This comprehensive inspection took place on 27 and 28 November 2017 and was unannounced. During our last inspection we found a breach in relation to Regulation 9 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. This was in relation to care plans. At this inspection we found that improvements have been made to meet the relevant requirements.

This service provides care and support to people living in 54 ‘supported living’ settings, so that they can 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 supported living; this inspection looked at people’s personal care and support. This service is also a domiciliary care agency. It provides personal care to 15 people living in their own houses and flats in the community

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.

The service had a registered manager who had been in post since November 2013.

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.

Care records and risk assessments were well-kept and up-to-date. Each person using the service had a personalised support plan and risk assessment. All records we saw were complete, up to date and regularly reviewed. We found that people and their relatives were involved in decisions about their care and support. There was an emergency continuity plan in all files looked at that would be used for example if the person was taken to hospital. The information was a summary of the care and support required and other relevant. We also saw that medications were handled appropriately and safely.

We found that recruitment practices were in place which included the completion of pre-employment checks prior to a new member of staff working at the service and disciplinary procedures had been followed appropriately and in accordance with policies. Staff received a comprehensive induction programme regular training and supervision to enable them to work safely and effectively.

People's GPs and other healthcare professionals were contacted for advice about people’s health needs whenever necessary. The provider had systems in place to ensure that people were protected from the risk of harm or abuse. We saw there were policies and procedures in place and training to guide staff in relation to safeguarding adults.

The service had quality assurance processes in place including audits, staff meetings and quality questionnaires. The services policies and procedures had been regularly reviewed by the provider and these included policies on health and safety, confidentiality, mental capacity, medication, whistle blowing, safeguarding and recruitment.

People told us they were happy with the staff and felt that the staff understood the support needs of the people using the service. The people and the relatives we spoke with had no complaints about the service. The provider had a complaints procedure in place and this was available in the ‘service user guide’.

This comprehensive inspection took place on 15 and 19 September 2016. Merseyside Supported Living provides services to 111 people living in 60 supported living houses where people are supported on a 24 hour, seven days a week basis. The service also provides outreach support to 18 people living in their own homes within the community.

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. The registered manager of the whole service was in attendance during the inspection. The service also had five project managers that each managed an allocated number of supported living premises.

We looked at both the outreach service as well as the supported living services.

During our visit, however we identified concerns with the service. We found a breach in relation to Regulation 9 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see what action we told the provider to take at the back of the full version of this report.

We identified that some support plans and risk assessments needed updating within some supported living houses and in the outreach services some people did not have any support plans in their home.

We were told that supported living service had sufficient staff but, on speaking to those receiving an outreach service in their own homes we told that if a regular support worker was off for any reason then there was no one to take their place and the person using the service would be without support.

Staff were recruited safely and there was sufficient evidence that staff had received a proper induction or suitable training to do their job role effectively. The majority of staff had been supervised and appraised.

People's medicines were handled safely and were given to them in accordance with their prescriptions. People's GPs and other healthcare professionals were contacted for advice about peoples health needs whenever necessary.

The provider had systems in place to ensure that people were protected from the risk of harm or abuse. We saw there were policies and procedures in place and training to guide staff in relation to safeguarding adults.

Each of the services we visited had been personalised by the people who lived in them and the people who lived at the home were clearly happy with the support that staff gave them and there was a good rapport between them.