This inspection took place on 15 November 2018. We gave the provider 24 hours' notice that we would be visiting to ensure someone would be at the service.

Mediline Supported Living Averill is a 'care home'. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection. Mediline Supported Living Averill provides care and support for up to three adults with a learning disability.

The house is a purpose-built bungalow within a residential area of Newton Heath, Manchester. Accommodation comprises of three single occupancy bedrooms and spacious communal areas including a lounge, kitchen and bathrooms. At the time of our inspection the house was fully occupied.

At our last inspection in March 2016 we rated the service 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 ongoing monitoring that demonstrated serious risks or concerns. This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection.

At this inspection we found the service remained Good.

Why the service is rated good.

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.

There was 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 also had oversight of another residential care home operated by the provider.

There were flexible staffing levels to meet the daily needs of people living at the service. Staff supported people in line with their personalised care records to manage individual risks and care needs. The management team had a robust overview of the staff teams training, supervision and appraisal needs.

Staff were aware of the importance of respecting people's choices. They constantly consulted people and supported them to make choices and worked within the requirements of the Mental Capacity Act 2005 (MCA). However, we found the best interests process had not been followed to ensure it as appropriate for one person to receive their medicines covertly.

Risks to people were assessed and action was taken to minimise any avoidable harm. Medicines were managed safely and administered as prescribed and staff had regular competency checks. However, we found room temperature records were not being recorded. High temperatures can increase the risk that medicines may not remain effective. The registered manager ensured recording charts were put in place once we brought this to their attention.

People were treated with dignity and respect by staff who were compassionate and caring. Staff treated people's private information confidentially. People were able to make decisions about how their care was provided, and were involved in reviews along with family members.

Staff were knowledgeable about people's individual care needs and care plans were person-centred and detailed. People participated in a wide range of activities within the service and in the community, they also enjoyed the company of others in the service.

The service was well-led. Systems were in place to assess and improve the quality of the service and complaints were responded to thoroughly. There was an open culture and learning was encouraged to drive improvement.

This inspection took place on 8 and 9 March 2016. We gave the provider 48 hours’ notice that we would be visiting to ensure someone would be at the service.

North West Community Services (Manchester) Limited provides care and accommodation for up to three people with a learning disability. On the day of our inspection there were three people using the service.

The home had a registered manager in place. 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.

North West Community Services (Manchester) Limited was last inspected by CQC on 6 February 2014 and was compliant with the regulations in force at that time.

Accidents and incidents were appropriately recorded and investigated. Risk assessments were in place for people who used the service and staff had been trained in safeguarding vulnerable adults. Medicines were stored safely and securely, and procedures were in place to ensure people received medicines as prescribed.

The home was clean, spacious and suitable for the people who used the service and appropriate health and safety checks of the premises had been carried out.

There were sufficient numbers of staff on duty in order to meet the needs of people who used the service. The provider had an effective recruitment and selection procedure in place and carried out relevant checks when they employed staff. Staff were suitably trained and received regular supervisions and appraisals.

The provider was working within the principles of the Mental Capacity Act and was following the requirements in the Deprivation of Liberty Safeguards.

Staff were aware of people’s nutritional needs and care records contained evidence of visits to and from external health care specialists.

People who used the service, and family members, were complimentary about the standard of care at North West Community Services (Manchester) Limited. Staff treated people with dignity and respect and helped to maintain people’s independence by encouraging them to care for themselves where possible.

Care records showed that people’s needs were assessed before they moved into North West Community Services (Manchester) Limited and care plans were written in a person centred way.

Activities were arranged for people who used the service based on their likes and interests and to help meet their social needs. Personal goals had been identified and set for people.

People who used the service, and family members, were aware of how to make a complaint however there had been no formal complaints recorded at the service.

The service regularly used community services and facilities and had links with other local organisations. Staff felt supported by the manager and were comfortable raising any concerns. People who used the service, family members and staff were regularly consulted about the quality of the service. Family members told us the management were approachable and understanding.

We used a number of different methods to help us understand the experiences of people who used the service, including observing the care being delivered, talking with staff and looking at records in the home.

Staff were friendly, patient, polite and treated people in a respectful way. Staff encouraged people to be independent and make choices but at the same time assisted people when they required support.

People's needs were assessed and care and support was planned and delivered in line with their care plan. People had individual care plans. The plans were well organised and included an index to each section. There were personal profiles, details of what was important to people and what others admired about them.

Staff we spoke to had a good understanding of what constituted abuse and that how they would report it to the manager if they had any concerns.

There were effective recruitment and selection processes in place. People were cared for, or supported by, suitably qualified, skilled and experienced staff.

People's records, staff records and other records relevant to the management of the services were up to date, accurate and fit for purpose.

During our visit we spoke with two people who lived at the home. One person told us they had “settled in well” and said “I like it here, I have a nice room and everything I need”. We observed staff interacting with another person who was not able to verbally communicate. It was clear staff understood their needs and had a good relationship with them.

The third person was happy to chat with us but did not answer specific questions about their care and support. However it was apparent they were happy and settled at the home and were able to make their own decisions, for example about their daily routine.

Comprehensive systems were in place to support new staff. On-going training and development was provided ensuring staff had the knowledge and skills needed to support the specific needs of people.

Information was easily made available to people about how they could raise any issues or concerns. We were told that no complaints had been received about the service provided.

A person using the service told us that he was satisfied with the care and services he received. He could always make choices and decisions about matters that affected him.

He said staff treated them all well, that they were enabled to maintain their independence and were treated with respect. "They’re alright, they help me a lot. I have no complaints. The staff are very nice”.

He also told us that they were keeping in touch with family and friends.

He said that he was getting support with healthcare needs, and he had ongoing attention from health care professionals.

The person we spoke with made positive comments about the catering arrangements. He said, "I can have anything I want, I get to chose and the staff cook for us”.

We received positive comments about how people spend their time, and we were told, "They take me out in the car so I can go shopping in Manchester. They always ask me what I want to do”.

We were told that the home was being kept clean and one person said, “My room is how I want it to be”.

He said about the staff team, “They’re very good to us. The staff are kind and never shout”.