We carried out an announced inspection of the service on 19 October 2016.

RNID Action on Hearing Loss Northdown Road is registered to provide a domiciliary care and supported living service to support people who have a hearing loss and additional care needs. People who used the service were also living with a learning disability and or an autistic spectrum disorder. The agency covers Margate and the surrounding area. At the time of our inspection there were seven people receiving a supported living service.

A registered manager was 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 the inspection the registered manager was not available and was in the process of de-registering with us. The deputy manager had successfully been recruited to the manager position and was in the process of applying to become the registered manager. We will monitor this.

People were protected from abuse and avoidable harm. People who used the service told us that they felt they were supported safely. Staff had received training in safeguarding adults and were aware of their responsibility towards the people they supported. Staff were aware of the provider’s whistleblowing procedure and were confident in using it if required.

Risks associated with people’s health and well-being including safety issues within their homes, had been assessed and planned for. Staff had detailed information about how to manage and reduce known risks and these were monitored for changes. People had been involved in discussions and decisions about how risks were managed. They had copies of their risk plans that were presented in accessible communication format of their choice.

People who used the service were involved in the staff recruitment and selection process. The provider had safe recruitment processes that were followed to ensure as far as possible, only suitable staff were employed. Staff were carefully matched to people requiring support to provide the best outcome for people using the service. There were sufficient experienced and skilled staff available to support people safely and meet their individual needs.

People were involved in discussions and decisions about the support they required with taking their prescribed medicines. Staff had received appropriate training in medicines management. There were good systems and processes in place that supported people safely with the storage and administration of their medicines.

People were supported by sufficient and appropriately trained staff that were well supported.

Staff had received an induction and continued training and support, this enabled them to provide effective care and support to people who used the service.

People were involved in discussions and decisions about the support they required with taking their prescribed medicines. Staff had received appropriate training in medicines management. There were good systems and processes in place that supported people safely with the storage and administration of their medicines.

Staff demonstrated a good understanding of the Mental Capacity Act (MCA) 2005. This legislation is designed to ensure people are supported to make their own decisions wherever possible. People told us that they were consulted and involved in how they wished to be supported. Where people lacked mental capacity to make specific decisions about their care and support, MCA assessments and best interests had been made and recorded. However, the provider had relied upon external professionals to do this and needed to take this responsibility where required.

Where necessary people who used the service received support from staff to ensure their nutritional needs were met

We contacted the service prior to our inspection to agree a suitable time to inspect. At the time of inspection the registered manager was not available so we met with the deputy manager. We made these arrangements at short notice and to ensure that the deputy manager was available and because we needed access to the information and records to help us to form a judgement about the service's compliance with the regulations we inspect against.

The service provided 24 hour support for 7 people who lived in their own homes. The service provided personal care, supported living services for people with hearing loss who may have additional care needs, such as a learning disability,

We also spoke with three people who use the service, the deputy manager and three support workers.

We found that people were asked to give consent and were involved in the decisions about the care and support they received. People told us and indicated that they were asked for consent before any care took place and their wishes were respected.

People who used the service told us and indicated that they were happy with the care and support they received. People were relaxed and responsive in the company of staff. They were able to let staff know what they wanted and we saw staff respond in a caring and positive way.

People said that there were enough activities and that they enjoyed going out in the local area and doing different things. People's health needs were supported and the service worked closely with health and social care professionals to maintain and improve people's health and wellbeing.

People told us and records confirmed that medicines were given to people when they needed them and in a safe way.

We found that robust recruitment procedures were in place and staff received the training and the support they needed to fulfil their role.

People told us they did not have any complaints about the service. They were confident if they did the staff would take action to resolve any issues.

We made a planned unannounced visit to the agency office. During the inspection we spoke with the manager and the administrator. We also spoke with three care workers over the telephone. The agency started providing a service in September 2011. There was only a small amount of people in the community receiving personal care.

We were unable to speak to people who use the service at this inspection as they were unable to communicate over the telephone. We looked at other ways of gaining their views by looking at records kept by the agency and their systems for making sure people received a good quality of service delivered in the way they wanted.