This inspection took place on 6 and 8 November 2018 October and was announced because Outreach Teeside provides personal care to people with a diagnosis of autism and/or learning disabilities in their own homes.

Not everyone using Outreach Teeside received a regulated activity. The Care Quality Commission (CQC) only inspected the services being received by people provided with ‘personal care’; help with tasks related to personal hygiene, nutrition and medicines.15 people were being supported with their personal care by the service at the time of this inspection. Seven people were living in their own homes with their families and eight people were living in ‘supported living’ settings 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 Registering the Right Support and other best practice guidance. These values included choice, promotion of independence and inclusion. People with learning disabilities and autism using the service can live as ordinary a life as any citizen. Registering the Right Support CQC policy.

We rated the service as good at its last inspection. 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 ongoing 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. Positive feedback was received about the leadership and management of the service. Staff received the training and support they required to be effective in their roles. Sufficient staff were employed to meet people’s needs. Recruitment policies minimised the risk of unsuitable staff being employed.

Risks to people were assessed along with the actions staff should take to reduce the risks identified. Staff knew how to safeguard vulnerable adults and were aware of the action they should take if they had any concerns. Medicines were managed safely. However, improvements could be made to how recordings were made on medicine administration records to make records easier to read. People living in supported living houses were encouraged to carry out their own health and safety checks.

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. However, some additional work was required in the recording of best interest decisions where people were unable to make their own decisions. Staff supported people to maintain their health and access healthcare services when needed.

People’s independence was promoted. People accessed a range of community and leisure facilities. Staff respected people’s rights and maintained their privacy. Relatives and people told us staff were caring. Support was planned and delivered based upon people’s support needs and preferences. Staff knew the people they were supporting very well.

People and their relatives told us they knew how to complain if it was needed. A governance system was in place to monitor the quality of the service. However, information regarding the actions that had been taken following issues been identified within audits was sometimes difficult to locate. The registered manager told us they were aware that this was an area that required further development.

Further information is in the detailed findings below.

The inspection of Outreach Teeside took place on the 23 June 2016 and was announced. We gave the registered provider 48 hours’ notice prior to the inspection. The registered provider was given notice because the location provides a domiciliary care service and we needed to be sure that someone would be in. The second day of inspection took place on 27 June 2016 and was announced.

The location was registered in April 2014 and had not previously been inspected.

Outreach Teeside provides personal care to people in their own home. At the time of the inspection Outreach Teeside were providing support to 11 people. Six people were supported in a supported living setting and received 24 hour support and five people were supported in their own home. The office base was used to provide day support for these five people.

The registered provider had 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.

There were systems and processes in place to protect people from the risk of harm. Staff were able to tell us about the different types of abuse and what actions they would take if they suspected abuse was taking place. Safeguarding alerts had been made when needed.

Risk assessments were in place for people who needed them and were specific to people’s needs. Risk assessments had been regularly reviewed and updated when required.

Emergency procedures were in place for staff to follow and personal evacuation plans were in place for people that used the service.

Robust recruitment procedures were in place and appropriate checks had been made before employment commenced.

There were sufficient staff on duty. Relatives told us there were enough staff day and night to meet the needs of the people who used the service. Staff told us there was sufficient number of staff employed by the service.

The service had policies and procedures in place to ensure medicines were managed safely. However, medication competency assessments of staff administering medication did not take place on a regular basis. Medicine was not always stored safely as medication storage room temperatures were not checked or recorded.

Staff performance was monitored and recorded through a system of regular supervisions and appraisals. Staff had received up to date training to support them to carry out their roles safely and had completed an induction process with the registered provider.

People were supported to maintain their health through access to regular food and drink. Appropriate tools were in place to monitor people’s weight and nutritional health. Staff knew how to make referrals to health professionals should anyone using the service become at risk of malnutrition.

Staff demonstrated good knowledge and understanding of the requirements of the Mental Capacity Act 2005 and Deprivation of Liberty Safeguards. However, people using the service had Court of Protection orders in place and deputy appointees but there was no documentation available to support this and the provider relied on obtaining this information from social workers.

People were supported to maintain good health and had access to healthcare professionals and services when needed. People made regular visits to their own GP.

From our observations, staff demonstrated that they knew people’s needs very well and could provide the support that was needed.

People and relatives were actively involved in care planning and decision making, which was evident in signed care plans. Information on advocacy services was available.

Relatives spoke highly of the service and the staff. People said they were treated with dignity and respect.

Care plans detailed people’s needs, wishes and preferenc