Pro Support Ltd is a care and support provider for people with mental health problems or learning disabilities and those with a dual diagnosis. The company is registered with the Care Quality Commission (CQC) as a domiciliary care agency as it provides support to people living in their own homes.

We inspected Pro Support on 1 and 2 March 2017. We announced the inspection two days beforehand to make sure the registered manager would be available at the office and so that the people using the service would know we were coming.

At the last comprehensive inspection of Pro Support Ltd on 7 and 8 October 2015 we identified five breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 (HSCA). We issued the provider with five requirements stating they must take action to address these breaches.

People using the service were either supported in one of four shared houses in the Gorton, Salford and Rochdale areas where they have their own tenancy or in their own homes. The registered manager of Pro Support Ltd is also the landlord to the four shared houses. At the time of the inspection the service was supporting 12 people with tenancies in the four shared houses.

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 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 last inspection we found that fire safety checks were not carried out properly. At this inspection we found the registered manager had a clear overview for all four tenancies and we found required checks such as fire extinguishers and smoke alarms had been completed in a timely manner.

At the last inspection we found issues with the way medicines were managed for people receiving support with their medicines. At this inspection we found there were now clear protocols in place to tell staff when people could take ‘as required’ medicines safely and medicines administration records were completed correctly.

We found behavioural risk assessments had improved and now contained sufficient detail for staff to understand and manage people’s behaviours that may challenge others.

There were a number of processes in place to monitor the quality and safety of the service. The systems in place to assess and monitor the quality of service provided were effective to ensure care provided was monitored, and that risks were managed safely.

People told us they felt safe at both of the houses we inspected. Staff could explain the different forms of abuse people may be vulnerable to and said they would report any concerns to the registered manager.

The recruitment process the service used was robust. This helped to ensure only those applicants suitable for employment were offered work within the service.

The staff we spoke with had a good understanding of the Mental Health Act 1983 and Mental Capacity Act 2005 and were aware of which people receiving a service had restrictions in place. We also noted that care plans had been developed to ensure people under any restrictions were being assessed and supported in line with their care plan.

There were enough staff to support people according to their care packages and the service could be flexible when people had appointments or needed transport.

Staff told us they felt supported by the manager and that training opportunities were good.

We saw people had access to a range of healthcare services and there was an effective system in place to remind and support people to attend their healthcare appointments.

People were supported to shop for and cook healthy meals and were encouraged to cook for others in the house where they lived.

People and their relatives told us they thought the staff were caring and that they promoted people’s dignity and privacy. We observed interactions betwe

We inspected Pro Support on 07 and 08 October 2015. We announced the inspection two days beforehand to make sure the registered manager would be available at the office and so that the people using the service would know we were coming. The service was registered in July 2014 and this was our first inspection.

Pro Support Ltd is a care and support provider for people with mental health problems or learning disabilities and those with a dual diagnosis. The company is registered with the Care Quality Commission (CQC) as a domiciliary care agency as it provides support to people living in their own homes.

People using the service are either supported in one of three shared houses in the Salford and Rochdale areas where they have their own tenancy or in their own homes. The registered manager of Pro Support Ltd is also the landlord to the three shared houses. At the time of the inspection the service was supporting 10 people with tenancies in the three shared houses.

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.

We found that fire safety checks were not carried out properly. Fire extinguishers had expired and checks were not made on smoke alarms even though the registered manager knew that people using the service were known to remove the batteries when they were cooking.

We found issues with the way medicines were managed for people receiving support with their medicines. There were no protocols to tell staff when people could take ‘as required’ medicines safely and medicines administration records were not completed properly.

Behavioural risk assessments did not contain sufficient detail for staff to understand and manage people’s behaviours that may challenge others.

We saw many documents that were not signed or dated. The support plans we looked at did not contain enough detail to understand the individual support needs of the people using the service.

Audit systems were not in place to assess, monitor and improve the quality and safety of the services provided and the registered manager had not realised that staff required training to undertake the checks that were delegated to them.

We found breaches of the Health and Social Care Act (HSCA) 2008 (Regulated Activities) Regulation 2014. You can see what action we have told the provider to take at the back of the full version of the report.

People told us they felt safe at both of the houses we inspected. Staff could explain the different forms of abuse people may be vulnerable to and said they would report any concerns to the registered manager.

The recruitment process the service used was robust. This helped to ensure only those applicants suitable for employment were offered work within the service.

There were enough staff to support people according to their care packages and the service could be flexible when people had appointments or needed transport. Staff told us they felt supported by the manager and that training opportunities were good.

We saw people had access to a range of healthcare services and there was an effective system in place to remind and support people to attend their healthcare appointments.

People were supported to shop for and cook healthy meals and were encouraged to cook for others in the house where they lived.

People and their relatives told us they thought the staff were caring and that they promoted people’s dignity and privacy. We observed interactions between people and staff that were relaxed and friendly.

People were involved in planning and evaluating their care. We saw examples of when people had requested changes to their support and the service had made this happen.

People had access to and described using advocacy services. We saw that this was documented in people’s care files.

People using the service and their relatives told us that if they had any concerns or complaints they would feel able to take these up with the registered manager.

People, their relatives and the support staff were in regular contact with the registered manager and operational manager and felt that they could get in touch at any time.

Team meetings were held regularly and staff were empowered to take ownership of the meeting content and use them as opportunities for professional development.