The inspection took place on 5 and 7 December 2017. The inspection was an announced inspection.

The Old Exchange provides care and support to people with a learning disability or autistic spectrum disorder living in a supported living setting 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.

People using the service lived in a house in ‘multiple occupation’ shared by eight people near Tunbridge Wells in Kent. Houses in multiple occupation are properties where at least three people in more than one household share toilet, bathroom or kitchen facilities.

People had a tenancy agreement and were supported by the same staff team providing their personal care and support to also successfully manage their housing and tenancy arrangements. People had their own bedroom which they could lock with a key and shared all communal areas such as lounges, kitchen and bathrooms. The service was in a residential street, close to shops and public transport so people could easily access community facilities. An office was situated on the premises to store confidential information and provide a private space where people could meet health and social care professionals and hold care plan reviews. The office had a sofa where people were welcome to sit whenever they wished. Due to the nature of the support needs of people, a member of staff slept on the premises each night and a bedroom was set aside for this purpose.

The service was previously registered with CQC as a residential home to provide accommodation with personal care. This was the first inspection since the provider cancelled that registration and registered to provide personal care and support within a supported living setting.

A registered manager was not employed at the service as the previous registered manager had left. A new manager, who was already employed by the provider within another setting was in the process of completing their application to register with CQC for this 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. The new manager would not be based on the premises, however a team leader was employed to carry out the day to day running of the service. The team leader would report directly to the new manager and in the meantime was reporting to the provider.

Staff were aware of their responsibilities in keeping people safe and reporting any suspicions of abuse. Staff knew what the reporting procedures were and were confident their concerns would be listened to.

Individual risks were identified and management plans to reduce and control risk were comprehensive, making sure people and staff had the guidance they needed to prevent harm while at the same time supporting independence. Accidents and incidents were recorded in detail by staff with actions taken. The provider monitored incidents to learn lessons from and support people to prevent accidents.

The processes for the administration of people’s prescribed medicines was managed and recorded well so people received their medicines as intended. Regular audits were undertaken to ensure safe procedures were followed and action was taken when errors were made.

Initial assessments were undertaken with people before they moved in to the service to make sure their assessed needs could be met and to inform the care plan. People and their relatives were involved in the development and reviewing of their care plans. People’s specific needs were taken account of and addressed in care planning and in practice to ensure equality of access