This inspection took place on 17 and 18 July 2018 and was unannounced.

This was the first comprehensive inspection of the service since it was registered with the Care Quality Commission (CQC).

MK Supported Housing Limited is a 'care home'. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection. MK Supported Housing provides personal care support to people with an acquired brain injury, learning disabilities or autism; it is registered to provide accommodation and personal care for four people. At the time of the inspection there were two people living at the service and one person regularly accessing the service for respite care.

The 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 complex needs using the service can live as ordinary a life as any citizen.

There was 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.

The quality assurance processes in place to monitor the quality and safety of the service and drive improvement required strengthening. The provider and registered manager had not identified the concerns highlighted at this inspection. Following the inspection, the registered manager sent us an action plan detailing when the deficiencies identified would be rectified.

People's capacity to consent to their care and support was not always assessed. People supported by the service were not able to consent to some aspects of their care. However, written capacity assessments and best interest checklists were not in place. Staff did demonstrate that they understood the principles of the Mental Capacity Act 2005 (MCA) and gained people's consent when supporting them. The registered manager had made applications under the Deprivation of Liberty Safeguards (DoLS) for people as necessary.

Improvements were required to maintain the safety of the environment and to ensure all health and safety checks were completed as planned. Some areas of the home required refurbishment and re-decoration. The provider needs to ensure that all planned maintenance and refurbishment is completed in a timely manner.

There were gaps in medicines record keeping and some necessary checks of controlled medicines had not been carried out. The provider could not demonstrate that staff had received all required training and had access to regular supervision.

Staff recruitment procedures ensured that appropriate pre-employment checks were carried out to ensure only suitable staff were employed at the service. However, the provider was using high numbers of agency staff and had not consistently monitored that appropriate employment checks had been carried out for these staff.

The agency staff that were used in the home, were deployed on a regular basis to ensure that people’s support was consistent. Staffing levels were suitable to meet people's needs.

People were supported in a safe way. Staff had an understanding of abuse and the safeguarding procedures that should be followed to report abuse. All the staff we spoke with were confident that any concerns they raised would be followed up appropriately by senior staff. People had risk assessments in place to cover any risks that were present within their lives, but also enabled them to be as independent as possible.

Staff supported people in a way which prevented the spread of infection. Staff used the appropr