This announced inspection took place on 14 March 2017. This service supports people with their personal care needs in a supported living environment. At the time of our inspection there were 25 people receiving support from Consensus Community Supported Limited – 55 Headlands.

There was 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.

The service demonstrated an excellent commitment to providing outstanding care which was embedded into the practices of the staff and the registered manager. The service put people’s views at the forefront of the service and designed the service around their needs. People were given every opportunity to be involved in the running of the service and to provide their opinions and feedback about what they wanted.

People were safe using the service. Staffing requirements were assessed in an innovative and dynamic way following consultations with people that used the service. The rotas reflected the support people required to maintain the choices they had made, and as a result the staffing arrangements were flexible to meet those needs.

People played a significant role in supporting the management to recruit the staff that were most suitable to provide the care and support people required. This included people interviewing staff and having trials with them to ensure potential new staff members had the right values and ethos to provide the standard of care people required.

The provider took a thorough approach to protect people from harm. They empowered people who used the service to understand and recognise if their care was not at an acceptable standard and that they could feel safe to report this. Staff were supported to understand safeguarding in a wider context, particularly with regards to institutional safeguarding and staff were confident they would report any matters of concern.

Staff received training that had been personalised to meet the needs of the people that used the service and the management team identified and utilised the strengths of the staffing team. A specialist group of staff were used by the service to help support people with behaviours that could harm themselves or others. They provided advice and guidance to staff within the service to give them new skills and strategies to keep people safe.

People were actively involved in decisions about their care and support needs. There were formal systems in place to assess people’s capacity for decision making under the Mental Capacity Act 2005. People’s nutritional needs were assessed and regularly monitored. People took as much control over their nutrition as they were able and staff supported people to learn and understand the importance of this.

People were treated with care, compassion and great kindness. Staff had an empowering and empathetic attitude to support people’s personal development, and each person was supported in a way that was individual to them.

The registered manager recognised the importance and value of good advocacy and went above and beyond expectations to encourage people to speak openly and honestly. The service recruited internal advocates to help support people who used the service, and also used an external advocacy service to offer people an independent person to help them make decisions. People were encouraged to identify and value their own support networks in order to improve their independence but showed a caring approach if people were in distress. People’s diversity and individuality was celebrated and people were encouraged and able to share private or vulnerable matters with an open and empathetic staff group.

Comprehensive assessments were made before people began usin

This announced inspection took place on the 4 and 11 March 2015.

55 Headlands provides personal care for people who live in four of the provider’s supported living premises. The people who use the service have a learning disability.

The service had been without a registered manager for a period of six weeks. The provider had appointed a new manager to run the service and they were in the process of registering with the Care Quality Commission (CQC). 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 in February 2014, we asked the provider to make improvements to the arrangements for supporting workers and this has been completed.

There were systems in place to calculate staffing based on people’s needs and people received enough support to meet their care needs. Medicine management systems were in place and people received the support they needed to take their medicines as prescribed. People received a detailed assessment of risk relating to their care and staff understood the measures they needed to take to reduce the risk of unsafe care. Staff were of good character and there were robust recruitment processes in place. People were safeguarded from the risk of abuse. There were clear lines of reporting safeguarding concerns to appropriate agencies and staff were knowledgeable about safeguarding adults.

The system of staff training and development had been improved and staff were appropriately supported by the manager. The manager and staff were aware of their responsibilities under the Mental Capacity Act 2005 and Deprivation of Liberty Safeguards (DoLS). There were procedures in place to assess people’s ability to make decisions about their care. Staff understood how to make best interest decisions when people were unable to make decisions about their care. People were supported to choose a nutritious diet and staff monitored people at risk of not eating and drinking enough. People were supported to access a range of health services including that of the GP and dental service.

People received care that was respectful of their need for privacy and dignity. There were systems in place to support people to make decisions about their daily care. People were encouraged to care for themselves and to live an independent life, where this was possible.

The system of care planning was responsive to people’s needs and people received a regular review of their care. People were supported to undertake a range of activities to support their social development. The provider had a system of complaints management which ensured people’s complaints were investigated and fully resolved.

Quality assurance systems were in place and identified potential failings in the service. People were encouraged to feedback about the service and the provider responded by improving the service in line with this feedback. The provider promoted an open and honest culture and staff raised any concerns about the service. The provider had clear aims and objectives in place and expected a good level of care to be provided to people.

We spoke with three people who used the service. All the people we spoke with said that they were satisfied with the care they received from staff.

A person told us that staff were: ‘’really good. They help me when I need them‘’.

We spoke with four relatives. They all told us that the care provided was of a high standard and that staff were always friendly.

One relative said; “staff are fantastic. They help my sister in every way possible’’. Another relative said: ‘’the service is very good and all staff are very caring’’.

One relative said that she had found one agency worker who did not have understandable English language skills. The manager said that she would follow up this issue.

One relative said that she could not remember having received a questionnaire from the service, asking for her views. The manager said that there was evidence in place to show that questionnaires were supplied to all relatives.

This was a positive inspection. People said that they were very satisfied with the service. The relatives we spoke with also said the service provided was of a high standard. The service also complied with standards relating to respecting and involving people in the service, meeting the care and welfare needs of people, ensuring that people were safeguarded from abuse, they ensured that staff were properly checked, and that services were properly monitored to meet people's needs.

This service has not been visited since February 2009. We spoke with six people who use the service. We also spoke with five relatives about their views of the care provided.

The people we spoke with all said that they were satisfied with the service. Staff were seen as helpful and caring. One person said: ‘’Staff help me when I need them.’’ Another person said: ‘’I like living here because I get all the help I need.’’

Their relatives all praised the care given by the staff of service. One relative said: '’Staff are always helpful. They keep me informed of all the important things in my son's life.’’

We spoke with eight people who used the service. They were all satisfied with the care they received from staff.

A person told us that staff were good at their jobs. She said; ‘’staff help us. I could not ask for better’’.

We spoke with the relatives of six people. They all told us that care was very good.

One relative said; ‘’the one to one care is good. However, staff turnover is far too high. It means my son has to start all over again with someone new which is frustrating for him’’.

This was a mixed inspection. People we spoke with thought care staff were caring. This was also the view of their relatives. The essential standards we inspected were met, except for staff always being supported. We have asked management to ensure comprehensive staff training is put into place, that induction for new staff is thorough to enable them to provide safe and effective care at all times, and that staff supervision is regularly provided to all staff.

There were suggestions made; for management to look at ways of making sure that care workers stayed in their jobs, so that consistent care was provided to people.