Castle Supported Living Limited

The care service continued to develop in line with good practice guidelines. The management and staff had redefined the values that underpin the service and everyone promoted the values. These values included choices, action, support, teamwork, local and everyone. The values enabled people with learning disabilities and autism using the service to live as ordinary a life as any citizen.

The types of services offered from this location include supporting people living in their own homes in single occupancy or shared housing. 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.

The inspection visit took place on 10 December and 17 December 2018 and was announced. The registered manager was given 48 hours' notice of the inspection, to ensure that she or other responsible people would be available to assist with the inspection visit.

At our last inspection, we rated the service Outstanding. On this inspection, we found the service had remained Outstanding. We found the evidence continued to support the rating of Outstanding and there was no evidence or information from our inspection and on-going monitoring that demonstrated serious risks or concerns. This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection.

There was a registered manager in place. A registered manager is a person who has registered with the CQC 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. Castle Supported Living is a registered charity and the registered manager whilst responsible for the day to day running of the service is accountable to a board of directors.

Staff demonstrated a genuine person centred culture. The registered manager had a robust and values based recruitment process in place. This helped to ensure that all staff recruited truly believed that people who have a learning disability should have the same opportunities and access to community resources as other citizens.

People who use the service were involved in the recruitment process either informally or being on the interview panel. All applicants are shown an video which has been made by people using the service. This provides an insight into what the service provides and helps to assess the prospective employees values.

A thorough and person-centred assessment process was in place resulting in detailed support plans. Everyone said their care needs were met and the service was very responsive. We saw very positive outcomes had been experienced by people.

Staff were carefully matched to people who use the service to ensure compatibility. Time and effort had been invested into matching the support worker with the person using the service. Staff displayed empathy and worked with people and their family members to understand how best to support them. People were put at the centre of everything the service provided. This helped ensure people's needs, wishes and hopes were understood and supported people to live fulfilled lives. The attitude and knowledge of staff and management clearly had a positive impact on people and their families. We saw evidence of good relationships that had developed between people using the service and staff members.

There was a strong commitment to continuous learning. A 12 month training plan was in place and staff went through an extensive induction programme. Families were invited to take part in training sessions. This was provided free of charge to assist with their understanding and to support their relative to have continuity of care as well as maximise the opportunities for people. People using the service had a core staff team to help provide them with continuity of care and develop trusting relationships.

Family members, staff and professionals described the service as being exceptionally well led.

Staff felt well supported and valued by the management team. They were confident in the management team's abilities and felt that their views would be listened to and actions taken where required.

The service went above and beyond to support families and people when in crisis. There was a strong emphasis on continually striving to improve the service. The registered manager and the management team were fully engaged with the running of the service. The registered manager and staff team continued to find innovative ways to improve the service and remained focused and enthusiastic in the way they provided care to the people they supported. This included the development of talking books. This creative idea was personal to the individual and helped them put their own words into a book format when they found it difficult to talk to someone face to face. The book was illustrated with the person's own pictures. The book was illustrated with the persons own pictures and recorded words. One book clearly provided instructions on how the person wanted their medication to be administered. Staff had an excellent appreciation of people's individual needs and constantly looked for inventive ways they provided care and interacted with people.

People received safe support with their medications that were well managed by all staff. Staff's competency to manage people's medicine was regularly reviewed.

The registered manager was proactive in supporting effective joint working with professionals and remained up to date with best practice guidance.

The service had strong links within the local community and there was overwhelming evidence of people attending local and national events of the awards and accolades that had been awarded to individuals and to the service. In addition a 'Pop Up Club' met weekly in a local community resource. Anyone could attend these workshops to talk about what was happening in the service, express their views and opinions, work on topics of interest, of just enjoy a chat and a brew.

People, their families, professionals and staff were engaged in the running of the service and encouraged to regularly feedback their views on the service delivery, and share ideas and suggestions on how the service

could be improved. Quality assurance questionnaires were used at every opportunity. We saw many creative ways of asking people for their views and opinions. All feedback forms were designed in an easy read and pictorial format in order that everyone could comment. Staff were skilled in helping people to express their views and communicated with them in ways they could understand. Feedback gathered was reviewed to support the registered manager and staff to ensure improvements could be made.

Staff were clear about their safeguarding responsibilities and knew how to recognise and report potential abuse. Staff carried out their roles and responsibilities effectively. Staff had an excellent understanding of managing risks and supported people to reach their full potential through consistent, personalised care.

Risks to people were robustly explored and recorded. The service supported people to have a full and meaningful life by using innovative ways to take positive risks and be actively involved in managing their own risks. People were supported by staff that were highly skilled, and knowledgeable about the person they were supporting.

Staff understood and followed the principles of the Mental Capacity Act 2005 (MCA) and people were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice.

A quality manager was a key part of the management team. There were robust systems in place to monitor the quality of the service.

People knew who to complain to if they were not satisfied with their care and we were told that appropriate action would be taken. People also had information about support from an external advocate should this be required.

Technology was used proactively to both support people's safety and communication needs.

The five questions we ask about services and what we found