About the service: Essential Futures is a domiciliary care agency which provides supported living and personal care to people living in their own homes in Warwickshire. Some people had 24- hour care, and other people received care calls at agreed times when support was required. At the time of the inspection the service provided different levels of support to 74 people; based upon their needs. Of these, 29 people were receiving the regulated service of personal care.

People’s experience of using this service:

¿ People were happy with the care and support they received from the service. They, and relatives, felt involved in how their care was planned and delivered, and overall, described positive relationships with staff who undertook their care calls.

¿ People had care plans which reflected people's needs and preferences. Staff knew people well and how to protect them from risks of injury.

¿ Risks had been assessed, and overall, management plans contained the detail to inform staff, should they need to refer to the information, of how to reduce risks of potential injury or harm.

¿ Staff were supported through an induction, training and meetings.

¿ The provider had implemented systems and processes to audit the quality of the service. Improvements were being implemented and needed to be embedded and sustained by the provider.

¿ The service met the characteristics of 'Good' in four of the five key questions. Overall, the service was well managed, however, we found some improvements were required in the key question related to Well Led. Our overall rating for the service is 'Good'. More information is in the full report.

Why we inspected: This was a planned inspection based on the rating at the last inspection.

Follow up: We will continue to monitor the service and plan to inspect it in line with our re-inspection programme. If we receive any information of concern we may bring our inspection forward.

This inspection took place on 16 June 2016 and was announced.

Essential Futures provides domiciliary care to younger adults with a learning disability or with mental health difficulties, in their own homes, some of which were shared. At the time of our inspection, 50 people were being supported.

The service had 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 told us they felt safe with the staff who supported them, and we saw people were comfortable with staff. Relatives were also confident people were safe. Staff received training in how to safeguard people from abuse and were supported by the provider who acted on concerns raised and ensured staff followed safeguarding policies and procedures. Staff understood what action they should take in order to protect people from abuse. Risks to people’s safety were identified, minimised and flexed towards individual needs so people could be supported in the least restrictive way possible and build their independence.

People were supported with their medicines by staff who were trained and assessed as competent to give medicines safely. People told us their medicines were given in a timely way and as prescribed. Checks were in place to ensure medicines were managed safely.

There were enough staff to meet people’s needs effectively. The provider conducted pre-employment checks prior to staff starting work, to ensure their suitability to support people who lived independently. Staff told us they had not been able to work until these checks had been completed.

People told us staff asked for consent before supporting them in ways they were comfortable with. People were able to make their own decisions and staff respected their right to do so. Staff and the registered manager had a good understanding of the Mental Capacity Act 2005.

People and relatives told us staff were respectful and treated people with dignity. We observed this in interactions between people, and records confirmed how people’s privacy and dignity was maintained. People were supported to make choices about their day to day lives. For example, they were supported to maintain any activities, interests and relationships that were important to them.

People had access to health professionals when needed and care records showed support provided was in line with what had been recommended. People’s care records were written in a way which helped staff to deliver personalised care and gave staff information about people’s communication, their likes, dislikes and preferences. People were involved in how their care and support was delivered and, where people wanted this, staff worked with advocates to ensure people were supported effectively.

People and relatives told us they felt able to raise any concerns with the registered manager. They felt these would be listened to and responded to effectively and in a timely way. Staff told us the management team were approachable and responsive to their ideas and suggestions. There were systems in place to monitor the quality of the support provided, but the provider was developing new systems, which they hoped would be more effective in obtaining the views and experiences of people using the service.

During our inspection of Essential Futures, we spoke with four people who used the service. We also spoke with the registered manager, three support workers and seven office based managers and staff. People we spoke with us all told us they were very happy with the service provided to them by Essential Futures. People said, "Everything is alright,” and “Everyone is brilliant, I have a fantastic time with them (staff)."

We found that people had been involved in the planning of their care. Care was delivered in a way that was unique to each person and took into account their specific needs. People we spoke with told us they were happy with the way care was given. One person said, "I know what I am doing every day, which is great."

Effective arrangements were in place for the recruitment and selection of new staff.

People had opportunities to express their views about the service they received from the provider. One person said, “I am always asked if everything is ok.” Another person said, “X (manager) visits all the time and asks me if I am happy.”

People told us that they were confident that they could raise concerns if they were not happy with the care and support they received. One person commented, “I can tell them anything.”

When we visited Essential Futures Limited we spoke with the manager and provider as well as eight members of staff. We looked at three sets of care records, staff training records and some of the systems used to measure and develop the quality of care and service provided.

On the following day we met seven people who used the service, in a group, with assistance from their key workers. We spoke with them about their experiences of receiving care and support from Essential Futures Limited. Everyone we spoke with said they were happy with the service they received.

We were told, "The staff are brilliant. I have moved on in my life because of them."

People commented that they were included in planning their care and support. We were told, "I sit with staff and go over my care plan. If things need to change, we make the changes."

People told us they felt well supported by the staff team and were aware of the procedure for raising any concerns or complaints. We were told, "You can call the staff or the office if you have a problem."