This service provides care and support to people with a learning disability living in ‘supported living’ settings, so that 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.

This inspection took place on 19 and 22 January 2018. The inspection was announced.

At the time of the inspection four people were being provided with a regulated activity. CQC inspects services against the regulated activity they registered to provide. This service is registered to provide personal care.

At the previous inspection of the service on 11 and 17 November 2015, we found a breach of regulation 17 the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014, and a breach of section 33 of the Health and Social Care Act 2008. We found that the quality assurance process was not effective in analysing, providing feedback and demonstrating improvements made to the service. Records were not always accurate, up to date and easily accessible. The service was managed at a different location from which it was registered. We also made a recommendation that the service seeks the relevant guidance about the roles and responsibilities of a registered manager. Overall, the service was rated Good.

Following the last inspection we asked the provider to complete an action plan to show what they would do and by when to improve the key question well-led to at least Good. We undertook this inspection to check that they had followed their plan and to confirm that they now met legal requirements.

At our inspection in January 2018, we found that improvements had been made. The regulated activity of personal care was taking place at the registered location. The provider was now compliant with the conditions of registration. Quality assurance processes were effective in analysing, providing feedback and demonstrating that improvements had been made to the service. And records were accurate, up to date and easily accessible.

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. Staff told us that the registered manager was supportive and people told us that they knew the registered manager well.

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. People with learning disabilities and autism using the service can live as ordinary a life as any citizen.

People were involved in planning their support and support was person centred. People had time on a monthly basis to discuss their support and told us they felt they were listened too. Support plans contained information about people’s life, friends and relatives, preferences and goals. There were details about what people could do independently and what support they needed to undertake tasks for themselves.

Staff understood the risks to people and were aware of the appropriate action to take to minimise the occurrence of the risk in the least restrictive way. Staff knew people well and understood how to support them in the way they wanted. People were supported to increase their independence and take new risks in a managed and safe way. People seemed relaxed and comfortable with staff.

People participated in activities and maintained friendships both within and outside the L’Arche community. People were supported to visit each other in their homes or in the community. People were encouraged to coo

We spoke with people who use the service and everyone we spoke with said that they were happy with the service provided.

People told us that they felt safe when staff were in their homes. People told us that they trusted the staff and that they had the support they needed.

The assessment process was robust so that the agency knew about a person’s range of needs before they offered a service. Care plans were detailed giving staff the guidance they needed to ensure that they met people’s needs. People told us that they had been involved in writing and updating their care plans and that they had a copy in their home to refer to.

Staffing was planned around individual needs and activities. This ensured that people had the support they needed when they needed it. People told us that the service was reliable.

The inspection took place on 11 and 17 November 2015 and was announced. We gave ‘48 hours’ notice of the inspection, as this is our methodology for inspecting supported living services.

At the previous inspection in July 2013, we found that there were no breaches of legal requirements.

L’Arche Kent provides supported living for people with a learning disability. Supported living is where people are provided with their own home via a tenancy agreement and personal support is provided by a separate agency: L’Arche Kent. At the time of the inspection the service provided support for three people. Two people lived in a flat and one person was living in a shared house.

The service has a registered manager who was available and supported us during the inspection. A registered manager is a person who has registered with the Care Quality Commission (CQC) 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 had regular contact with the people who used the service, but had delegated the responsibility of managing the service to locality managers and their deputies. The people who used the serviced lived in two distinct areas in Canterbury. Each area had a locality leader and deputy who oversaw the supported living service and a residential care home in the area.

The agency was not managed from the location which it was registered with the Commission and was therefore in breach of its condition of registration. It was managed on a day to day basis by staff that were not registered with the Commission to do so. The registered manager was office based and acted as a care and support coordinator for several L’Arche services, which was their job title. We have made a recommendation in relation to the day to day management of the service.

There was not an effective system in place for ensuring that feedback from people and their representatives was shared with them, nor that all records were up to date and accurate.

Relatives and their representatives had confidence in the staff team and felt that people were in safe hands at all times. Staff had received training in how to safeguard people and they and the registered manager knew how to report any concerns so that people could be kept safe.

Assessments of potential risks had been undertaken of people’s personal care needs and their home environment. People were supported to do things that they wanted to do, in a safe and planned way so t they could live a full life in the community. Guidance was in place for staff to follow to make sure that any potential risks to people were minimised.

People said the agency provided the support when they needed it. Staffing support for people was based on people’s individual needs and choices. The agency was flexible in how it provided support and could do so at different times for people each day, to meet their individual needs and choices.

Robust checks were carried out on potential staff to make sure that they were suitable for their role in supporting people living in their own homes.

People were encouraged to take as much responsibility for their medicines as they were able. Staff had received training in medicines management so they could support people to make sure they received their medicines when they were required.

New staff received a comprehensive induction, which included shadowing more senior staff. Staff were trained in areas necessary to their roles through face to face and on-line training. Some staff had completed additional specialist training to make sure that they had the right knowledge and skills to meet people’s needs effectively. Most staff had undertaken training in The Mental Capacity Act 2005. They understood that people had the capacity to make day to day decisions and choices. The Mental Capacity Act 2005 provides the legal framework to assess people’s capacity to make certain decisions, at a certain time.

People’s health care and nutrition needs had been assessed and clear guidance was in place for staff to follow, to ensure that they were met. Staff were knowledgeable about people’s health care needs and the agency liaised with health professionals as appropriate.

People’s needs had been fully assessed before the agency started to support people in their own homes. The care, treatment and support needs of people were clearly identified in people’s plans of care. They included people’s choices, preferences, goals and preferred routines. Staff knew people well and understood their likes and dislikes and how to support them to make their own decisions. Staff valued the people they supported and treated them with kindness and respect.

People who used the agency were supported as part of wider L’Arche community and had the opportunity to be involved in its social events and activities. People had been supported to follow their aspirations such as going on holiday, and looking after a pet. People were supported by the agency to budget their own monies, plan their meals, shop for their own food, and take responsibility for keeping their home clean.

People said that they did not have any complaints about the agency, but they knew what to do to raise any concerns. Staff spent time talking with people about their well-being and if they had any worries on a regular basis, to help minimise the occurrence of any concern or complaint being raised.

The management team and staff were clear about the aims and values of the service and the ways in which these should be met. Staff understood these aims and put them into practice by providing personalised care.

The views of people and their representatives were regularly sought and were positive about the quality of care the agency provided. Relatives and representatives said they would recommend the agency to other people and that L’Arche was a community. Staff were aware of the aims and values of the service to treat people who used the service as equals.

We found two breaches of the Health and Social Care Act 2008 (Regulated activities 2014). You can see what action we told the provider to take at the back of the full version of the report.