This inspection took place on 8 and 15 September 2017. This was an announced inspection as Creative Support West Berkshire is a Domiciliary Care Agency (DCA) and supported living service. A DCA is a provision that offers specific hours of care and support to a person in their own home. The service was provided to people with a primary diagnosis of learning disabilities with associated needs. The service was offered to 42 people who received the regulated activity of personal care across eight complexes of privately rented sites including, houses and flats. We were told at the time of the inspection that the provider was considering reducing the number of complexes overseen by this location, however nothing had been confirmed. We therefore inspected all locations.

At the time of the inspection a registered manager had been in post since March 2016. The service had previously been registered at a different location, where the registered manager was registered, and CQC reports had rated the service as Good. 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.

Staff knew how to keep people safe by reporting concerns promptly through the safeguarding procedure that was taught as part of the induction process. This was further followed through as a topic of discussion within team meetings and in individual supervision meetings. Systems and processes were in place to recruit staff who were suitable to work in the service and to protect people against the risk of abuse. People were supported with their medicines by suitably trained, qualified and experienced staff. Medicines were managed safely and securely, being kept in people’s individual flats.

There were sufficient numbers of suitably trained and experienced staff to ensure people’s needs were met at each location. Staff were matched to meet people’s needs as per experience, knowledge, age and general personality, where possible. This was particularly noticeable within the service catering to support people with high needs.

All staff received a thorough induction, a minimum of mandatory training and support from experienced members of staff, where required. Staff reported feeling supported by the registered manager and said they were listened to if they raised concerns.

People who could not make specific decisions for themselves had their legal rights protected. People’s care plans showed where decisions were made on behalf of a person, these were always done in the best interest of the person.

People using the service said they were happy with the support and care provided. People and where appropriate their representatives confirmed they were involved in the planning and review of their care. Care plans focussed on the individual and recorded their personal preferences. We noted that these were not always kept up to date, and that each complex used a different style of paperwork. The registered manager, advised us that measures would be taken to ensure one set of care plans were rolled out, and cross referenced with risk assessments.

People told us communication with the service was good and they felt listened to. Communication methods were employed by the service that were most appropriate to meeting people’s needs. This reflected in people we spoke with reporting they were always given choice and were treated with respect by staff.

The quality of the service was monitored regularly by the location manager, registered manager, and the regional director. Whilst audit systems were in place for monitoring paperwork, there were numerous documents for the registered manager to select from. This could at times cause confusion. The registered manager told us she would review all audits, compiling