The announced inspection took place on 18 and 19 October 2016. The service was last inspected in August of 2013 where they met all the regulations that we checked.

North West Community Services (GM) Limited provides a range of support and care services to people with a learning disability, older people and those with mental and physical disabilities. This is done through a range of tailored services, including outreach, supported living, day services and domiciliary care. There is an office base and staff provide people with a range of care and support including with; personal care, medicines management, shopping and domestic help.

At the time of the inspection 119 people lived independently and received care and support from 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 2008 and associated Regulations about how the service is run.

We visited one service and found staff did not always follow safe working practices within the administration and recording of medicines procedures. We watched a staff member prepare two people’s medicines and take them to the two people together. They did not follow good practice or the providers medicines policy. However, at another two services that we visited, staff were following correct procedures and other people and relatives we spoke with did not indicate any concerns with medicines. We have made a recommendation in connection with the safe administration of medicines.

People who used the service and those supporting them knew who to report any concerns to if they felt they or others had been the victim of abuse. Staff had received training in safeguarding and knew about whistleblowing procedures.

Emergency procedures were in place should the staff need to activate them to keep people safe, for example, in the event of a fire or poor weather conditions.

Risks to people's health and safety were managed and detailed plans were in place to enable staff to support people safely. Accidents and incidents were investigated and monitored for any trends forming.

We found one supported living accommodation that we visited in need of redecoration and some refurbishment work. We have asked the provider to support people to address the outstanding work.

There were enough staff with the right skills training and experience to meet people's needs, and although holidays and sickness interfered with staffing rotas, this was managed well with attention given to minimise the impact to people through inconsistency of the same staff as much as possible. Staff felt supported and suitable training and development opportunities were in place.

People told us they felt confident that should concerns be raised these would be dealt with appropriately. People told us they could contact the management team or staff at the service if they needed to discuss anything. People had the opportunity to talk about their opinions of the service during reviews and through meetings or surveys they completed.

Care Quality Commission (CQC) is required by law to monitor the operations of the Mental Capacity Act 2005 (MCA), and to report on what we find. MCA is a law that protects and supports people who do not have the ability to make their own decisions and to ensure decisions are made in their ‘best interests’. We found the provider was complying with their legal requirements.

People were supported to be able to eat and drink suitable amounts to meet their needs. People received a range of treatment when needed from health care professionals which helped to promote their health and well-being, including GPs, dentists and specialist consultants.

People were treated with kindness and respected by staff. Staff had a good relationship

The people who used the service said they were happy with the support they received. People described the staff as ‘great’ and ‘friendly’. One person told us, “The staff are good, we go out to lots of places.” Another person told us, “The staff take me out every day” and “I can speak to the staff about anything, they are lovely.”

Relatives of the people who used the service said they were very happy with the care provided. One person said, “The staff are very kind and professional, they are very good staff, and very patient.” Another relative told us, “The staff are very good indeed. My relative receives care from a small team of staff and there is very little change. My relative does not like change so this situation is very good.”

Staff were trained on how to safeguard people from abuse and harm when they were first employed and this was part of the on-going training programme.

The people who used the service appeared comfortable in the company of staff. They described the staff as ‘lovely’ and ‘really good’. One person said, “The staff are great, you can have a laugh with them.” Another person told us, “The staff are always nice.”

Relatives of the people who used the service had no concerns to raise about their relative’s safety and welfare.

Quality assurance systems had been developed to regularly assess and monitor the quality of the service provided. The systems were focused on the needs of the people who used the service. These quality assurance systems ensured the people who used the service benefited from safe quality care and treatment that was based on effective management.

One of the relatives we spoke with said the service was flexible and took account of their changing circumstances which they said was very useful.

People who used the service said they were happy with the standard of care and support they received. They said the staff were always friendly and they had never been treated badly. They had no concerns to raise. Their comments included:

“The staff have good manners, they are very nice”.

“The staff are always there for you”.

"The staff are very hard working, they are the best staff."

"I have known the staff for a long time, I can do what I want, I'm happy with everything".

“The support workers are doing fine, I’m really pleased with them”.

“I’m happy with the care I get, the staff are lovely. I have never been treated badly”.

“I’m very happy with everything, no problems at all”.

“The staff always ring me if they are late”.