This inspection visit took place on 05 and 06 December 2017 unannounced. We also visited the provider’s offices again on 12 December to feedback our findings.

Fylde Community Link Supported Living and Domiciliary Service provides support to adults with a learning disability across the Fylde, Blackpool, and Wyre areas of Lancashire. People's support is based on their individual needs and can range from 24 hour care within a supported living environment to a set number of visits each week from the domiciliary service.

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. The aim of the guidance is to help services ensure people with learning disabilities and autism using the service can live as ordinary a life as any citizen.

This service provides personal care and support to 81 people living in ‘supported living’ settings, so they can live in their own home as independently as possible. People’s care and 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.

They also provide domiciliary care to 34 adults with a learning disability. The service provides personal care to people living in their own houses and flats.

There were three registered managers in place. 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.

At the last inspection the service was rated Requires Improvement. At this inspection we found the service had improved and was rated Good.

Although a number of people had limited verbal communication and were unable to converse with us, we were able to speak with 19 people who received support. They gave us positive feedback about the service they received and told us they were cared for by staff who met their needs and treated them well.

Relatives told us staff were caring, well-trained and attentive to the needs of their loved ones. They told us they were happy with the care provided and gave positive feedback about how the service was provided.

People we spoke with and staff told us there were always enough staff to provide the support people required. Staff we spoke with knew people they supported very well. They were able to share important information about people’s care needs and how they preferred to be supported.

The service had systems to record safeguarding concerns, accidents and incidents and take necessary action as required. The service carefully monitored and analysed such events to learn from them and improve the service. Staff had received safeguarding training and understood their responsibilities to report unsafe care or abusive practices. The registered provider had reported incidents to the commission when required.

Risk assessments were completed to assess the potential risk of harm to people while receiving care and support. Staff drew up plans of support to lessen these risks. Risk assessments and associated plans of support were kept under regular review.

Staff had been recruited safely, appropriately trained and were well-supported. They had the skills, knowledge and experience required to support people with their care and support needs.

The provider had implemented a new risk assessment for medicines administration, which had helped to improve the level of independence people had with their medicines. Systems were in place which helped to ensure medicines were managed properly and safely, in line with best practice guidance.

People were treated as unique individuals by staff who supported them. Through con

This inspection took place on the 02 & 03 August 2016 and was announced. The provider was given notice because the location provides a domiciliary care service we needed to be sure that someone would be available.

We last inspected this service in June 2014. At that inspection we found the service was meeting the legal requirements in place at the time.

Fylde Community Link Supported Living and Domiciliary Support is a community based, non-profit making agency that offers support services for adults with learning disabilities within Blackpool, Fylde and Wyre. The agency can also provide a service for people who have physical disabilities and/or sensory impairments. The agency provides personal care and support to people in their own home and to people living in supported living services.

At the time of our inspection, Fylde Community Link Supported Living and Domiciliary Support provided services to 120 people. 69 of these people were in supported living. They shared 18 properties. 51 people received support in their own homes.

There were three registered managers for this service. Two registered managers were present throughout our inspection and the third registered manager was present on the first day only. 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.

We looked at recruitment processes and found the service had recruitment policies and procedures in place to help ensure safety in the recruitment of staff. These had been followed to ensure staff were recruited safely.

We looked at assessments undertaken for eight people. Risk assessments had been undertaken. We found care plans identified risk management in a person centred way. A significant number of incidents had been acted on appropriately.

Reviews had been carried out for people when significant incidents had happened. People were protected from bullying, harassment, avoidable harm and abuse because staff had responded to concerns of bullying and harassment when they noticed them. We found that the service had not consistently followed safeguarding reporting systems, as outlined in its policies and procedures and within the local safeguarding body arrangements. We made a recommendation about this.

The service promoted staff development; staff received training appropriate to their roles and responsibilities. Staff told us they felt well supported by management and we saw evidence that regular supervisions had been undertaken.

The service had gained people’s consent to care and treatment in line with the Mental Capacity Act (MCA). We looked at people's care records and found mental capacity assessments, with supporting best interests’ decisions records. The Local Authority had been informed of people whose care involved restrictive practice. However, we found this had not been consistent. We found a significant number of people that had not been referred to the local authority to be considered for deprivation of liberties authorisation.

Care records held details of joint working with health and social care professionals involved with people, who accessed the service.

We received consistently positive feedback about the staff and the care people received. Staff received training to help ensure they understood how to respect people’s privacy, dignity and rights. People and their relatives told us they had developed positive relationships with care staff. We saw evidence of this during the inspection.

We found people's needs were being met in a person centred manner and reflected their personal preferences. There were clear assessment processes in place, which helped to ensure staff had a good understanding of people's needs before they started to support them. People’s

We considered our inspection findings to answer questions we always ask: -

• Is the service safe?

