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Inspection carried out on 10 October 2018

During a routine inspection

The inspection of Santa Care took place on 10 October 2018 and was unannounced.

Santa Care is a care home. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. The Care Quality Commission (CQC) regulates both the premises and the care provided, and both were looked at during this inspection. Santa Care provides care and support for up to five women who have learning disabilities, some of whom live with mental health conditions. At the time of our inspection five people were using the service.

The care service has been developed and designed in line with the values that underpin the Registering the Right Support (RRS) 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.

The care home is owned and managed by Santa Bapoo, an individual who owns two other care homes in North West London. There is no requirement for a separate registered manager for this location. On the day of the inspection there were five people using the service. Public transport and a range of shops and other amenities are located close to the home.

At our previous comprehensive inspection on the 1 and 4 March 2016 we rated the service 'requires improvement' area of Safe. This was because we identified one breach of legal requirement because there were insufficient numbers of staff deployed to meet people’s needs and keep them safe. During a follow-up focused unannounced inspection on the 1 December 2016 we found that the provider had taken action to ensure that there were always sufficient staff on duty and therefore had addressed our concerns. Whilst improvements had been made, we did not revise the rating for the key question Safe, because to improve the rating to Good we required a longer-term track record of consistent good practice.

During this inspection we found there were no breaches of the regulations of the Health and Social Care Act (Regulated Activities) Regulations 2014, and we rated the service overall as Good.

All the people using the service told us that they felt safe, were happy living in the home and satisfied with the care and support that they received from staff.

Staff were knowledgeable about people’s needs and engaged with them in a respectful, sensitive and encouraging manner. Staff had a caring approach to their work and understood the importance of treating people with dignity, protecting people's privacy and respecting their differences and human rights.

People's care plans were up to date and personalised. They included details about people’s individual needs and preferences, and guidance for staff to follow so people received the care and support that they needed and wanted.

People had the opportunity to choose, plan and take part in a range of activities that met their interests and needs.

Appropriate staff recruitment procedures were in place so that only suitable staff were employed. Staffing levels and skill mix provided people with the assistance and care that they needed.

Staff received the training and support that they required to carry out their roles and responsibilities in meeting people’s individual needs and supporting their independence.

People’s medicines were managed safely. People were supported to access the healthcare services they needed. Staff liaised closely with healthcare and social care professionals to ensure that people’s health, medical and care needs were met.

People told us that they enjoyed the meals provided by the service. Their dietary needs and preferences were accommodated by the service.

Staff understood their obligations regarding the Mental Capacity Act 2005 (MCA). 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

Inspection carried out on 1 December 2016

During an inspection looking at part of the service

We carried out an unannounced comprehensive inspection of this service on1 and 4 March 2016. At which a breach of legal requirements was found. This was because the provider did not always ensure there were sufficient numbers of suitably qualified, competent, skilled and experienced persons deployed at all times in order to meet people’s needs and keep them safe.

After the comprehensive inspection, the provider wrote to us to say what they would do to meet legal requirements in relation to the breach. We undertook an unannounced focused inspection on the 1 December 2016 to check they had followed their plan and to confirm that they now met legal requirements.

This report only covers our findings in relation to this topic. You can read the report from our last comprehensive inspection, by selecting the 'all reports' link for Santa Care on our website at www.cqc.org.uk

Santa Care is registered to provide accommodation and personal care for 5 adults. who have a learning disability and/or mental health needs. The home is owned and managed by Santa Bapoo, an individual who owns two other care homes in North West London. There is no requirement for a separate registered manager for this location. On the day of our visit there were five people living in the home. Public transport and a range of shops and other amenities are located within walking distance of the service.

At our focused inspection on the 1 December 2016, we found that the provider had followed their plan and legal requirements had been met. The provider had taken action to address our concerns about there being insufficient numbers of staff on duty to ensure people were safe and their needs and preferences were met at all times. The provider had provided an additional care worker to work in the service each day to deliver the support and care people needed including enabling people who needed support from staff to access community facilities if they wished to do so.

Inspection carried out on 1 March 2016

During a routine inspection

This unannounced inspection of Santa Care took place on the 1 and 4 March 2016. At our last inspection on 18 and 19 the September 2013 the service met the regulations inspected.

