Ryde House Outreach provides support to people living with a learning disability, to access the community and provide respite for their main carer. Not everyone using Ryde House Outreach Service received a 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.

Our inspection was based on the care and support provided to fourteen people receiving personal care, with three of these being young people. Each person received a variety of care hours from the agency depending on their level of need. Some people had a learning disability or autism and were living in individual supported living flats; they required support to enable them to retain a level of independence. Other people were receiving support in their own home or to access activities in the community.

This inspection was conducted on 30 and 31 August 2018 and was announced. We gave the provider two working days' notice of our inspection as we needed to be sure key staff members would be available.

We last inspected the service in March 2017 when we did not identify any breaches of regulation, but rated the service as 'Requires improvement'. At this inspection, we found improvements had been made.

There was a registered manager in place. A registered manager is a person who has registered with the CQC 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 home is run.

There was a genuine person-centred culture, where staff displayed empathy and worked with people and their family members to understand how best to support them. People were put at the centre of everything staff did, to help ensure their needs, wishes and hopes were understood and to help them to live fulfilled lives. The attitude and knowledge of staff and management clearly had a positive impact on people and their families.

There was a strong emphasis on continuity of care and learning, to maximise the opportunities for people. Training and guidance for families was provided free of charge to assist with their understanding and to support their relative to have continuity of care. People were provided with core staff teams to help provide them with continuity of care and develop trusting relationships.

Family members, staff and professionals described the service as being exceptionally well led. Staff felt well supported and valued by the management team. They were confident in the management team’s abilities and felt that their views would be listened to and actions taken where required.

The management team and staff had developed exceptionally positive and supportive relationships with family members. The service went above and beyond to support families and people when in crisis.

There was a strong emphasis on continually striving to improve the service. The provider was fully engaged with the running of the service. The registered manager was proactive to support effective joint working with professionals and remain up to date on best practice guidance.

People, their families, professionals and staff were engaged in the running of the service and encouraged to regularly feedback views on service delivery, and share ideas and suggestions on how the service could be improved. Quality assurance questionnaires were sent to people, their families, staff and professionals annually. Feedback gathered was reviewed to support the registered manager and staff to ensure improvements could be made.

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. There was overwhelming evidence that the core values of choice, promotion of independence an

Ryde House Outreach provides support to people, living with a learning disability, to access the community and provide respite for their main carer. At the time of our inspection the service was providing support to 31 people within the community. However, only four of those people were receiving a personal care service, which is regulated by the Care Quality Commission and subject of this inspection.

The inspection was carried out by one inspector on 18 May 2017 and 23 May 2017. The provider was given two days’ notice because the location provides a domiciliary care service; we needed to be sure someone would be in.

The service did not have a registered manager. This was because the previous registered manager had recently left and the manager who had taken over had not yet completed their registration process with the Care Quality Commission (CQC). A registered manager is a person who has registered with the CQC 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 home is run.

The systems in place to monitor the quality and safety of the service were not robust. People were supported by staff who understood their needs. However, their care records were not always personalised, accurate or up to date.

Although staff followed legislation designed to protect people’s rights, the assessment of their capacity and how they make decisions was not always documented.

People were supported to take their medicine by staff who had been trained and assessed as competent. However, best practice guidelines were not always followed in respect of hand written documentation and the use of pain assessment tools.

The new manager, who had been in post for four weeks, had recently completed an audit of the service, which they presented to the provider. Although the manager had identified these areas for improvement during their audit it was too soon for all of the actions to have been completed and the new practices to be embedded into the service.

People’s families told us they felt their relatives were safe. Staff and the manager had received safeguarding training and were able to demonstrate an understanding of the provider’s safeguarding policy and explain the action they would take if they identified any concerns.

People were supported by staff who had received an induction into the service and appropriate training, professional development and supervision to enable them to meet people’s individual needs. There was enough staff to meet people’s needs and support them to engage in the activities they wanted to do.

Staff were aware of the risks relating to people and how to manage them. Healthcare professionals such as GPs and district nurses were involved in people’s care when necessary.

Staff developed caring and positive relationships with people and were sensitive to their individual choices and treated them with dignity and respect.

There was an opportunity for people’s families to become involved in developing the service and they were encouraged to provide feedback on the service provided through spot checks and service reviews.

People’s families told us they had seen an improvement since the new manager had arrived and felt the service was well led. The provider had arrangements in place to deal with any concerns or complaints.

Staff were aware of the provider’s vision and values, how they related to their work and spoke positively about the culture and management of the service.