• Is the service effective?

• Is the service caring?

• Is the service responsive?

• Is the service well-led?

Below is a summary of what we found. The summary is based on our observations during the inspection, speaking with people using the service, the staff supporting them and from looking at records.

Is the service safe?

We observed people being supported by staff in a safe, caring and respectful manner. People told us they felt safe and comfortable when they received support from Fylde Community Link. On person told us, “The staff are very kind and helpful. I am very confident that they will support me in the way I need them to”.

We saw evidence that people were supported with their medication appropriately. Medication practices undertaken by staff followed the service’s policy and we observed staff were trained in related principals. This meant people were protected against the risks of unsafe management of medicines because appropriate protocols were in place. One person told us, “I’m completely confident that the staff know what they’re doing with medication. I trust them to do this properly”.

Is the service effective?

We observed that staff respected people and enabled them to make basic, day-to-day decisions. The service held people’s recorded consent to care and staff were able to demonstrate a good understanding of related principals. One person told us, “The staff never take over and help me to make my basic decisions. That way I still feel in control”.

People’s social, health and support needs were assessed and regularly reviewed. Support plans were individualised and risk assessments were in place. This meant people were protected against ineffective care provision because people’s changing needs were monitored.

Is the service caring?

We spoke with seven people to gain an understanding of their experiences of the support they received. Their response was very positive. One person told us, “The staff are really helpful. They don’t talk down to me and really help me”. Another person said, “My worker is brilliant, he really looks after me”.

Staff explained that they worked in a caring and friendly manner. They described being respectful to and working with people to understand their needs. One staff member told us, “A consistent approach is key in the work we do. It’s about taking small steps, which often leads to better care for people”. This meant people were safeguarded against inappropriate care provision because staff understood people’s individual needs.

Is the service responsive?

People’s needs were properly assessed, monitored and reviewed. This meant the provider had continuously assessed whether the service was able to maintain people’s care levels. One person told us, “If I feel panicky about anything I ring up the office and they are great. They help me to calm down and to understand what is going on”.

We saw that the service responded appropriately to complaints received. This followed Fylde Community Link’s complaints policy. Responses to issues raised and actions undertaken were recorded. This meant the provider had minimised the risks of unsafe care because complaints had been acted upon.

Is the service well-led?

Fylde Community Link had a range of quality audits in place. Other regular processes underpinned this, such as staff supervision and team meetings. People who accessed the service were given the opportunity to feedback about the service. This meant people were protected against inappropriate care because the manager had systems to check the quality of care.

Managers and staff had a good understanding of the appropriate handling of complaints. We were shown evidence of complaints that had been handled correctly and in a timely fashion. This meant the service was well-led because people were enabled to make complaints, which managers acted upon.

We spoke with a range of people about the agency. They included the registered managers, staff members and service users. We also asked for the views of external agencies in order to gain a balanced overview of the service people received from Fylde Community Link. The Expert by Experience spoke to a number of service users and their carers by telephone.

People who used the service told us they were happy with the support they received. One person said, “Before I came here I couldn’t read, write or cook. Now I can manage my own personal care." Another person told us, “I haven’t been here long but I am really happy. They are good at getting me to do things.” People told us their needs had been discussed and they had agreed to the support to be provided. They told us their carers provided sensitive and flexible personal care support and they felt well cared for.

We looked at how the service was being staffed and reviewed staff training and supervision records. We saw there were sufficient staff with a range of skills and experience. Staff told us they felt supported, had regular meetings with the provider and their training was kept up to date.

There were a range of audits and systems in place to monitor the quality of the service being provided.

We spoke with a range of people about the agency. They included the registered manager, staff members, volunteers and people who use the service.

People who use the service told us they were happy with the support they received. One person said, "I am very happy with my carers." People told us their needs had been discussed and they had agreed to the support to be provided. They told us their carers provided sensitive and flexible personal care support and they felt well cared for.

We visited one of the houses where the agency provided a supported living service. This helped us to observe the daily routines and gain an insight into how people's care and support was being managed. We observed staff treated people with respect and dignity.

People said that before they were offered the care service everything was agreed with them and they knew what to expect. People also said that they felt the staff respected their privacy and dignity when carrying out their care.

We spoke to three people who receive care and support from Fylde Community Link and they were very satisfied with the way the service operated. They said that the staff were very good, and that they always did what has been agreed. They said that their care and support was discussed with them, carried out sensitively and that they were treated with dignity and respect.

People who use the agency told us that the care staff arrive on time and stay for the time that has been agreed. They said that the carers were very good and always carried out the care that had been agreed and recorded in their care plan.