Next Steps Community Care LTD is a domiciliary care agency. It provides personal care to people living in their own houses and flats. It provides a service to older adults, younger adults, people living with dementia, people with physical disability, people with autism or learning difficulties and people with a sensory impairment. Not everyone using Next Steps Community Care LTD received a regulated activity; Care Quality Commission (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.

The announced comprehensive inspection took place between the 7 and 9 February 2018. We gave the service 48 hours’ notice of the inspection visit because it is small and the manager is often out of the office supporting staff or providing care. We needed to be sure that they would be in.

The rating at our previous inspection was good. At this inspection we found the evidence continued to support the rating of good and there was no evidence or information from our inspection and on-going monitoring that demonstrated serious risks or concerns. This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection.

A registered manager was 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.

People were kept safe by staff who knew how to recognise and report any potential harm. A sufficient number of staff were in post and any new staff continued to be recruited in a safe way. Risk to people were identified and managed. Trained and competent staff administered people’s medicines safely. Infection prevention and control systems were in place and staff cared for people as hygienically as practicable. Systems and processes were in place that enabled the provider to take on-board any learning when things did not go as planned.

Staff were trained and had the skills they needed to meet people’s assessed care and support needs. People were supported with their nutritional and health care requirements. Staff worked with external stakeholders who were also involved in people’s care. 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 continued to be cared for with dignity and respect by staff who showed them compassion. People’s preferences were respected by staff who knew each person well and how to meet these.

Staff promoted people’s privacy and people could be as independent as they wanted to be.

People’s care was person centred and their records reflected this. People were treated equally no matter what their needs were. Concerns were acted upon before they became a complaint. People were given accessible ways to raise concerns. Policies and procedures were in place as guidance for staff should any person require end of life care.

The registered manager led by example and they had maintained an open and honest staff culture. Staff were aware of the standard of care that was expected. People, relatives and staff had a say in how the service was run. The registered manager remained aware of their responsibilities. Staff were supported in their role. Quality assurance, audit and governance systems were effective in driving forward improvement. The service and its staff team worked in partnership with others and people’s wellbeing benefited from this.

Further information is in the detailed findings below.

Next Steps Community Care LTD is registered to provide personal care for people being looked after in a supported living service. People who use the service have a learning disability and mental health needs. At the time of our visit there were 17 people using the service.

This comprehensive inspection took place on 12 January 2016 and was announced.

A registered manager was in post at the time of the inspection. A registered manager is a person who has registered with the Care Quality Commission (CQC) 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 kept safe and staff were knowledgeable about reporting any incident of harm. People were looked after by enough staff to support them with their individual needs. Pre-employment checks were completed on staff before they were assessed to be suitable to look after people who used the service. People were supported to take their medicines as prescribed and medicines were safely managed.

People were supported to eat and drink sufficient amounts of food and drink. They were also supported to access health care services and their individual health needs were met.

The CQC is required by law to monitor the Mental Capacity Act 2005 (MCA) and the Deprivation of Liberty Safeguards (DoLS) and to report on what we find. The provider was acting in accordance with the requirements of the MCA so that people had their rights protected by the law.

Assessments were in place to determine if people had the capacity to make decisions in relation to their care. When people were assessed to lack capacity, their care was provided in their best interests. In addition, the provider had notified the responsible authorities when some of the people had restrictions imposed on them for safety reasons. The provider was waiting to hear the results of the actions that these authorities may be taking.

People were looked after by staff who were trained and supported to do their job.

People were supported by kind, respectful and attentive staff. Relatives were given opportunities to be involved in the review of their family members’ individual care plans.

People were supported with a range of hobbies and interests that took part in and out of the home. Care was provided based on people’s individual needs. There was a process in place so that people’s concerns and complaints were listened to.

The provider had submitted notifications as they were required to and demonstrated that they operated a transparent culture as part of their duty of candour. The registered manager was supported by a team of managerial and care staff. Staff were supported and managed to look after people in a safe way. Staff, people and their relatives were able to make suggestions and actions were taken as a result. Quality monitoring procedures were in place and action had been taken where improvements were identified.