Bedford Supported Living Service provides personal care and support to people with learning disabilities living in their own homes. The service is provided within four supported living housing schemes located in the town of Bedford and the surrounding area.

At the time of our inspection 46 people were using the service.

At the last inspection in June 2015, the service was rated Good.

At this inspection we found the service remained Good.

The service has a registered manager. A registered manager is a person who has registered with the 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.

People using the service felt safe. There were systems in place to safeguard people from the risk of possible harm.

Personalised risk assessments were completed and updated regularly.

The service had robust recruitment procedures in place. There were sufficient staff on duty to meet the care and support needs of people in each of the housing schemes.

Staff were knowledgeable and competent in their roles and were supported by way of supervision and appraisals. These were consistently completed for all staff and were used give feedback on performance and plan future personal development.

People were supported to maintain their health and well-being and accessed the services of health professionals.

Staff were kind, helpful and maintained people’s dignity throughout their care and support. Positive relationships existed between people and staff.

People were involved in planning their care and deciding in which way their care was provided. Each person had a detailed care plan which was reflective of their needs and had been reviewed at regular intervals. Staff were knowledgeable about the people they were supporting and provided personalised care.

People and staff knew who to raise concerns to and information regarding the complaints procedure was available in each housing scheme. The provider had a consistent process for receiving complaints, concerns and compliments.

Quality assurance processes were in place. Feedback on the service was encouraged and people were provided with frequent opportunities to express their views on the care and support they received.

There was an open culture. People and staff found the registered manager supportive and approachable.

Further information is in the detailed findings below.

We carried out this inspection to follow up on our previous findings of non-compliance with medication training from our inspection on 28 November 2013. We found the provider had made the necessary changes.

We considered all the evidence we had gathered under the outcomes we had inspected to answer questions we always ask; Is the service caring? Is the service responsive? Is the service safe? Is the service effective? Is the service well lead?

This is a summary of what we found-

Is the service caring?

We observed staff responding to people’s needs and interacting in a positive way. People who used the service were encouraged to be as independent as possible.

Is the service responsive?

Care plans and risk assessments were in place and updated when people’s needs changed. People were assisted to enjoy activities of their choice, with support when required.

Is the service safe?

There was appropriate numbers of staff on duty to provide support to the people who used the service. Staff had attended suitable training to enable them to carry out their duties effectively.

Is the service effective?

It was clear from our observations that staff had a good rapport with people. One person who used the service told us, “I like it here, but sometimes another person shouts, and I don’t like that. When that happens, the staff come to my flat to make sure I am OK”.

Is the service well lead?

The service had a registered manager in post, who was supernumerary to the staff on duty. Records showed that regular quality audits had been carried out to check the service provision.

When we inspected Bedford Supported Living Service on 28 November 2013, they provided care and support to 20 people in their own homes. We spoke with three people who used the service and three staff. People we spoke with were happy with the care and support they received. One person said, "It's alright living here. I like my flat and staff are helpful when I need support."

We saw that people's needs had been assessed. There were appropriate support plans and risk assessments in place, which had been reviewed regularly and when people's needs changed. Their consent was sought prior to any care or support being delivered.

The provider had effective medication management systems in place. However, we found medication training and competency assessments were inadequate to ensue that people who used the service were protected against the risks associated with unsafe medicine management practices.

We found the provider had effective systems in place to assess and monitor the quality of the service they provided.

Bedford Supported Living Service provided support to people with a learning disability who were accommodated in flats in three schemes in the Bedford area. Staff usually worked in the same scheme but cover for each other when necessary.

We found that care was planned and delivered in line with individual care plans. One person had recently taken up a new interest and this was very important to them. Staff were seen to be supportive and encouraging so the person's confidence was boosted. One person said "I have a key worker and I go to them if I need anything."

The system used by the service for protecting people from abuse, was reviewed on our visit of 2 November 2012. The system used was robust and followed the local multi agency process.

We spoke with one staff member who had completed National Vocational Qualification (NVQ) level two in care and another staff member who had worked in the care sector for over 20 years. Staff had received training that was relevant to the type of needs the people using the service had.

The manager had sent out questionnaires to all the people using the service and we saw comments such as "I enjoy living here and my independence." and another comment made said "The staff are friendly."

This inspection took place on 11 & 12 June and was announced.

The inspection was carried out by one inspector.

Bedford Supported Living Service provides care and support to adults with learning disabilities who live in their own home. At the time of the inspection 31 people were using the service.

There was a manager employed. The manager was not registered, however; they were going through the process of registration 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.

People felt safe using the service. It was evident from talking with staff that they were aware of what they considered to be abuse and how to report this.

Staff knew how to use risk assessments to keep people safe alongside supporting them to be as independent as possible.

There were sufficient staff, with the correct skill mix, to support people with their needs.

Recruitment processes were robust

Medicines were stored, administered and handled safely.

Staff were knowledgeable about the needs of individual people they supported. People were supported to make choices around their care and daily lives.

New staff had undertaken the provider’s induction programme and training to allow them to support people confidently.

Staff had attended a variety of training to ensure they were able to provide care based on current practice when assisting people.

Staff always gained consent before supporting people.

There were policies and procedures in place in relation to the Mental Capacity Act and Deprivation of Liberty Safeguards. Staff knew how to use them to protect people who were unable to make decisions for themselves.

People were able to make choices about the food and drink they had, and staff gave support when required.

People had access to a variety of health care professionals if required to make sure they received on-going treatment and care.

People were treated with kindness and compassion by the staff.

People and their relatives were involved in making decisions and planning their care, and their views were listened to and acted upon.

Staff treated people with dignity and respect.

There was a complaints procedure in place which had been used effectively.

People were complimentary about the registered manager and staff. It was obvious from our conversations that staff, people who used the service and the registered manager had good relationships.

We saw that effective quality monitoring systems were in place. A variety of audits were carried out and used to drive improvements.