The Risings is a five bedroom detached house on the outskirts of Exeter. The service provides accommodation and support for up to five younger adults with a range of complex learning and behavioural difficulties. At the time of the inspection there were four people living in the home. This was the first inspection of this service since it registered with the CQC on 11 July 2016 to provide support to people over the age of 18. Prior to this it was a children’s service inspected by OFSTED.

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. The registered manager was on annual leave on the day of the inspection, so we spoke with them on their return by telephone. The deputy manager was covering and available throughout the inspection.

There was a high level of confidence in the leadership and management of the service expressed by people, relatives and staff. Managers had a ‘hands on’ approach, and were always available to offer support and guidance. One relative told us how they had valued the support they themselves had been given when their family member moved into The Risings. The managers had told them, “Any problems you’ve got to run it by us”. They added, “I was there for nearly two hours. As a parent handing them over it’s difficult and they did help me. They told me, “Nothing’s changed except their address. You’re still their voice”.

The Risings had previously been the provider’s only service for children, which meant people needed to move into an adult placement when they were 18. Relatives and external professionals told us this had impacted negatively on those people affected and they had lost some of their skills and confidence. These people had wanted to return when The Risings re-registered as a service for adults, and were now beginning to regain the confidence and skills they had lost. This required a highly personalised and responsive approach, and relatives and health professionals confirmed the progress people had made.

The service placed a strong emphasis on a ‘person centred approach’, and ensured people, and their advocates where appropriate, were fully consulted and involved in all decisions about their lives and support. This meant people’s legal rights were protected. People’s individual communication needs were understood and all information provided in a format appropriate for them, which meant they could participate fully. We observed that staff were kind and caring and treated people with dignity and respect. A relative told us, “I can’t get over how all those people are treated so wonderfully…exactly the same whether they have family support or not…the young adults come first”.

Policies and procedures ensured people were protected from the risk of abuse and avoidable harm. Staff told us they had regular safeguarding training, and they were confident they knew how to recognise and report potential abuse. Staff were recruited carefully and appropriate checks had been completed to ensure they were safe to work with vulnerable people

There were enough staff deployed to meet people’s complex needs and to care for them safely. People were engaged in a variety of activities within the home and in the community and there were sufficient numbers of staff to support people to go out when they wanted to. This ensured people experienced a good quality of life. There had been some difficulty in recruiting staff to fill vacant support worker posts. The provider had reviewed pay and job roles, and at the time of the inspection a successful recruitment campaign was underway. It was anticipated the service would be fully staffed in the next few weeks.

A comprehensive induction and