This unannounced comprehensive inspection was carried out on 29 and 30 August and 3 September 2018.

Merseyside Branch Office is a supported living service which is run by Alternative Futures Group Limited. The service is registered to provide personal care to older people, people with learning disabilities and/or mental health needs.

At the time of our inspection the service was providing personal care to 135 people living in their own homes, in order to support them to 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 people supported in their own homes; this inspection looked at people’s personal care and support.

The service did not have a registered manager in place at the time of the inspection. However, a new manager had been in post for several months and was in the final stages of registering with CQC. 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 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.

During our inspection we found that the service did not have clear records to specifically identify the people they provided the regulated activity of personal care to, as the records included information about all of the people the service supported. This lack of clarity had undermined the accuracy of notifications provided to CQC, which hampered our monitoring of the service. We discussed this with the manager who acknowledged that they had identified this problem and work was underway to review and confirm the people receiving personal care from the service. Shortly after our inspection the manager confirmed that this work had been completed and they now had accurate records relating to the people in receipt of personal care.

We found that the service had systems in place to protect people from abuse. Staff we spoke with were knowledgeable about the different types of abuse and knew how to raise concerns if necessary. The records we reviewed showed that safeguarding concerns were promptly and effectively managed by the service. The service was also meeting its obligation to notify CQC of any safeguarding concerns.

We reviewed people’s care files and found there were personalised risk assessments in place and these were reviewed regularly.

Medication was correctly administered and recorded by staff who had appropriate training and experience. The staff we spoke with told us that they were confident managing people’s medication and people received the right medication at the right times. The people we spoke with told us that they received their medication correctly and when they needed it.

Staff were safely recruited and were supported with an induction process. Criminal records checks, known as Disclosure and Barring Service (DBS) records, were carried out. We also saw that official identification, such as a passport or driving licence and verified references from the most recent employers were also kept in staff files. This ensured that the staff the service recruited were safe, suitable and competent to work with vulnerable people.

The service had accident and incident recording processes in place. The records we reviewed were well-maintained and up-to-date. Accidents and incidents were carefully monitored by a person employed as a risk and governance lead. This enabled the manager and senior staff to safely identify and manage any t