United Response - Limborne Supported Living Services provides care and support to people living in two ‘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. At the time of our inspection 12 people were supported by this service.

This unannounced comprehensive inspection took place on 31 October 2017. At our previous inspection in November 2015 we found that the service was good over all but required improvement in relation to our question ‘Is the service safe’. This was because we identified that necessary safeguarding alerts about three incidents had not been made. This was a breach of the regulations.

At this inspection we found that staff understood local safeguarding procedures and their role in protecting people from abuse and avoidable harm. Records showed where concerns about people’s safety had been identified the local authority had been appropriately informed. This meant the service was no longer in breach of the regulations.

There were clear management structures at the service and the provider had ensured that the staff team had been appropriately support since the registered managers resignation. An interim manager was currently providing effective leadership to the staff team and interviews for the permanent manager’s position were planned for the day following our inspection. We were subsequently informed that a new manger had been appointed, who would apply to the commission to become the service’s 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.

People and their relatives told us they felt safe and well cared for by the staff team who they got on with well. Their comments included, “We get on very well with the staff that are here,” “The staff are very kind, caring and welcoming” and “They are looking after me.” A health and social care professional told us, “I consider the service to be very safe and caring for the tenants they support.”

Staff had the skills and experience necessary to meet people care needs. The service operated an extensive induction process and staff training was updated regularly. Relative told us, “They don’t just let new staff get on with things. They have a new staff member and I think she has done three months of supervision” and “The training that they get seems quite good” While staff commented, “We are always going on training.”

Recruitment practices were robust and there were sufficient staff available to meet people’s care needs. Staff rotas showed planned staffing levels were routinely achieved. The service had one full time staff vacancy at the time of this inspection and agency staff had been used to cover some shifts. People had expressed concerns about the use of agency staff to cover weekend shifts and the acting manager was working to resolve these issues and a new member of permanent staff had been appointed. People told us, “There are enough staff” and staff commented, “We are never understaffed.”

Staff and the interim manager understood the requirements of The Mental Capacity Act 2005 and the importance of respecting people’s decisions and choices. During the inspection, at both addresses, we observed staff supporting people to make choices and respected their decisions. Care plans provided staff with guidance on how to support people with decision making and staff told us, “[People] all chose what they want to do.”

Staff knew people well and understood their individual care and support needs. People’s care plans provided s

This inspection took place on 15 September 2015 and was announced.

Limborne Supported Living Services is registered to provide personal care to people in a supported living environment. These were two houses where people had their own bedrooms and shared the communal living areas such as bathrooms, dining rooms, lounges and kitchen. Each person had a tenancy agreement for their accommodation. People were supported with their personal care and assisted to live independently. At the time of the inspection a service was provided to 11 people aged between 23 and 62 years with needs related to a learning disability or mental health.

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.

People were not always adequately protected from abuse or harm that may breach their human rights. Whilst the service had policies and procedures for reporting any safeguarding concerns, incidents were not always fully looked into and consideration given to making referrals to the local authority safeguarding team for investigation.

Risks to people were assessed and recorded, such as when they went out independently. There was corresponding guidance on how staff should support people so they could take part in activities and maintain their independence.

Sufficient numbers of staff were provided to meet people‘s needs. Pre-employment checks were made on newly appointed staff so that only staff who were suitable to provide care were employed.

People received care from staff who knew people’s needs well and were able to communicate effectively with people so they could provide care in the way people preferred. Staff had access to a range of relevant training courses and said they were supported in their work.

People were involved in choosing and cooking their meals. This was done with the support and guidance of staff so people had a healthy diet.

People’s health care needs were assessed and recorded. Care records showed people’s physical health care needs were monitored and that people had regular health care checks.

Staff had positive working relationships with people and demonstrated a caring attitude. People were consulted about the way they wished to be assisted.

People were invlolved in any assessment of their needs and in care planning to meet those needs. Regular care reviews took place which people took part in so people’s changing needs could be accommodated. People’s prefernces were central to how people were supported. This is called person centred care.

People were supported to attend a range of activities including supported employment, social activities, holidays and outings.

People had opportunities to raise any concerns which were listened to and acted. Relatives said any concerns raised were promptly acted on.

Staff were committed to their work and demonstrated values of compassion and respecting people. The service promoted people being empowered to make decisions about their lives and to develop independence. People were able to contribute to decisions about the service such as staff recruitment.

A number of audit tools were used to check on the effectiveness, safety and quality of the service. This included seeking the views of people and relatives..

We found a breach of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see what action we told the provider to take at the back of the full version of this report.