We inspected the New Beginnings North East Ltd office on 8, 9 and 15 March 2018. The inspection was announced, as we gave the provider one week’s notice to enable staff to arrange ways for us to meet people who used the service. During our inspection visits on 9 and 15 March 2018, we visited people in their homes.

When we last inspected the service in December 2015, we found the provider was meeting legal requirements and rated the service as Good. At this inspection in March 2018, we have rated the service as Outstanding.

New Beginnings North East Ltd provides care and support to people with learning disabilities living in '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. At the time of this inspection, the service provided care to 76 people.

Not everyone using New Beginnings North East Ltd 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.

Two registered managers were in place. 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.

New Beginnings North East Ltd 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 provider, registered managers and staff put people at the forefront of everything they did. The provider created an ethos and culture of individualised and person-centred care. People’s rights were championed and they were supported to live full and enriched lives. People were as independent as they could be. A positive approach to risks enabled people to live more fulfilled lives. The reduction of staff input to people’s individual care was carefully planned.

The provider understood the value of community. They supported people to be active members of their local area. Staff valued people, their skills and the contributions they made. People were supported to volunteer for charitable organisations. Staff had helped people to find roles which matched their interests. Staff celebrated people’s achievements and displayed passion when talking about the goals people had worked towards.

Staff went ‘the extra mile’ to enable people to live fulfilling lives. Staff changed their working patterns to support people to go to rave music events and rock clubs until the early hours in the morning.

People we spoke with told us they would not hesitate in sharing any concerns. Complaints were well managed, and had been investigated and responded to. The registered managers acknowledged the value to the service from any complaint as an opportunity to improve their service.

There was a strong, visible person-centred culture. People were supported by a core staff team who provided consistent care. Staff knew people very well. People were involved in the recruitment process, and selected their staff teams based on their personalities and common interests.

People were very comfortable with their support staff. One relative told us the service had ‘transformed’ their family member so they were no longer unhappy.

The provider set a culture of openness and transparency. They built reflection, and opportunities to identify lessons learned, into all of their

The inspection took place on 22, 24 and 28 September 2015 and was announced. We had last inspected New Beginnings North East Ltd in December 2013. At that inspection we found the service was meeting the legal requirements in force at the time.

New Beginnings North East Ltd provides personal care and support to people with learning disabilities, some of whom have complex needs. At the time of our inspection services were provided to 67 people who lived in their own homes, either alone or with families, or in shared houses with support.

The service had 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.

We found that care was appropriately planned to protect people’s welfare and keep them safe from harm. The staff understood their roles in preventing risks and safeguarding people from being abused. However, whilst safeguarding concerns had been reported to the local safeguarding authority, the service had not notified the Care Quality Commission of all incidents that had occurred.

There was a thorough recruitment procedure to ensure new staff were properly checked and vetted before they began working with people. Sufficient staff were employed to enable people to have safe and consistent care. Staff were given suitable training and support to equip them with the necessary skills to meet people’s needs.

People were supported in taking their medicines safely and to access health care services and stay healthy. Staff assisted people in meeting their nutritional needs including, where necessary, support with special diets and with eating and drinking.

People and their families were involved in and agreed to the care and support provided. When needed, formal processes were followed to uphold the rights of people who were unable to consent to their care. Legal arrangements had been made for some people to ensure they received the care they required.

A person centred approach was taken in planning and delivering people’s care. Care plans were very personalised to the individual’s needs and preferences and were kept under regular review. People were encouraged to be as independent as possible and engaged in a range of activities to develop their skills and meet their social needs.

There were good relationships between people and the staff who cared for them. People’s views about their care were sought and there were opportunities for them to influence the service they received. Commissioners spoke highly of the staff and managers and said they provided a caring and effective service. Systems were in place for managing complaints and obtaining people’s feedback about the service.

There was a clear management structure that provided staff with good leadership and support.  However, the service’s policies and procedures did not always provide staff with clear guidance on current best practice. People’s care experiences and the quality of the service were actively monitored and a number of developments were planned to continue to improve the service.