This inspection started with an unannounced visit to the head office of West House on 18 October 2016. We then arranged a visit to one of their services on the morning of Saturday 22 October 2016 and we returned to the main office on 25 October 2016 to complete the inspection. The service was last visited 24 August 2013 and they were compliant with the legislation at this last inspection.

West House Domiciliary Service is part of West House. The organisation is a charitable trust which provides residential care and support in the community to people living with a learning disability. The provider has a number of small care homes, this domiciliary and supported living service and also operates cafes, a therapeutic centre, day centres and community contact hubs, and a market garden where people who use services can have work placements.

West House Domiciliary Service provides care and support in the Carlisle, Allerdale and Copeland areas. They support nearly sixty people who are living with a learning disability. Support is given in people's own homes and can range from a few hours a week to full support twenty four hours a day, seven days a week. Some people live in tenanted properties referred to as supported living. People in these supported living services share a home with other people with learning disability and there is a staff team who deliver the care and support to all of the people living in the property. Others live in their own properties, either on their own or with families, and are supported according to their needs.

The service had two registered managers. 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 service had good arrangements in place to ensure people who used the service were kept as safe as possible. Staff were trained to help prevent people from being subject to harm and abuse.

We saw that staff received good levels of training and supervision to help them to understand the issues around discrimination and human rights.

We had evidence to show that there were detailed and up to date risk assessments and risk management plans in place for all aspects of the service. The organisation had an emergency plan which was put into operation in December 2015 during the Cumbria floods.

There were suitable arrangements in place for staff to voice their concerns because the service had a 'whistleblowing' procedure and staff felt confident that they could approach management with any concerns.

Arrangements were in place to monitor any incident or accidents and the service was prompt in notifying the Care Quality Commission, safeguarding teams and social work staff.

Staffing levels were suitable to meet the needs of people using the service. New staff were appropriately recruited, given suitable induction, closely monitored and supervised for the first few months. Staff received good levels of training in a wide range of subjects. We saw that staff received this kind of support throughout their career and all aspects of staff development were given a high priority. Good disciplinary and grievance systems were in place.

Good arrangements were in place to help staff support people with their medicines. The staff managed all aspects of medicines management for some people and this was done well.

Staff received training and supervision in relation to infection control and good hygiene standards so that they helped people to have clean and safe homes.

The registered managers had a very good understanding of the Mental Capacity Act 2005 and were working with the local authority to ensure they had suitable arrangements in place where there was any suggestion that someone was being deprived of their liberty. There was

We spoke with people who received the support that West House provided. People told us, "They are looking after me very well. I am very pleased since they took over my care." Another person said, "They are all very good. They arrive on time and stay a bit longer if they can. They always ask if there’s anything else I need. I feel very well looked after." People told us they were involved in the development of their care and support plans.

The people we spoke with said that they did not have any concerns about the service. They told us that they knew who to contact at the office if they did have any concerns or problems.

From our observations we saw that people received the support they needed and were given choices about their care. We observed that staff treated people with respect. Staff encouraged people to maintain their independence and control over their lives. People were being supported to lead interesting and meaningful lives of their own choosing through the input of the agency.

We saw that the provider had an effective system to regularly assess and monitor the quality of service that people receive.They regularly asked people what they thought of the service and made changes in light of what people said.

We spoke with people who received the support that West House provided. People told us that they were "Very happy with the service" and that they "Have the same carers. They listen to what I have to say." The people we spoke with said that they did not have any concerns about the service. They told us that they knew who to contact at the office if they did have any concerns or problems.

People were involved in the development of their care and support plans. They told us that they knew what was recorded in their care plan and that “staff provide the support needed.” Saying, "All the staff are great" and "I do amazing things like go to college, have a job, go bowling and to the cinema and the gym. The staff help me to do all of this".

From our observations we saw that people received the support they needed and were given choices about their care. We observed that staff treated people with respect. Staff encouraged people to maintain their independence and control over their lives. People were being supported to lead interesting and meaningful lives of their own choosing through the input of the agency.