This inspection took place on 23 November 2017 and was announced.

This service provides care and support to people living in three ‘supported living’ settings. Supported living settings support people to live in their own home as independently as possible. People’s housing are provided under separate contractual agreements. CQC does not regulate premises used for supported living; this inspection looked at people’s personal care and support.

The service had 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 in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

The care service has been developed and designed in line with the values that underpin the Registering the Right Support and other best practice guidance. These values include choice, promotion of independence and inclusion. People with learning disabilities and autism using the service can live as ordinary a life as any citizen.

At the last inspection in October 2015, the service was rated Good. At this inspection we found the service remained Good.

People told us they felt safe at the service. People had risk assessments in place to cover various aspects of their daily lives. People were encouraged to be independent and to take everyday risks. There was guidance for staff on how to manage identified risks to people.

People told us they were happy with the service provided. Sufficient experienced and trained staff were deployed to ensure people’s needs were met. Staffing was flexible and additional support was provided where necessary. People were supported by staff who were trained to carry out their roles effectively. Staff received mandatory training as well as training which was tailored to the needs of those they supported. All staff received an induction and an on-going programme of supervision and appraisal. Staff told us they felt well supported.

Staff were extremely knowledgeable about the people they supported, their likes and dislikes and interests. Appropriate arrangements were in place for the safe administration and storage of medicines.

People were protected from abuse and harm. Staff told us they would be confident to raise any concerns they had and they would be acted upon. An effective recruitment and selection process was in place to ensure people were cared for by suitable staff. The provider carried out monthly health and safety checks to ensure people lived in a safe environment.

Accidents and incidents, although very few, were accurately recorded and reported and any lessons learned were shared with staff. The service learned from any mistakes and used these as an opportunity to raise standards.

There was a culture of openness and honesty and staff felt able to raise concerns or suggestions.

People's rights were protected by staff who under stood the Mental Capacity Act and how this applied to their role. Nobody we spoke with said they felt they had been subject to any discriminatory practice for example on the grounds of their gender, race, sexuality, disability or age.

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.

From our observations and feedback from people living in the home we could see staff were extremely caring, considerate and gentle in their approach to people. Interactions between staff and people were very positive and reassuring. Communication flowed easily and familiarity was evident.

People's privacy and dignity was maintained and staff went the extra mile to support people in areas of people's lives that were important to them. The quality of care we observed was outstanding, this was because everyone wa

We undertook an announced inspection of the Ethicare (Durham) Ltd on 29 October 2015. We gave the provider 48 hours’ notice of our visit because the service is small and the registered manager is often out of the office supporting staff or providing care. We needed to be sure that they would be available. Ethicare (Durham) Ltd was registered by CQC on 28 October 2014 and this was our first inspection of the service.

Ethicare (Durham) Ltd is a small domiciliary care agency which provides personal care services. At the time of our inspection the service was providing 24 hour personal care and support to three people sharing a home in the community. The people were funding their own care through a direct payment.

People who used the service were complimentary about the standard of care and support provided by Ethicare (Durham) Ltd.

The service had a registered manager. A registered manager is a person who has registered with the Care Quality Commission (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.

The registered manager was accessible and approachable. Staff and people who used the service felt able to speak with the registered manager and provided feedback on the service.

People were kept safe and free from harm. There were appropriate numbers of staff employed to meet people’s needs and provide a flexible service. Staff were able to accommodate last minute changes to appointments as requested by the people who used the service or their relatives.

The provider had an effective recruitment and selection procedure in place and carried out relevant checks when they employed staff.

Staff received regular training and were knowledgeable about their roles and responsibilities. Staff had the skills, knowledge and experience required to support people with their care and support needs.

Staff received regular supervision and appraisal which meant that staff were properly supported to provide care to people who used the service.

Staff knew the people they were supporting and provided a personalised service. Care plans were in place detailing how people wished to be supported and people were involved in making decisions about their care. Care plans were written in a person centred way and were reviewed monthly or when people’s needs changed.

Staff supported people to help them maintain their independence. People were encouraged to care for themselves where possible. Staff treated people with dignity and respect.

The provider had a robust quality assurance system in place and gathered information about the quality of their service from a variety of sources.