We carried out this announced inspection on 18, 23 and 24 October 2018. The service was previously inspected in April 2016 when it was operated by a different provider and was found to be good in all areas. At this inspection we again rated the service as Good.

Options Kernow provides personal care to people living in their own homes in the community. It is a supported living service which aims to support people to 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. At the time of our inspection the service was providing support to 12 people with a learning disability living in Cornwall. Each person was supported by a team of staff for up to 24 hours per day.

People felt safe and well cared for by staff who’s company they enjoyed. People told us, “I am happy living here”, “[The staff] are nice to me” and “The staff are very good. I can have a laugh with them.” People’s relatives were also complimentary of the support the service provided and commented, “[My relative] is safe, [they] are very well looked after”, “The staff are wonderful, conscientious and caring” and “[My relative] likes them.”

All staff had completed safeguarding training and understood their role in ensuring people were protected from harm, all forms of abuse and discrimination. Staff were confident any concerns they reported to their managers would be addressed.

Each person was supported by a dedicated team of staff who they knew well. We found that the service employed sufficient staff to meet people’s needs and records showed planned levels of support had been achieved. There were appropriate systems in place to ensure people needs were met during unexpected periods of staff absence and staff told us “If someone phones in sick someone else comes in within a couple of hours.” The service only agreed to provided additional packages of care where suitable staff were available.

Staff were well trained and knew how to meet people’s support needs. All new staff completed comprehensive induction training which included the care certificate. All training was updated and staff told us, “The training is very good” and “They give you plenty of training.”

Care plans provided staff with sufficient guidance to enable them to meet people’s support needs. These documents were designed to help staff to provide consistent support. Care plans included details of the level of support people normally required with specific tasks and activities. Information about people’s life history hobbies and interests was included along with background information on the person needs to enable staff to provide personalised support. People and their relative’s had been involved in the development and review of care plans. We were told, “I made my own guidelines up, They do what I want them to do” and “I am involved in the care plan reviews.” Staff said people care plans were accurate and up to date and commented, “The care plans are very good” and “The care plans are very informative they are the first point of call. They are kept up to date.”

Risk assessments had been completed and clearly identified the actions staff must take to ensure people’s safety. This included any environmental risks in people’s homes and any risks in relation to the care and support needs of the person. Where people were at risk of becoming anxious or confused staff were provided with details of events and incidents likely to cause anxiety and guidance on how to support people to manage these issues. All staff had completed training in positive behavioural management techniques and staff told us, “We are trained in positive behaviour management techniques but we very rarely use it. Only when necessary to keep people safe. I think we have only had to use it twice in the last two years.” Relative were confident these techn

We carried out this announced inspection on 20 April 2016. This was the first inspection for the service since operating from this location.

Hillcrest Kernow is a domiciliary care agency that provides personal care and support to people with a learning disability or a mental health condition in their own homes. At the time of our inspection the service was providing a 24 hour supported living service and personal care to nine people. A supported living service is one where people live in their own home and receive care and support to enable people to live independently. People have tenancy agreements with a landlord and receive their care and support from a domiciliary care agency. As the housing and care arrangements are separate, people can choose to change their care provider and remain living in the same house.

There was a registered manager in post who was responsible for the day-to-day running of the service. 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 and associated Regulations about how the service is run.

Most people using the service had limited verbal communication and were un able to tell us their views about the care and support they received. However, we observed people were relaxed and comfortable with staff, and they received care and support in a way that kept them safe. People had a good relationship with staff and were comfortable with the staff that supported them. Relatives told us, “Staff are wonderful, I can’t fault them” and “[Person’s name] is very happy, they are always laughing.”

Staff had received training in how to recognise and report abuse. All were clear about how to report any concerns and were confident that any allegations made would be fully investigated to help ensure people were protected.

People received care from staff who knew them well, and had the knowledge and skills to meet their needs. People were supported by dedicated staff teams who were employed to work specifically with each person using the service.

Staff supported people to maintain a healthy lifestyle where this was part of their support plan. People were supported by staff with their food shopping and with the preparation and cooking of their meals.

People were supported to access the local community and take part in activities and outings that they enjoyed and wanted to do. Some people liked to have planned activities each day and for other people staff responded to their needs and wishes on a daily basis. Records showed that people went out most days for walks, shopping, day centres and visiting local attractions.

The management and staff had a clear understanding of the Mental Capacity Act 2005 and how to make sure people who did not have the mental capacity to make decisions for themselves had their legal rights protected.

There was a positive and open culture in the service, the management team provided strong leadership and led by example. Staff were positive about the how the service was run. Staff told us, “You can pop into the office at any time”, “The communication is good within the management team” and “We [staff] are all well looked after.” A relative told us, “I have confidence in how the service is managed.”

Relatives said they knew how to make a formal complaint if they needed to but felt that issues would be resolved informally as the management and staff were very approachable. There were effective quality assurance systems in place to make sure that any areas for improvement were identified and addressed.