This service provides care and support to people living in five different ‘supported living’ settings, so that they can live in their own homes 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.

At our last inspection in February 2016 the service was rated overall Good. At this inspection we found that the service had deteriorated and received an overall rating of Requires Improvement.

This inspection took place on 10 and 11 April 2018 and was announced. At the time of the inspection the service was supporting 13 people with their personal care needs.

The service had 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.

Improvements were required to the handling of safeguarding incidents, and to accidents and incidents within the service. Investigations into these matters were delayed and ineffective at ensuring prompt action was taken to prevent similar issues and concerns occurring again.

Improvements were required to ensure that staff completed regular and effective training. Staff were not effectively monitored to ensure they completed their training in a timely way, and this was of concern at our last inspection and sufficient action had not been taken to resolve this.

Improvements were required to the auditing systems that were in place to ensure they were effectively reviewing people’s care plans and risk assessments; and that when actions had been identified they were actioned promptly. In addition, improvements were required to the records of people’s care to ensure they were accurate and contained current information and guidance.

The registered manager operated good recruitment practices and people were supported to take their medicines as independently as possible. There were adequate numbers of staff on duty to keep people safe and people had risk assessments in place which encouraged their independence and kept them safe.

People were actively involved in decisions about their care and support needs and there were systems in place to assess people’s capacity for decision making under the Mental Capacity Act 2005. People’s nutritional and healthcare needs were regularly monitored and staff were given regular supervision.

People were treated with care, compassion, and respect. Staff treated people well and each person was supported in a way that was individual to them. People were treated with dignity, respect, and kindness. People were able to maintain their independence with the support of staff.

People and their relatives were involved in completing comprehensive assessments when people began to use the service and people’s care packages were designed around each person’s individual needs, styles, preferences, and values. People were supported to follow their interests and procedures to manage complaints had been established and people and their relatives were aware of how to raise concerns if they needed to.

At this inspection we found the service to be in breach of one of the Care Quality Commission (Registration) Regulations 2009 (part 4) and we are considering our criminal enforcement actions.

We inspected the service on 3 February 2016 and the visit was announced.

Melton Supported Living Service provides domiciliary care for up to 21 people with learning disabilities in their own homes. At the time of our inspection 21 people were using the service. The service is provided in different accommodation types including flats and bungalows. These were located near to the office where the registered manager was based.

It is a requirement that the service has 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. At the time of our inspection there was a registered manager in place.

People felt safe and staff knew about how to protect them from harm and abuse. The provider had a range of risk assessments in place to keep people safe although some needed reviewing. The registered manager had made arrangements to check equipment regularly.

People who showed behaviour that could challenge had plans in place to support them. Some staff needed an update to their training in this area. Accidents and incidents had been carefully looked at to try and stop them from happening again.

There was a plan for staff about what to do in an emergency. This included how to support people to evacuate their homes.

Staffing levels were appropriate to keep people safe and the provider had a thorough recruitment process in place. This included checking the suitability of staff before they had started working for the provider.

People received their prescribed medicines. Where people handled their own medicines, there were systems in place to support them to do this safely.

People received support from staff who had undertaken regular training. Some of this training needed updating. For example, where people had specific conditions that required specialist training, this was not always up to date. The registered manager made plans after our visit to make sure this would happen. Staff met with their managers and received regular support.

People were supported to make their own decisions where they could. However, where people may have lacked the capacity to do this, the provider had not carried out mental capacity assessments or best interest meetings. We were given information after our visit to show how this was going to be improved immediately. Staff showed a good understanding of the Mental Capacity Act 2005 and had received training in this area.

People had access to food and drink that they preferred and were encouraged to eat healthily. Where there were concerns about a person’s weight, specialist advice had been sought. People had access to a range of healthcare professionals such as their GP.

People told us that staff members were caring. We saw staff responding well to people. People’s independence was being encouraged and people told us that this was important to them. Staff knew about people’s communication needs and we saw staff meeting these when we visited.

Staff knew about people’s preferences and interests including their cultural needs. For example, one person liked listening to hymns.

People were involved in planning their own care where possible. We saw that people were given choices on a daily basis about things that mattered to them. For example, one person was supported to choose what they wanted to wear.

People were being treated with dignity and respect. For example, information held and shared about people was being undertaken in a careful and sensitive way.

People were involved in the assessment of their own needs where they could. Where they could not, others had been involved such as family members. People’s needs had been regularly reviewed.

People had support plans that contained information about the

Some people using the service had complex needs and were not able to verbally communicate their views and experiences to us. One person, who was able to give their views verbally, told us, “I am happy with everything here. The staff let me do things for myself and they are always nice to me when they come.”

Relatives were also satisfied with the service. One relative said, “The quality of life for people is excellent and the care individualised. My (family member) often says what a pleasure it is to be cared for by this service. They are just so happy.” Another relative commented, “The service has exceeded our expectations. Staff have gone out of their way to help our (family member) settle it.”

People told us staff consulted with them to make sure they were happy with the support provided. One person said, “The staff ask me if I’m happy with them and I say I am. If I didn’t like any of the staff I would go to the office and tell the boss.”

Relatives said the manager worked hard to ensure the service was of a high standard. One relative told us, “I trust the manager. She’s on the ball and very keen to get things done. If you raise something with her she deals with it.”

Some improvements were needed to care plans and staff training and the manager said she would address these.

We visited the offices of this care agency which is based in a residential area of Melton Mowbray. The service currently provides care for twenty-one people in a variety of locations from individual flats to multiple tenancies. We looked at the quality assurance questionnaires that were circulated both to people using the service and their relatives. People were asked to comment if they were satisfied with the services provided, could add comments and return these anonymously if they wished. We also spoke to people using the service who indicated they were happy with the range of services provided. Relatives we spoke with stated, “The quality of life since (person’s name) is much better than Silverdale” (residential provision). “After the initial move which was not planned well, you can’t fault them – they offer a good service.” Another stated (the care) “works quite well really.”

When we spoke with staff they were aware how to support people and this reflected the support plans we viewed at the time. We saw staff were subject to a secure recruitment process prior to commencing their employment. We also saw that staff are thoroughly trained to enable them to support the wide variety of peoples needs, all of which points to ensuring peoples’ safety.