This inspection took place on 26, 27, 28 and 29 June 2018 and was announced. The provider was given 48 hours’ notice because the location provides a domiciliary care service and we needed to be sure that someone would be at the office to assist with the inspection. This was the first inspection since the service was registered at this location in January 2017.

This service is a domiciliary care agency. It provides personal care to people living in their own houses and flats in the community. It provides a service to people with physical disabilities, learning disabilities or autistic spectrum disorders and older people.

Not everyone using Real Life Options – Teesside and Redcar Outreach and Supported Living receives regulated activity. CQC only inspects the service being received by people provided with ‘personal care’; help with tasks related to personal hygiene and eating. Where they do we also take into account any wider social care provided. At the time of our inspection 16 people were receiving personal care.

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.

There was a registered manager in place. 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.

Staff received the training needed to provide effective support but the provider did not have effective systems in place to monitor and record this.

People and their relatives said staff at the service kept people safe. Risks to people were assessed and plans developed to reduce the chances of them occurring. The provider had contingency plans in place to provide support in emergency situations. Accidents and incidents were monitored to see if lessons could be learned to help keep people safe. Effective infection control policies and procedures were in place.

People were safeguarded from abuse. Medicines were managed safely. The registered manager and provider monitored staffing to ensure enough staff were deployed to support people safely. The provider’s recruitment processes reduced the risk of unsuitable staff being employed.

Staff were supported with regular supervisions and an annual appraisal. 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 received the support they wanted and needed to manage their food and nutritional health. People were supported to access external professionals to monitor and promote their health. An assessment of people’s support needs was carried out before they started using the service to ensure the service could provide the support people needed.

People and their relatives spoke positively about the support they received from staff. People were supported to maintain their independence by using and enhancing their independent living skills and living as full a life as possible. Relatives we spoke with said staff promoted values of choice and independence. Support plans contained guidance to staff on how they could include people in the care they received and encourage them to do as much as possible for themselves. Staff told us they were committed to empowering people when delivering support. People told us they were treated with dignity and respect. Procedures were in place to support people to access advocacy services.

People and their relatives told us they received personalised care based on how they wanted to be s