Isle of Wight Supported Living Service is a domiciliary care agency. It provides care and support services to people living in their own homes in the community. Not everyone using Isle of Wight Supported Living received a regulated activity; CQC only inspects the service being received by people provided with 'personal care'; help with tasks related to personal hygiene and eating. Where they do, we also consider any wider social care provided.

At the time of the inspection, Isle of Wight Supported Living were providing the regulated activity of personal care for 28 people. Our inspection was based on the care and support provided to these people, each of whom received a variety of care hours from the service depending on their level of need. People had a learning disability or autism and were living in individual supported living flats or shared houses; they required support to enable them to retain a level of independence.

This inspection was conducted between 9 and 14 August 2018 and was announced. We gave the provider two working days’ notice of our inspection as we needed to be sure key staff members would be available.

We last inspected the service in June 2017 when we did not identify any breaches of regulation, but rated the service as ‘Requires improvement’. Following that inspection, the registered manager told us the improvements they planned to make. At this inspection, we found improvements had been made.

Individual and environmental risks to people were managed effectively.

Staff supported people to take their medicines in a safe way. Staff followed infection control procedures and used personal protective equipment when needed.

Staff understood their safeguarding responsibilities and knew how to identify, prevent and report abuse. The registered manager reported incidents appropriately to the local safeguarding authority and conducted thorough investigations.

There were enough staff available to complete all care and support required. Robust recruitment procedures were in place to help ensure that only suitable staff were employed.

People and relatives were complementary about the staff and the quality of care they provided. New staff completed an effective induction into their role and experienced staff received regular refresher training in all key subjects. Staff were appropriately supported by team leaders and managers.

Staff followed legislation to protect people’s rights and sought consent before providing care or support to people.

Care plans were informative, up to date and reviewed regularly. People received personalised care from staff who understood their individual needs well. Staff were flexible and adaptable when people’s needs or wishes changed.

Staff were responsible for supporting people to meet their nutritional needs, they encouraged people to maintain a healthy, balanced diet based on their individual needs and preferences.

Staff supported people to access healthcare services where needed.

Staff were caring and compassionate. They built positive relationships with people, encouraged them to be as independent as possible and involved them in decisions about their care.

Staff treated people with dignity and respect and protected their privacy during personal care.

People and relatives had confidence in the service and felt it was managed effectively. They knew how to raise a complaint and felt they would be listened to.

There was a clear management structure and an effective quality assurance process in place. The provider sought and acted on feedback from people.

There was an open and transparent culture. The registered manager notified CQC of all significant events and understood their responsibilities under the duty of candour requirements.

This inspection took place on 1 and 8 June 2017 and was announced. The service was given 24 hours’ notice because the location provides a domiciliary care service; we needed to be sure that someone would be available in the office.

Isle of Wight Supported Living provides personal care and support to people with a learning disability in seven houses providing 24 hour support. At the time of this inspection they were providing a personal care service for 28 people with a variety of care needs.

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. The registered manager oversaw the running of the service and was supported by team leaders who were allocated a geographical area to manage.

People, relatives and staff spoke positively of the management. There were systems in place to monitor the quality of the service however, these had not been fully effective and had not identified the concerns we found within the safe and effective domains of this report. The provider’s systems had failed to ensure that where a person who lacked capacity was making decisions which were harmful placing them at risk, staff had failed to assess their mental capacity to understand the implications of their decisions. Risk management guidance from an external health professional was not being followed. This was placing the person at risk.

Risk assessments and support plans had been developed with the involvement of people and their relatives. However, not all risks to people’s health and welfare had been managed safely.

Staff knew about people’s individual capacity to make decisions and supported people to make their own decisions. However, staff had failed to ensure that when a person made unsafe or unwise decisions they had the mental capacity to make these decisions and understand the consequences of them.

Staff understood how to protect people from abuse and were responsive to their needs. People were protected against the risk of abuse, and checks were made to confirm staff were of good character to work with people. There were sufficient staff to meet people's diverse needs and people were supported to take their medicine as prescribed.

Staff understood people’s needs and abilities and knew people well. The delivery of care was tailored to meet people’s individual needs and preferences. People were generally well supported to maintain good health.

Staff were provided with a comprehensive induction and ongoing training to support the people they worked with.

The registered manager and provider’s management team actively sought and included people and their representatives in the planning of care. There were processes in place for people to express their views and opinions about the service provided.

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