About the service: Murray House is registered to provide personal care to adults with learning disabilities, autism or autistic spectrum disorders. People had a core number of agreed hours at set times and there was some limited flexibility to provide these hours when people may need them, outside of agreed times. Care and support was provided to people in a specialist ‘extra care’ housing service, meaning each person had their own tenancy/flat.

People’s experience of using this service:

• People were encouraged and supported by staff to make decisions about their care and how this care was delivered to them. Staff knew people’s preferred ways of communicating, to assist people to make their own choices.

•Relatives gave us mixed opinions about the consistency of care staff as the service used a high number of agency staff, although there were enough staff to support people. A relative felt staffing rotas, although improved, at times got in the way of certain activities when some staff had to finish their shift.

•Risks to people were managed in a way that kept them as safe as possible. Risk management guidelines helped care workers when supporting people. Risks which affected people’s daily lives, both in the home and out in the community, were documented and managed by staff.

•Staff were trained to administer medicines and they did so in a safe way, completing appropriate records which were regularly audited and checked.

•The provider arranged training for staff that met the needs of people using the service.

•Care plans were personalised, but needed improvements to reduce duplication and to make sure they corresponded with each other. This was planned for.

•People’s support hours were more structured so people knew how much time they had with staff, to achieve the things they wanted to do.

•People were supported to make daily living choices such as what they wanted to eat and how to maintain good mental and physical health.

•Staff were aware people’s needs could change, and understood when to seek advice and involve other health care professionals and services. Staff knew how to keep people protected from poor practice or abuse.

•People were treated respectfully and with understanding. Staff were keyworkers for people which helped them get to know people well. Staff’s feedback to us showed they took a genuine interest in people and they knew them well.

•Part of staff’s support was to encourage and support people to be as independent as possible. 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 practice.

We found the service met the characteristics of a “Good” rating in five areas. For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection: Good. The last report for Murray House was published on 5 October 2016.

Why we inspected: This was a planned inspection based on the rating at the last inspection. The previous ‘good’ service provided to people had remained consistent.

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

This inspection took place on 2 September 2016. The inspection was announced. We gave the provider 24 hours’ notice of our inspection. This was to make sure we could meet with the manager of the service and care workers on the day of our inspection.

Creative Support - Warwickshire ‘Murray House’ is a supported living service registered to provide personal care to people living in their own homes. The service is for adults with learning disabilities, autism or autistic spectrum disorders. Care and support was provided to people in their own flats by care workers at pre-arranged times. People had access to call bells for care workers to respond whenever additional help was required. At the time of our visit the agency supported nine people with personal care and employed 15 care workers. Support hours provided by the agency depended on people’s assessed needs. Some people required 24 hour support.

The service had a registered manager. A requirement of the provider’s registration is that they have a registered manager. 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 and relatives told us they felt safe using the service and care workers understood how to protect people from abuse. Risks to people’s safety inside and outside their homes were identified and care workers understood how these should be managed. However, information about the actions required to minimise risks associated with people’s care were not always fully recorded. The registered manager said they would ensure risk assessments contained all the information needed.

There were enough suitably qualified care workers to meet people’s needs effectively. People received their care and support from care workers who they knew, and at the times needed. The provider conducted pre-employment checks prior to staff starting work, to ensure their suitability to support people in their homes.

The manager understood their responsibility to comply with the requirements of the Mental Capacity Act 2005 (MCA) and Deprivation of Liberty Safeguards (DoLS). Records showed MCA assessment were completed when needed. Care workers gained people’s consent before they provided personal care and knew how to support people to make decisions.

People were supported with dignity and respect. People were supported and encouraged to live as independently as possible, according to their needs and abilities. People told us care workers were caring and kind and understood their needs.

Care workers completed training considered essential to meet people’s needs safely and effectively. Care workers completed an induction when they joined the service and had their practice regularly checked by a member of the management team.

Care workers supported people to see healthcare professionals when needed and to follow the health professionals' advice. Systems were in place to manage people’s medicines safely and care workers had received training to do this.

People and relatives were involved in planning and reviewing their care. Care workers understood people's needs and abilities because they read the care plans and shadowed experienced staff when they started working for the service. Care plans detailed people’s needs and informed care workers how people preferred their care and support to be provided. People received personalised care.

People and relatives did not have any complaints about the service. However, they knew how to raise any concerns and were confident these would be listened and responded to effectively.

People, relative’s and care workers felt the management team were approachable. Care workers felt valued because the management team were available to provide support and listened to