Step by Step provides support to people with learning disabilities. The support is provided to people who live as tenants under a supported living scheme. A supported living scheme is one where people live in their own home and receive care and support in order to promote their independence. At the time of our inspection the service provided support to 31 people living in their own homes. However, only 15 people required support to meet their personal care needs. Therefore we only looked at the care and support received by those people. Step by Step provides other services which help people to live independently, such as assistance with shopping and enabling people undertake activities in the community. There is a log cabin facility in the grounds of its offices where staff support people with planned activities. People can also socialise with other people and staff in this area.

This inspection took place on 9 and 10 January 2017. The provider was given 48 hours’ notice that the inspection would be taking place. This was because the location provides a supported living service to people who are often out during the day; we needed to be sure that someone would be in.

The service was last inspected on 23 January 2014, when it was compliant with the regulations relevant at that time.

Two registered managers were employed at the service. 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.

Kind and caring staff ensured people received support that was responsive to their needs and as set out on their support plans. People were supported to attend a variety of events outside of their homes. Staff ensured people’s privacy and dignity was respected. Staff knew the people they supported well and ensured their preferences were met. Relatives were complimentary about the support provided by staff. One relative said “[person’s name] is happy living there, and that’s the main thing”.

People’s support plans described how staff were to support people. In particular they gave staff directions on how to manage any behaviours that may place the person or others at risk. Any risks to people were identified and plans put in place to minimise the risks. These risk assessments and management plans were used to support people to develop their independent living skills and become involved in leisure and educational activities to enable them to enjoy a more fulfilling life. For example, one person had wished to have driving lessons and had been supported to do so.

People’s support plans contained goals for each individual. One person told us how the service had supported them to become more independent and that had meant they needed less support.

People were supported to maintain a healthy balanced diet. They were supported to plan, shop for and prepare their meals. Staff ensured people’s health care needs were addressed. Everyone had an annual health check from their GP. People were supported to attend healthcare appointments when necessary.

People were protected from the risks of abuse. Staff knew how to recognise and report abuse both within the service and to outside agencies. Thorough recruitment procedures ensured the risks of employing unsuitable staff were minimised. Staff had a good understanding of the principles of the Mental Capacity Act 2005. However, there was no written evidence that people’s capacity to make decisions had been formally assessed, or that best interest meetings had been held where required.

Staff received training that helped them meet people’s needs. This included first aid and managing people’s specific health conditions. New staff received a thorough induction. Staff received regular supervision to support them in their role. St

Sarum offered a care, enabling and support service. At the time of our inspection there were twenty seven people receiving a service. People told us they felt well supported by staff.

We spoke with six people who use the service. we were told "I do well with staff support. They show me how to do things for myself". Another person told us "Staff support me when I'm anxious. Sometimes I don't know why I feel upset, but they help me until I feel better".

We spoke with two people who use the service who worked in the local community. One person told us that staff helped them to organise their day. The other person told us that staff have helped them to learn how to use public transport to get to and from work and how this has helped their independence.

We saw up to date care plans which considered individual needs. These plans contained risk assessments for all activities which were perceived to carry a potential risk. We saw that the service consulted with external agencies to access appropriate advice and support for each individual.

People were protected from harm and the risk of harm through staff training and detailed risk assessment of their daily activities. Staff we spoke with explained the safeguarding policy and procedure which included details of how to inform the safeguarding team and the Care Quality Commission as required.

We found that Sarum was offering an effective and enabling service to people, with good systems in place to monitor the quality of service, with an emphasis on continual improvement.

We spoke with two people who used the service. They indicated that they were happy with the way staff cared for them and that they were supported to live well in the community.

People’s consent to care was gained and we saw evidence that people received the care they needed. Staff had training in the Mental Capacity Act (2005) and Deprivation of Liberty Safeguards (DoLS) to ensure people's rights were protected.

We saw up to date plans of care which considered individual physical, emotional and mental health care needs. We saw risk assessments and that all documentation was kept up to date to ensure people had their changing needs met. We saw that the service consulted with specialists to ensure people had the benefit of expert advice.

People were protected from harm and the risk of harm through staff training and risk assessments. The service also referred safeguarding incidents to the local authority and to the Care Quality Commission as required