We carried out an announced inspection of the service on 30 November and 1 December 2016. JRH Support - Head Office is registered to provide personal care to people in their own homes. At the time of our inspection the service was providing the regulatory activity of personal care to 25 people living in their own homes and nine people living in supported living.

On the day of our inspection there was a registered manager in place who was also the provider. 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.

People were supported by staff who made them feel safe when they were in their home. Regular assessments of the risks to people’s safety were conducted and regularly reviewed. Care plans were in place to address those risks.

Staffing levels were adequate to meet people's needs however, we received mixed feedback about the consistency of staff. Appropriate checks of staff suitability to work at the service had been conducted prior to them commencing their role. People received the level of support they required to safely manage their medicines.

Staff received appropriate induction, training and supervision. People’s rights were protected under the Mental Capacity Act 2005. People received the assistance they required with their meals.

People’s day to day health needs were met by the staff and where appropriate referrals to relevant health services were made where needed.

People and their relatives felt staff supported them or their family member in a kind and caring way. People were provided with the information they needed that enabled them to contribute to decisions about their support. People were provided with information about how they could access independent advocates to support them with decisions about their care. People felt staff maintained their dignity when they supported them with their personal care.

People’s care plans were written in a person centred way. People and their relatives where appropriate, were involved with planning the care and support provided. People’s care records were regularly reviewed. People felt supported to take part in a range of hobbies and interests that were important to them and were provided with the information they needed if they wished to make a complaint.

The registered manager understood the responsibilities of their registration with the CQC. Staff understood the values and vision of the service and had a clear understanding of their roles and responsibilities. There were a number of quality assurance processes in place that regularly assessed the quality and effectiveness of the support provided.

At the time of this inspection the service was providing personal care in supported living services to 23 people with a learning disability living in their own homes. Four people who lived in the same house invited us to visit them as part of our inspection. In addition the service provided a variety of positive one-to-one support, including some personal care, to other people living in their own homes in the community who had mental health conditions, alcohol dependency and other personal challenges.

Below is a summary of what we found. The summary describes what people using the service, relatives and staff told us, what we observed and the records we looked at.

If you want to see the evidence supporting our summary, please read the full report.

We spoke with three people who used the service. We also spoke with the registered manager, the operations manager and five other members of staff. We looked at written records, which included copies of people's care records, staff personnel files and quality assurance documentation.

Is the service safe?

We saw that care plans and risk assessments were informative and up to date. Staff we spoke with were familiar with their contents, which enabled them to deliver appropriate and safe care.

People were protected from the risk of abuse, because the provider had taken reasonable steps to identify the possibility of abuse and prevent it from happening. People were protected by safe and effective recruitment practices. People were cared for by staff who were properly trained and supported to develop professionally.

Is the service effective?

People were treated with respect and were encouraged to promote their independence and community involvement.

People we spoke with were satisfied with the care and support they received and were complimentary about the care staff. This was consistent with positive feedback reported in the provider's own annual quality assurance survey. People were given information and support to help them understand the care and support available to them.

Is the service caring?

We spoke with three people who used the service at their own home. One person said to us, "It's fantastic here. I really like living in this house. Staff help me cook food and my favourite is pizza." We asked another person if they liked living at their home. They replied, "Yes." We asked two people if they were looking forward to their forthcoming holiday. They both nodded enthusiastically and replied, "Oh, yes."

All interactions we witnessed between staff and people who used the service were encouraging and friendly. People were offered choices, encouraged to make decisions for themselves and staff were attentive to their needs. One staff member summed up the level of respect shown to people by commenting, "I actually feel privileged to be a part of their lives."

Is the service responsive?

People were consulted about and involved in their own care planning and the provider acted in accordance with their wishes. Care plans and risk assessments were regularly reviewed.

Five staff members told us that all of the members of the management team were approachable and they would have no difficulty speaking to them if they had any concerns about the service.

Is the service well led?

Staff said that they felt well supported by the manager, the operations manager and the management team, and they were able do their jobs safely. There was a range of quality monitoring systems in place to ensure that care and support was being delivered appropriately by staff, that the service was continuously improving and that people were satisfied with the services they were receiving.

People's plans of care identified the care people needed and how this was to be provided. People could choose the things they wanted to do and the level of support they needed. People were treated with dignity and respect. One person we spoke with said, "The carers are just so good. I had different carers to start with but now everything is sorted. They know exactly what help or support I need."

People we spoke with told us that the staff who cared for them appeared confident and competent to provide the care people needed. One person said, "They are all so good. I can't fault the way that I am supported."

The provider completed audits of people's care plans, policies and other documents held at the office. However, we found that these audits and reviews of people's care plans were not always effective in identifying errors or omissions of information. The provider told us that they would correct the identified errors and omissions straight away. Everyone we spoke with told us that they were either happy, or very happy with the care they were provided with.

We reviewed the provider's complaints records. We saw that all complaints had been responded to and resolved to the satisfaction of the complainant. One person we spoke with said, "If ever I needed to complain I would call the office or social services." Everyone we spoke with told us that they had never had cause to complain.

We spoke with three people who were using the service. The people we spoke with told us that they had been involved in the development of their care plans. One person said, “The staff always ask me what I need.” Another person said, “The care I receive is wonderful I get everything I need.”

We spoke to three relatives of people who use the service and one person said, “The staff keep me updated and keep good records of what they have done.”

People told us they felt safe with the support they were being provided. One person said, "I feel safe and I can talk to staff." People told us that they liked the staff and staff were able to meet their needs. They also told us they felt they could speak to the manager or staff and they would be listened to.

We found that staff were supported to provide care that met people's needs. The provider was making appropriate checks before a new member of staff started work. We also found that the provider took steps to assess the quality of the service being provided.