We carried out a comprehensive inspection of Independent Lives (Disability) on 19 and 21 December 2017.

This service is a domiciliary care agency. It provides personal care to people living in their own houses and flats in the community. It provides support to adults across the whole population. At the time of the inspection 52 people were using the service.

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 service was last inspected on 16 and 18 February 2016 and was rated ‘Good’. At this inspection we found the evidence continued to support the rating of good and there was no evidence or information from our inspection and on-going monitoring that demonstrated serious risks or concerns.

At the last inspection on 16 and 18 February 2016, we asked the provider to take action to make improvements as we found people did always have safe and proper support with their medicines. At this inspection we checked to see if the provider had taken actions to address these issues and found that they had and people were receiving safe support with their medicines.

The service had systems and processes in place to encourage and enable accessible and open communication with people who used and were connected to the service. However, many people we spoke with said that communication was not very good and they felt their views and experiences were not always acted on to improve the service. This is an area of practice in need of improvement.

The service had sufficient staff and people’s needs were being met but some people told us care calls did not always take place at their preferred times. The service was aware of this and had invested in resources to improve the service in this respect.

There was a complaints policy in place and people told us they knew how to raise a complaint and felt confident to do so. Some people felt like complaints were not dealt with properly and issues were not resolved. The service aimed to resolve all complaints to everyone’s satisfaction. The service was open and transparent and offered apologies when people had made complaints.

There were safe recruitment practices and systems and processes in place to keep people safe from abuse. Accidents or incidents which were responded to quickly to put actions into place to keep people safe. The registered manager reported incidents and accidents onto other relevant partner agencies for review and agree any necessary actions to keep people safe.

The organisation had an Equality and Diversity policy in place. Staff also received training to help them understand the importance of recognising and preventing discriminatory abuse against people and supported people to understand their rights. People, equipment and people’s homes had risk assessments in place to keep people safe. The service ensured that people were involved in this process and restrictions on their independence were minimised.

Staff received infection control training and used Personal Protective Equipment (PPE) when supporting people with personal care tasks. Any hazardous waste was managed correctly. Staff had received food hygiene training to safely support people with any food preparation and handling support.

Staff received Mental Capacity Act 2005 (MCA) training and understood the relevant consent and decision-making requirements of this legislation. People or a relevant person acting in their best interests had signed their support plans to say they consented to their care. People were involved in regular reviews of their support and could see their care plans whenever they wanted.

Staff had regular training and updates to be able to have the right skills

This inspection took place on the 16 and 18 February 2016 and it was announced.

Independent Lives (Disability) also known as ‘Lend a Hand’ is a charitable organisation. They are a domiciliary care service providing support to people in their own homes mainly between Littlehampton and Shoreham-by- sea in West Sussex. The service supports older people, people living with dementia, people with a physical disability, people with a learning disability, people with sensory impairments and people with mental health needs. At the time of our visit, they were supporting 92 people with personal care.

The service had a registered manager in post who had been registered since October 2013.

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.

Medicines were not always managed safely. The records in place did not demonstrate that people had received their medicines as prescribed. Staff administered medicines to people in their own homes in a personalised and professional manner, however significant gaps were noted in the records. This was fed back to the registered manager who had recognised this issue. During the inspection the registered manager told us about the new medicine system they would be introducing to drive improvements and minimise the risks to people.

People spoke positively about the support they received from the service and records reflected that there was sufficient staff to meet people’s needs.

People told us that they felt the service provided a safe service. Staff understood local safeguarding procedures. They were able to speak about what action they would take if they had a concern or felt a person was at risk of abuse.

Staff felt confident with the support and guidance they had been given during their induction and subsequent training. Staff also told us they were satisfied with the level of support that they were given from the management team. Supervisions, appraisals and unannounced spot check visits were consistently carried out for all staff who supported people.

Staff spoke kindly and respectfully to people and involved them with the care provided. Staff had developed meaningful relationships with people they supported. Staff knew people well and had a caring approach. Staff demonstrated how they would implement the training they received and were provided with additional training when it was identified.

People received personalised care. People’s care had been planned and individual care plans were in place. They provided clear guidance to staff on how to meet people’s individual needs. Where risks to people had been identified these were assessed and actions had been agreed to minimise them.

People were involved in determining the care that they received and staff understood how consent should be considered. Staff were vigilant to changes in people’s health needs and their support was reviewed when required. If people required input from other healthcare professionals, this was arranged. Staff often supported people with their healthcare appointments.

A range of quality audit processes overseen by the registered manager were in place to measure the overall quality of the service provided. We found the registered was open to feedback and discussions about how the service could be improved.

We found one breach of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see what action we have told the provider to take at the back of the full version of the report.