About the service:

Limelight is a ‘supported living’ service in Cheadle, providing personal care to four people with a learning disability and/ or autism in their own tenancies.

People’s experience of using this service:

All of the people who lived at Limelight told us in their words or own ways of communicating that they were very happy with the care they received. One person told us, “They are here to look after us – and they do that. They do it perfectively.”

The provider, registered manager and long-standing staff team had created an exceptionally caring service for, and in real partnership with, the people using it. The service’s outstandingly caring culture was reflected in the way that people who lived at Limelight supported and respected each other in truly nurturing, kind ways. There was a consistent focus on promoting people’s quality of life through developing their independence and choices.

People told us, and we saw, that the service promoted good health and wellbeing outcomes for people, including support to eat well. People were listened to by staff, but also supported to speak up and be respected, valued members of their community. People felt safe with the care and support from staff. There were enough staff to meet people’s needs and provide flexible, person-centred support, including access to meaningful activities.

People using the service and staff were involved in the design and delivery of their care and the service. Staff felt well supported by managers, through supervision and training. Learning opportunities were also available for people using the service.

Rating at last inspection:

At the last inspection the service was rated Good (13 April 2016). The service continued to meet the characteristics of Good in most of the areas we looked at.

The service had developed an exceptionally caring culture under remarkably dedicated leadership and enhanced people’s quality of life. We therefore improved the rating for Caring to Outstanding. Further information about these improvements is in the full report under our Caring findings.

Why we inspected:

This was a planned inspection that was scheduled based on the previous rating. We inspected to check whether the service had sustained its Good rating.

Follow up:

We will follow up on this inspection through ongoing monitoring of the service, through conversations and notifications.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

We inspected Limelight on 25 February 2016. The inspection was announced. At the last inspection on the 10 September 2013 the service met all the standards in the areas we inspected.

The service is registered to provide personal care to people in a supported living setting, the service was provided from a shared house specialising in services for adults who have learning disabilities and sensory impairments. At the time of our inspection there were four people who used 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 and associated Regulations about how the service is run.

People were kept safe because staff understood how to recognise possible signs of abuse and the actions they needed to take if people were at risk of harm. People’s risks were assessed in a way that kept them safe whilst promoting their independence.

We found that there were enough suitably qualified staff available to meet people’s needs in a timely manner. The registered manager made changes to staffing levels when people’s needs changed.

People who used the service received their medicines safely. Systems were in place that ensured people were protected from risks associated with medicines management.

Staff were trained to carry out their role and the provider had safe recruitment procedures that ensured people were supported by suitable staff.

Staff had a good knowledge of the Mental Capacity Act 2005 (MCA) and the Deprivation of Liberty Safeguards (DoLS). The MCA and the DoLS set out the requirements that ensure where appropriate decisions are made in people’s best interests where they are unable to do this for themselves. People’s capacity had been assessed and staff knew how to support people in a way that was in their best interests. We found that where people were able they consented to their care and treatment.

People were supported with their individual nutritional needs and were able to access other health services with support from staff.

People told us and we saw staff were kind and compassionate. Staff treated people with respect, gave choices and listened to what people wanted.

People’s preferences in care were recorded throughout the care plans and we saw that people were supported to be involved in hobbies and interests that were important to them.

The provider had a complaints procedure that was available to people in a format that they understood and people knew how to complain if they needed to.

Staff told us that the registered manager was approachable and led the team well. Staff and the registered manager had clear values and were enthusiastic about their role and what their support meant for people.

People, relatives and staff were encouraged to provide feedback on the service provided. The registered manager had systems in place to assess and monitor the quality of the service provided.

During the inspection we spoke with two people who used the service, staff who provided support and the registered manager. We did this to understand the experiences of people who received support.

We found that the provider had systems in place to gain consent for care and treatment from people who used the service. We spoke with staff who told us that they respected people’s decisions and understood their responsibilities with regards to the Mental Capacity Act 2005.

We spoke with people who used the service who told us that the staff were caring and treated them with respect. One person told us, “I like the staff they are very good and they look after me well”. Another person told us, “The staff listen to me and help me when I ask them to”.

We saw that the provider had an effective recruitment system in place and had undertaken the necessary checks on staff to ensure that people were safe from the risk of harm.

We found that the provider had effective systems in place to assess and monitor the quality of the service provided.

We saw that records were stored safely and securely. Care records we viewed were accurate and contained up to date details of people’s support needs.

We spoke to people who used the service and their relatives. People who used the service told us that they were involved in their support plans and relatives we spoke with told us "The service always keeps me fully involved" and "The manager lets me know when there are reviews planned".

We observed staff treating people who used the service with dignity and respect and gave encouragement, whilst promoting peoples' independance. People we spoke with told us "Staff treat me good and help me to look nice" and "Staff listen to me".

We spoke with people who used the service who told us that they felt safe. Staff we spoke with understood the procedures to follow if they were concerned that a person who used the service was at risk of harm.

People who used the service were supported by experienced staff. Staff we spoke with told us that they had received training, which was refreshed regularly.

The provider had some systems in place to monitor the quality of the service provided, but these did not include action plans to show how the provider had responded to any concerns raised.