The inspection took place on 17 and 18 September 2018 and was announced. We gave Creative Support – Trafford Supported Living Service, 48 hours’ notice to advise we would visit, as we needed to ensure someone would be available at the registered office and to prepare people supported by the service for our visit. At our last inspection of this service in September 2016, we found the service to be good in all areas. At this inspection, we found the service remained good in all areas.

Creative Support – Trafford Supported Living Service provides care and support to people in ‘supported living’ settings to enable people to live as independently as possible. People’s care and housing are provided under separate contractual agreements. The Care Quality Commission (CQC) does not regulate premises used for supported living; this inspection looked as people’s personal care and support.

Creative Support – Trafford Supported Living Service supports people with learning and physical disabilities and autism. At the time of inspection, there were 35 people receiving personal care living across ten properties situated in the Trafford area.

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 on the Health and Social Care Act 2008 and associated regulations about how the service is run.

People received their medicines safely. Staff received training and had their competency to administer medication checked. People were supported to administer their own medicines if deemed safe to do so.

Risk assessments were person centred and highlighted how risks should be managed. Risks where people may become challenging, were clearly recorded with actions for staff to take to prevent people’s anxieties from escalating. Staff were knowledgeable about how to manage each person’s anxieties.

Staff confidently explained their responsibilities in safeguarding vulnerable adults from abuse. Staff had full confidence in the management team should they raise an allegation. Staff received training in safeguarding vulnerable people.

Staff were recruited safely. The service completed robust checks to ensure new staff were suitable to work with vulnerable people.

Property safety checks were regularly completed.

The service worked in line with the Mental Capacity Act 2005 and people had their capacity assessed if required. Where people did not have capacity to make a specific decision, decisions were made in people’s best interests which included family and / or professional involvement. Best interest’s meetings were clearly documented.

People received support with their health needs. The registered manager had worked with local learning disability teams and primary care providers to ensure people had access to health support services quickly and when required.

Staff received training appropriate for their job role. Where people had specific care needs, staff received training to enable them to support these needs. Staff had the opportunity to pursue additional qualifications to enhance their knowledge.

People were supported to receive healthy and nutritious diets. Staff could describe the types of diets people required. Menus were devised with people based up on their personal likes and dislikes. Where people were at risk of malnutrition, weights were monitored, and any concerns reported to health professionals promptly.

We observed staff treating people with dignity and respect. Caring interactions were seen throughout our inspection and staff supported people with complex needs in a calm and supportive manner.

The service ensured people who identified at lesbian, gay, bisexual or transgender (LGBT) had their characteristics protected. LBGT was championed throughout the service with people being able to support local PR

The inspection took place on 19 September 2016. The inspection was announced. This was because the service was a domiciliary care service and we needed to be sure that someone would be available so we could carry out our inspection.

Creative Support Trafford Supported living is a Domiciliary Care service that provides personal care and support to people with learning disabilities who live in their own home. The service covers the Trafford area and at the time of our inspection provided support to 40 people.

The service had registered manager in place. 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 spoke with support staff who told us that the registered manager was always available and approachable. Throughout the day we saw people who used the service and staff were comfortable and relaxed with the manager and each other. The atmosphere was relaxed and we saw that staff interacted with each other and the people who used the service in a person centred way and were encouraging, friendly, positive and respectful.

From looking at peoples care plans we saw that they were written in plain English and in a person centred way and made good use of pictures, personal history and described individuals’ care, treatment, wellbeing and support needs. These were regularly reviewed and updated by the the manager.

Individual care plans contained personalised risk assessments. These identified risks and described the measures and interventions to be taken to ensure people were protected from the risk of harm. The daily records we viewed also showed us that people’s health was monitored and referrals were made to other health care professionals where necessary for example: their GP and care managers.

Our observations during the inspection showed us that people who used the service were supported in a person centred way by sufficient numbers of staff to meet their individual needs and wishes within their own homes and within the community. The recruitment process that we looked into was safe, inclusive and people were involved in choosing their own staff.

When we looked at the staff training records and spoke with the registered manager we could see staff were supported to maintain and develop their skills through training and development opportunities. The staff we spoke with confirmed they attended a range of learning opportunities. They told us they had regular supervisions with the manager, where they had the opportunity to discuss their care practice and identify further mandatory and vocational training needs.

We were able to observe how the service administered medicines on the day of our inspection we were able to establish how people managed them safely in their own home. We looked at how records were kept and spoke with the manager about how staff were trained to administer medicines and we found that the medicines administering process was safe.

During the inspection it was evident that the staff had a good rapport with the person who used the service and we were able to observe the positive interactions that took place. The staff were caring, positive, encouraging and attentive when communicating and supporting people in their own home with daily life tasks, care and support.

People were being encouraged to plan and participate in activities that were personalised and meaningful to them. For example, we saw staff spending time engaging with people on a one to one basis in activities and we observed and saw evidence of other activities such as art, drama and socialising. People were being supported regularly to play an active role in their local community both with support and independently.

The Mental Capacity Act 2005 (MCA) pr