We carried out an announced inspection of the service on 19 and 21 September 2018. This service provides care and support for 58 people living in ‘supported living’ settings, which will be referred to as ‘sites’ in this report. The sites referred to are people’s homes. People live at these sites with support from staff so that they can live 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.

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 has two registered managers, one of which was present during 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. Each of the ‘sites’ was managed by a service manager who reported directly to one of the two registered managers.

This is the service’s second inspection under its current registration. In our previous inspection the service received a rating of ‘Good’ overall. After this inspection, the service has retained this rating.

Prior to the inspection we had received concerns that some people may have experienced neglect or avoidable harm at the service. During this inspection we reviewed these incidents with the registered manager and found they had taken the appropriate action in relation to these incidents. Most of these incidents were not substantiated, where inappropriate staff action had taken place, this was dealt with through disciplinary or dismissal. We concluded that the provider had the appropriate systems and staff in place to protect people from neglect and avoidable harm.

People had detailed risk assessments that were designed to support people to lead active lives, without unnecessary restrictions, whilst keeping them safe. Most of these were up to date and where they were not, action was taken to address this. People had the support of staff to keep them safe and lead their lives in the way they wanted to. People’s medicines were managed safely and staff followed procedures to protect people from the risk of the spread of infection. Processes were in place to ensure if accidents or incidents occurred, they were investigated and preventative measures put in place to minimise the risk of recurrence.

People’s received care and support in line with current legislation and best practice guidelines. Staff were well trained and received regular supervision of their role. People were supported to lead healthy lives and this included making healthy food choices. Effective relationships with external health and social care organisations were in place to ensure people’s health was regularly monitored. 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 support this practice.

People liked the staff and had formed positive relationships with them. Staff treated people with respect and dignity and people were supported to make decisions about their care and support.

Advocates were made available if people needed further support. People’s diverse needs were considered when care and support was planned for them. People’s records were handled appropriately and in line with the Data Protection Act.

People’s support records reflected their personal preferences and focused on supporting peo

This announced inspection was carried out on 21 and 24 July 2017. Nottingham Regional Office provides support and personal care to people who live independently some of whom are in a supported living environment in Nottinghamshire. At the time of the inspection there were 22 people using the service who received personal care.

The service had a registered manager in place at the time of our inspection. 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 supported by staff who understood the risks people could face and knew how to make people feel safe. People were encouraged to be independent and risks were mitigated in the least restrictive way possible.

People were supported by consistent staff who they knew. People were provided with the support they needed to take their medicines as prescribed.

People were provided with the care and support they wanted from staff who were trained and supported to do so. People’s human right to make decisions for themselves was respected and they provided consent to their care when needed. Where people were unable to do so the provider followed the Mental Capacity Act 2005 legal framework to make the least restrictive decisions in people’s best interest.

People were supported by staff who understood their health needs and ensured they had sufficient to eat and drink to maintain their wellbeing. People were treated with dignity and respect and their privacy was protected.

People were able to influence the way their care and support was delivered and they could rely on this being provided as they wished. People were informed on how to express any issues or concerns they had.

People were supported by a service which was person centred and put their interests first. There were systems in place to monitor the quality of the service so that improvements could be made when needed.