This inspection took place on 13 and 19 September 2018 and was announced. The provider was given 48 hours' notice of our inspection, because this is a small service and we needed to be sure that someone would be in.

St John of God Care Services Supported Living provides care and support to people 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 service supports people living within Richmond, Catterick Village and Leyburn and specialises in supporting people with a learning disability or autistic spectrum disorder. At the time of our inspection 25 people received support.

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.

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.

Whilst staff had completed some training essential to their role, training specific to the needs of the people who used the service had not been provided. This included epilepsy and positive behaviour support training. We have made a recommendation about the provider ensuring staff received the specialist training required. For one person who was responsible for assessing the competency of the staff with their medicines support, they themselves had not had their competency assessed since 2015. Whilst mental capacity assessments were completed around medicines support, people’s mental capacity in other areas of their lives had not been assessed, when the person was thought to lack capacity. Best interest decisions had not been recorded to demonstrate professionals and relatives had been included in discussions about the person’s care and the actions taken were in the person’s best interest and the least restrictive option. Staff received supervisions, however appraisals had not been completed.

The quality assurance checks completed had not identified some of the issues we highlighted during our inspection, including staff having not completed all necessary training, appraisals having not been completed and mental capacity assessments not in place. The registered manager and provider were responsive to the issues raised and were in the process of developing their quality assurance tools to ensure the safety of the people who used the service. The management team promoted a person-centred culture and demonstrated they wanted the service to continually improve.

People told us they felt safe. Staff understood the actions to take in the event of an accident or incident or if they had any safeguarding concerns for people. Risk assessments were in place when there was an identified risk, however we found for one person their risk assessment had not been updated following a fall. This was completed between day one and two of our inspection. There were sufficient staff in place to meet people’s needs and to simply spend time with another engaging in activities. People received their medicines as required. For one person, protocols for their as and when needed medicines were not all in place. Staff undertook their medicines training and had their competency assessed.

Although consent forms were not in place, staff did seek people’s consent and understood the importance of this. People were supported to eat a diet of their choosi

This inspection took place on 20 January 2016. The previous inspection took place on 18 December 2013, when the service was compliant with the regulations assessed at that time.

St John of God Care Services Supported Living is coordinated from an office base located on the Aske Hall Estate, near Richmond. The service provides supported living services to people living in Scorton, Leyburn and Catterick Village. The service is registered as a supported living service and provides the regulated activity ‘personal care’ to people living with learning disabilities and autism.

At the time of this inspection the service supported 28 people and employed 47 staff who were involved in providing the regulated activity.

The service had a registered manager, who had been registered with us since October 2010. 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.

People who used the service and relatives told us that the service was safe. People were protected by staff who were aware of safeguarding procedures and could demonstrate how they had taken action to safeguard people when necessary. People who used the service, relatives and staff also told us that the registered manager and management team listened and acted on feedback.

Safe arrangements were in place for staff recruitment, with people who used the service being involved in the recruitment process. Staff rotas were organised in advance and ensured that enough staff were available to keep people safe. Where agency staff were used information about their qualifications and experience was obtained, they were introduced to the service and used regularly to help maintain continuity.

The service had health and safety related procedures, including emergency plans, in place. Systems for reporting and recording accidents and incidents, including detailed reviews and actions, were in place.

The care records we looked at included detailed individual risk assessments and management plans. Risk had been managed collaboratively and in a way that helped to maintain people’s independence.

Safe systems were in place for assisting people with medicines, where this was part of their agreed care plan. Detailed information was available about people’s medicines and the support they needed. Records and discussions with staff evidenced that that staff were trained and checks took place to ensure medicines were being given safely.

Staff had been provided with training and support to help them carry out their role. This included specialist training relevant to the needs of the people staff were supporting. Staff told us they were well supported and monitored by the registered manager and other staff.

The support people needed with eating and drinking was detailed in their care and support plan and professional advice had been sought if people had additional nutritional needs. People were involved in meal planning and food preparation where possible, and enjoyed regular ‘take away’ nights.

People’s care records included detailed information about their health and wellbeing, so that staff were aware of information that was relevant to their care. Relevant health care professionals had been involved when needed and people had been supported to make decisions about their health and treatment options.

People and their relatives told us that staff were caring and treated them well. Staff were able to describe how they worked to maintained people’s privacy and dignity. We saw examples of people being supported to maintain their privacy and independence.

People’s care records showed that their needs had been assessed and planned in a detailed and person centred way. People who used the service and their relatives told

We carried out this inspection by visiting people in thier own supported living scheme and also by visiting the premises where the business is operating from. We saw that people experienced care, treatment and support that met their needs and protected their rights. People who were receiving a service told us they were happy with the care and support they received. Comments included "I get the help I want, when I want it" and " I like everything, I would not change a thing. I am always listened too and I know that everyone wants what's best for me."

People who used the service were protected from the risk of abuse, because the provider had taken reasonable steps to identify the possibility of abuse and prevent abuse from happening. Detailed policies for safeguarding and whistle blowing were in place for staff to follow and refer too. We saw appropriate referrals were made to the Local Authority Safeguarding Teams.

Staff received appropriate professional development. Staff told us they received a good level of support and training to enable them to carry out their role and were supported in their personal development.

The provider had an effective complaints system in place that was accessible to everyone and was available in different formats, such as pictorial and written.

People told us that they felt supported and cared for. They said staff were very kind and helpful.

People we spoke to were happy with the care and support they received. Comments made by people who use the service included 'they let us take our time', 'I like living here' and 'quite happy really, good stuff'. People told us that staff were nice, polite and respected their privacy. For example one person said that staff always knocked before entering their bedroom and 'they don't just barge in, just in case you are doing something'. People also told us that they liked their staff and were happy with the support their received. During our visits we observed that staff interacted nicely with the people they were supporting and the atmosphere in the houses seemed relaxed and friendly. People we talked to described the staff as 'really good', ‘scrumptious’ and said they were nice and polite.

Staff who work for the service felt that they were well trained and supported. Comments made by staff included ‘they try to help you out as much as they can and any problems get sorted straight away’, ‘they are very supportive the management here’, ‘training is brilliant’ and 'I think it’s really good’. Staff also thought that people received a good service, with comments including 'I think the tenants get a lot of support', 'they are lovely houses and they get supported to the best they probably can be' and 'the support here I think is good, they don't do without anything'.

We contacted North Yorkshire County Council's contracts department to see if they had any concerns or comments to make about the service. They confirmed that they were not aware of any concerns about the service, the care people are receiving or how the service worked with them. We also contacted a number of other professionals to ask about their experiences of the service. Comments made to us included 'the staff are always courteous, friendly and are knowledgeable about the individual residents. They refer appropriately and report on progress of planned care treatments. We have a good working relationship and have no concerns regarding the care provided' and 'they are very good at acting on the advice given and support the clients accordingly. In my experience I have always felt that staff were mostly competent and experienced and familiar with the clients that I see. They are always polite, helpful and accommodating’. We have received no concerns as a result of our enquiries.