This service provides care and support for up to 13 people living in six 'supported living' individual settings in and around Nottinghamshire and an additional 12 people living in their own homes. People's care and housing are provided under separate contractual agreements. The Care Quality Commission 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.

At our last inspection in December 2015, the service was rated 'Good'. At this inspection we found that the service remained 'Good' in Safe, Effective and Well-led and had improved to 'Outstanding' in the Responsive and Caring key questions.

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 remained safe because staff had received appropriate training and the provider had systems and processes in place to support people from avoidable harm. 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 with their tenancy to live in a safe environment. People received support from a team of staff that provided consistency and continuity. Safe staff recruitment checks were carried out before staff commenced employment. People who used the service were involved or represented in the recruitment of staff. People received appropriate support with the administration, storage and management of their prescribed medicines. Staff were aware of the importance of infection control measures and had received appropriate training.

People continued to receive an effective service. People were supported by staff that had received an appropriate induction and ongoing support and training. The registered manager used best practice guidance to develop and support staff to provide effective care and support. People were fully involved in meal preparation and choice. Staff were aware of people's nutritional needs and promoted healthy eating. Systems were in place to share information with external services and professionals when required. People received appropriate support to maintain their health and achieve good health outcomes.

People received outstanding care. Staff provided excellent person centred care; they were a dedicated staff team who went above and beyond what was expected of them. People who used the service and relatives described staff as very caring, kind and compassionate who wanted the very best for the people they supported. People were involved in their care and support and staff respected their privacy and dignity. Independence was promoted by staff, who clearly understood the principles of supported living. People were enabled to self-direct the support they received; this was empowering and gave people maximum choice and control of how they lived their life. Staff had a good understanding of people's diverse needs, preferences, routines and personal histories. People had access to advocacy support should this support be required.

People received an outstanding responsive service. People were fully involved in their care and support and lead active and fulfilling lives. The service was very responsive and supported people to achieve their hopes, dreams and aspira

This inspection took place on 30 and 31 December 2015. Nottingham Supported Living (DCA) is a supported living and outreach service which provides personal care and support to people in their own home and in various supported living services across Nottinghamshire. On the day of our inspection 29 people were using the service.

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 felt safe and were supported by staff who knew how to keep them safe. Risks to people’s health and safety were assessed and appropriately managed and people were supported by a sufficient number of staff. People received the support they needed to safely manage their medicines and were encouraged to be as independent as possible in the management of their own medicines.

Staff had the knowledge and skills to care for people effectively and felt well supported. People received the level of support they required to have enough to eat and drink and were supported to access a range of healthcare services.

The Care Quality Commission (CQC) monitors the use of the Mental Capacity Act 2005 (MCA) and the Deprivation of Liberty Safeguards (DoLS). We found this legislation was being used correctly to protect people who were not able to make their own decisions about the care they received. Where people had the capacity they were asked to provide their consent to the care being provided.

People were treated with kindness and respect by staff. Caring relationships had been developed and people were supported by staff who understood their personalities and sense of humour. People and their relatives were able to be involved in the planning and reviewing of their care. Staff supported people to make day to day decisions.

People were provided with support that was responsive to their changing needs and staff helped people to maintain any hobbies and interests they had. People felt able to make a complaint and the provider had taken action to raise awareness of the complaints procedure. There was an appropriate response to any complaints received.

The culture of the service was open and honest. People and staff gave their opinions on how the service was run and their suggestions were implemented where possible. There were effective systems in place to monitor the quality of the service and a service improvement plan ensured that improvements to the service were made.

People who used the service understood the care choices available to them. We talked to five people who used the service. They all said staff supported their choices about their care. One person said, “They ask my opinion and listen to me. I get a choice of what I want to do.” People expressed their views and were involved in making decisions about their care. Their privacy, dignity and independence were respected.

People who used the service told us the care and support provided was good and they got on well with staff. One person said. "The support staff are the best I have had – I have come on a long way thanks to them”. People’s needs and risks were assessed and care and support was planned and delivered in line with their individual care plans. Arrangements were in place to deal with foreseeable emergencies.

People were not always cared for by staff who were supported to deliver care and treatment safely and to an appropriate standard. Some staff did not receive regular supervision and not all staff had had an appraisal during the previous year.

The provider had an effective system to regularly assess and monitor the quality of service that people receive.

There was an effective complaints system available. Comments and complaints people made were responded to appropriately.

Before people received support, they were asked for their consent and the provider acted in accordance with their wishes.

We spoke with five people who used the service and asked them if they received support that met their needs. People were positive in their responses and comments included: “this year’s been the best yet, I feel really well supported”, “I get on well with everybody” and “they let me decide what I do”.

We found that people’s needs had been assessed and then a support plan had been produced. People had been involved in reviewing their support plan and records contained appropriate details about people’s health and social support network.

We found that staff had been screened as to their suitability to work with vulnerable adults and were aware of the appropriate reporting processes should an allegation of abuse be raised.

The service had an effective quality assurance system.