This announced inspection of Options for Supported Living took place on 27 October 2016.

Options for Supported Living is a domiciliary care agency that provides personal care and support to people in their own homes. The agency is based in Liverpool city centre and provides care and support to people throughout the Merseyside area.

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. At the time of our inspection the registered manager was on leave, however we spoke to the deputy chief executive.

People and their families told us that they felt safe and secure knowing the staff from Options were supporting them. Staff were able to describe the action they would take if they felt someone using the service was at risk of harm or abuse.

Risk assessments were well written and gave a thorough and detailed explanation of how to support people, including what action the staff must take to help minimise the risk in the least restrictive way possible. Staff understood the concept of what was acceptable risk taking in order to promote positive experiences for people.

There were procedures in place relating to the safe management, storage, and administration of medication. People told us they received their medications on time and there was training in place for staff with regards to safe medication administration and this was reviewed regularly.

Incidents and accidents were analysed and a ‘debrief’ of each incident and accident was recorded in people’s files including any remedial action that had been taken as a result.

Staff were recruited safely and checks were carried out on staff before they started work at the service to ensure they were suitable to work with vulnerable people.

Staff followed the principles of the Mental Capacity Act 2005 to ensure that people’s rights were protected where they were unable to make decisions for themselves. Staff understood the importance of gaining consent from people and the principles of best interest decisions. Routine choices such as preferred daily routines and level of support from staff for personal care was acknowledged and respected.

Staff were trained in a range of subjects in accordance with the provider’s training policy and the staff’s training and development needs. Staff told us they felt the training was of good quality and they were able to request additional training when they felt they needed it. Staff told us training was discussed with them as part of their supervision. Staff were supported to complete an induction and there were shadow shift opportunities so people and staff could get to know each other.

People were supported to maintain their nutritional wellbeing by staff and some people were supported to cook for themselves to maintain their independence. Some people lived at home with family members so staff were not always required to cook meals with or for people. People told us staff helped them prepare meals and supported them to shop for ingredients to plan meals.

People were supported to maintain their health needs and all medical appointments were well logged in people’s ‘Health Action Plans’.

People told us and we observed that staff treated them with kindness and respect in their own home and when supporting them in the community. Relatives of people who used the service spent time talking with us and explaining how the staff support was having a positive effect on their family member.

People and their families were fully involved in all decisions regarding their care and support. These decisions ranged from what staff supported them, to how they spent their time and what their care plans looked like.

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We spoke with a range of people about the agency. They included the registered manager, staff members, people who used the service and their carers. We also asked for the views of external agencies in order to gain a balanced overview of the service people received from Options for Supported Living.

People who use the service told us they were happy with the support they received. One person said, "Options provides an excellent service. The team that look after my son are marvellous." People told us their needs had been discussed and they had agreed to the support to be provided. They told us their carers provided sensitive and flexible personal care support and they felt well cared for.

We looked at how the service was being staffed and reviewed staff training and supervision records. We saw there was sufficient staff with a range of skills and experience. Staff told us they felt supported, had regular meetings with the provider and their training was kept up to date.

There were a range of audits and systems in place to monitor the quality of the service being provided.

Due to the different ways people who were supported by Options for Supported living communicated we were not able to directly ask them their views on the support they received. However we spoke with the relatives of three people who used the service, who told us they were happy with the service provided by the agency. They told us that the service was reliable and they were supported by the same carers on a regular basis, which was important to them. People told us they knew how to make a complaint if they had any concerns and that they were regularly asked for their views on the service.

Other comments included:

“The carers are absolutely brilliant”.

“I’d give them ten out of ten”.

“The whole family feel supported”.

“The whole team are lovely and the girls in the office are so helpful”.