Mill Road is a domiciliary care agency. This service provides care and support to people living in a ‘supported living’ setting, 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. People using the service lived in a single ‘house in multi-occupation’ shared by eight people. Houses in multiple occupation are properties where at least three people in more than one household share toilet, bathroom or kitchen facilities. Mill Road provides a service to adults with a diagnosed learning disability and other medical conditions.

The inspection took place on 5 November 2018 and was unannounced.

Not everyone using Mill Road receives regulated activity; CQC only inspects the service being received by people provided with ‘personal care’; help with tasks related to personal hygiene and eating. Where they do we also take into account any wider social care provided. At the time of our inspection, four people were receiving a regulated activity.

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.

People were protected from the risk of abuse at staff were aware of safeguarding practices. Risks to people were identified and managed appropriately, and accidents and incidents were recorded so lessons could be learnt and the quality of the service improved. Staff carried out safe infection control practices and medicines were stored and administered in line with best practice guidelines.

Pre- assessment were carried out before people moved in to the service to ensure that their needs could be met. This was followed by a transition period which was personalised to meet the needs of each individual person. Care plans and activities were also person centred. The service actively supported people to find volunteering, educational and employment opportunities.

There were a sufficient number of staff to meet people’s needs and staff had received correct recruitment checks. Staff were up to date with mandatory training and received regular supervision. Communication between staff was effective. Staff respected people’s privacy and dignity. People were treated in a kind, caring and respectful way by staff.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice. People were supported to make healthy informed choices around meal times and to be as independent as possible. People were able to express their views and supported to make decisions around their care. The service had been proactive in approaching people about their end of life wishes, but people were not ready to discuss this topic.

People had access to healthcare professionals and specialist teams who were part of a person’s review process. Feedback was gained from people, relative and staff on a regular basis in order to act on suggestions to improve the service, and they in turn felt the manager was approachable.

The service had received multiple compliments from relatives. People and relatives knew how to raise a complaint if needed. Robust audits carried out by people and staff identified any issues in the service and these were resolved in a timely manner. Plans were in place to improve communication opportunities for people, and there was extremely close partnership working with stakeholders and other organisations. The registered manager did not always make the Commission aware of all notifiable inciden