Reach Housing & Enablement Services Limited

This service provides care and support to people living in nine 'supported living' settings, so that they can live in their own home 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.

The care service has been developed and designed in line with the values that underpin the Registering the Right Support and other best practice guidance. These values include choice, promotion of independence and inclusion. People with learning disabilities and autism using the service can live as ordinary a life as any citizen.

At our last inspection in August 2015, the service was rated 'Good'. At this inspection we found that the service remained 'Good' in Safe, Effective and Caring and had improved to 'Outstanding' in Responsive and Well-led key questions.

The service had a registered manager in place at the time of our inspection. 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 remained safe because staff were aware of their roles and responsibility of how to support people to remain safe. The registered provider had systems and processes in place to support people from the risks of abuse and avoidable harm. Risks associated to people's needs had been assessed and planned for and were reviewed to ensure staff had up to date information. People were supported to live in a safe environment. People received support from a team of staff that provided consistency and continuity. Safe staff recruitment checks were carried out before staff commenced employment and people who used the service and or relatives, were involved in the recruitment of staff. People received appropriate support with the administration, storage and management of their prescribed medicines. Staff were aware of the importance of infection control measures and had received appropriate training.

People continued to receive an effective service. 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. People were supported by staff that had received an appropriate induction and ongoing support and training. The registered manager used best practice guidance to develop and support staff to provide effective care and support. The principles of the Mental Capacity Act (2005) were followed when decisions were made about people's care. People were supported to plan, shop and cook meals as fully as possible. Staff were aware of people's nutritional needs and promoted health

eating. Systems were in place to share information with external services and professionals when required. People received appropriate support to maintain their health. Staff worked with external healthcare professionals to achieve good health outcomes for people.

People continued to receive good care. Relatives spoke positively about the approach of staff whom they said were kind, caring and compassionate. People were involved as fully as possible in their care and support and staff respected their privacy and dignity. Independence was promoted and staff had a good understanding of people's diverse needs, preferences, routines and personal histories. People were supported to access different types of advocacy support when required.

People received an outstanding responsive service. People were involved as fully as possible in their care and support. People's support plans focussed on their individual needs, creating a person centred approach in the delivery of care and support. Regular meetings were had with people to discuss their care and support and the activities they wanted to participate in. This included an annual holiday of their choice. People were supported to participate in activities, interests and hobbies that were important to them. Staff had been creative and had used innovative approaches to support people with their dreams and aspirations. Staff promoted people's independence and people were active citizens of their local community. People received opportunities to develop their social and friendship circle. Staff used effective communication methods to support people's sensory and communication needs. People had access to the registered provider's complaints procedure that was presented in an appropriate format. Additional and creative ways had been developed for people to share their views about the service. People's end of life wishes had been discussed with them.

The service was outstanding in being well-led. The registered manager had developed an open and inclusive service, they had a clear vision and set of values based on social inclusion that the staff fully understood and adhered to. Staff felt listened to, supported and involved in the development of the service. People who used the service and relatives received opportunities to share their views, experience of the service and were involved in developing the service further. Audits were carried out and action plans put in place to address any issues which were identified. The service had been successful in achieving the National Autistic Society Autism Accreditation.

Accidents and incidents were recorded and investigated. The provider had informed us of notifications. Notifications are events which have happened in the service that the provider is required to tell us about.

The five questions we ask about services and what we found