A person said, “The staff are pretty good really. They help me without being too bossy. We have our own list of things to do when they call and it’s like they’re friends.” A relative said, “The staff are excellent and are very caring. I’m very happy for them to help my son because I know he’ll be treated with genuine kindness.”

People had been given information about the support they could receive and they had been assisted to make decisions about things that were important to them.

People said that they had received all of the support they needed. Records confirmed that assistance had been provided in a safe, reliable and responsive way.

People had been supported to safely manage their medication.

The provider employed enough staff to give it the capacity it needed to consistently meet people’s needs for support.

We saw that a range of quality checks had been completed to help ensure that people reliably received the help they needed.

We carried out a planned inspection looking at these domiciliary care services. Everyone spoke positively about their care workers and felt that they fully supported their care needs. Without exception people said all staff spoke to them in a calm and respectful way.

People told us their care was personalised to their needs. People's preferred names were used even when there were changes in staff. People were happy that staff adapted well when care changes were made. One person told us, "I appreciate it when staff adapt to my wishes."

People felt staff were well trained and understood their needs. People told us they felt safe and if they had concerns they would speak with any staff member. One person told us, "I feel I can approach any member of staff to talk to."