This comprehensive inspection took place on the 3 and 6 October 2016. Harbour Supported Living Services provides support to people living in shared housing environments or in their own homes in the Birkenhead and Wallasey areas. The agency provides continuing support for people with learning disabilities, mental health issues and drug or alcohol abuse, and short-term support for people referred by the hospital admission prevention service. The service was providing support to 80 people at the time of this inspection.

The manager was registered with the Care Quality Commission. 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 and associated Regulations about how the service is run. The registered manager was not on duty at the time of this inspection as they were on annual leave.

We looked at the medication records for five people. The medication procedure for staff was to prompt people or to administer their medication. Records informed that support staff would record all medication on the provider’s medication record sheets. There was information in relation to covert medication practices for staff to follow, we were told that no person was receiving this service.

We looked at records relating to the safety of the office premises and its equipment, which were correctly recorded. We were shown where confidential records were stored in lockable filing cabinets and password protected on the computers.

People were supported to prepare food and drinks and could choose the meals that they prepared if this was part of their person centred care plans (PCCP). Where people’s weight changed this was recognised, with appropriate action taken to meet the person’s nutritional needs.

The provider complied with the Mental Capacity Act 2005 and its associated codes of practice in the delivery of care. We found that the staff followed the requirements and principles of the Mental Capacity Act 2005 (MCA). Staff we spoke with had an understanding of what their role was and what their obligations where in order to maintain people’s rights. The service was not providing support to any person who did not have the capacity to make their own decisions.

We found that the person centred care plans and risk assessment monthly review records were all up to date in the five files looked at on the service computerised system. There was updated information that reflected the changes of people’s health.

People told us they felt safe with staff. The management had a good understanding of safeguarding. The registered manager had responded appropriately to allegations of abuse and had ensured reporting to the local authority and the CQC as required.

Accidents and incidents were recorded and monitored to ensure that appropriate action was taken to prevent further incidents. Staff knew what to do if any difficulties arose whilst supporting somebody, or if an accident happened.

The staffing levels were seen to be sufficient at all times to support people and meet their needs and everyone we spoke with considered there was adequate staff on duty.

The service ensured all new staff had a Disclosure and Barring Service (DBS) check. Three of the four staff files looked at did not include a photograph of the staff. The staff personnel records did not include all of the relevant information required. We spent time discussing this with the management team.

We have made a recommendation about the information required for staff recruitment at the service.

The service had an induction programme in place that included training staff to ensure they were competent in the role they were doing at Harbour Supported Living Services. Staff told us they did feel supported by the provider, the registered manager, the office manager and senior suppo

Comprehensive information was provided for people in a ‘welcome pack’. The agency had a number of ways of enabling people to express their views. Monthly house meetings were held in all shared accommodation. Three monthly ‘focus groups’ were held with a group of service users. People were asked to give written feedback and comments we saw included: ‘excellent service, very pleased with it’ and ‘very good, friendly, very pleased’.

The majority of people who used the service had mental health needs. They were supported to attend an annual health check and encouraged to visit a dentist and optician. Some people lived in shared properties and others had a tenancy in their own flat. The largest supported living service accommodated seven people. Team leaders visited each house at least weekly, and sometimes daily. People had individual packages of care and a full range of support services was provided. The agency also provided some short term packages of support for people by request from the hospital admissions prevention team.

There were enough well qualified and experienced staff to ensure that people received the support that they required.

A written complaints procedure was in place and records showed that complaints people made were investigated and responded to appropriately.

There was a good standard of record keeping across all aspects of the service.

We spoke to six people who used the service. They told us that staff were kind and caring and they were given the support to be independent and learn new skills. People said "I am happy here" and "The staff are great." Another person said "I am made up with the service."

We spoke with five members of staff and they confirmed that they liked working at Harbour Supported Living Service.

We spoke with the local authority safeguarding team and they confirmed they had no concerns with this service.