Santa Care is registered to provide accommodation and personal care for 5 adults. The home provides care for people who have a learning disability and/or mental health needs. The home is owned and managed by Santa Bapoo, an individual who owns two other care homes in North West London. There is no requirement for a separate registered manager. On the day of our visit there were five people living in the home. Public transport and a range of shops are located within walking distance.

The atmosphere of the home was welcoming. People were treated with respect and staff engaged with people in a friendly and courteous manner. Throughout our visit we observed caring and supportive relationships between staff and people using the service. People’s privacy and dignity were respected.

Staff understood how to safeguard the people they supported. People’s individual needs and risks were identified and managed as part of their plan of care and support. However, we found that there were not sufficient numbers of care staff deployed at all times to meet people’s needs and to make sure they and staff were always safe.

Care plans were personalised and reflected people’s current needs. They contained the information staff needed to provide people with the care and support they wanted and required.

People were encouraged and supported to make decisions for themselves whenever possible and their independence was promoted. People were provided with the support they needed to maintain links with their family, friends and advocates.

People were supported to maintain good health and their well-being was promoted. They had access to appropriate healthcare services that monitored their health and provided appropriate support, treatment and advice when people were unwell. People were provided with a choice of food and drink which met their preferences and dietary needs.

Staff were appropriately recruited, trained and supported to provide people with individualised care and support. Staff told us they enjoyed working in the home and received the support they needed to carry out their roles and responsibilities.

Staff understood the legal requirements of the Mental Capacity Act 2005 (MCA) and Deprivation of Liberty Safeguards (DoLS). They knew about the systems in place for making decisions in people’s best interest when they were unable to make one or more decisions about their care and/or other aspects of their lives.

There were systems in place to regularly assess, monitor and improve the quality of the services provided for people.

We found one breach of the new Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.

Inspection carried out on 18, 19 September 2013

During a routine inspection

All the people who lived at Santa Care did not have English as their first language, but most had some understanding of English. All the staff in the home spoke Gujarati or Hindi, and care plans for communication provided information on each person�s preferred language and how they communicated. Everyone who we met and spoke with during the inspection was able to understand our questions and to reply using spoken language and sign language.

The care plans were written taking each person�s views and preferences into account, and provided detailed information on the support needed to meet their personal and healthcare needs.

Care plans contained information on the activities in the home and community that each person enjoyed, including visiting the temple or mosque and support for daily prayers. One person told us about the celebrations planned for Diwali at their day centre. They said that they enjoyed cooking meals at the home, and staff supported them with this.

The provider had taken steps to provide care in an environment that was suitably designed and adequately maintained. Our inspection of 27 October 2012 found that the premises were not adequately maintained. On this occasion we saw evidence that the provider had had taken action on all the improvements that we recommended at the last inspection.

Inspection carried out on 27 October 2012

During a routine inspection

We spoke with three people who use the service, one relative and one member of staff to get their views about the service that is provided in the home. People were satisfied with the standard of care and support they received and with the way their independence was promoted. We observed that people were encouraged to maintain independent living skills and to take part in the daily life of the home.

People said that staff talked to them about their care and support and asked them about their views. One relative confirmed they were involved in the care of their family member. People told us of their involvement in the local community and about the arrangements in the home for them to take part in festivities and celebrations according to their cultural backgrounds. Some said they went to day centres and one person reported that they had a volunteering job that they enjoyed. They all told us they go for walks and shopping around the area where they lived.

Whilst, most areas of the home were well maintained and decorated we also found some areas that needed to be redecorated and made good. Some of these were identified during a previous inspection and had not yet been addressed.

Inspection carried out on 11 March 2011

During a routine inspection

People told us that they are able to make choices in their daily life. During our visit we observed that people were asked about their choices. They were involved in the daily life of the home such as meal preparation and cleaning of the home. A person said that they enjoy making hot drinks for other people and visitors to the home

Another person told us that they enjoy their work in the local community and others said that they enjoy going to the day centre. We observed that people were able to go out in the local community on their own and according to their risk assessment.

People reported that they were satisfied with the support that they get from staff in the home. They said that they would speak with staff if they have any concerns and that there is always a member of staff that they could speak to. Despite English not being the first language of people who use the service, they said that members of staff are able to communicate with them, as most staff who work in the home are able to communicate in the same ethnic language as them.

People reported that they chose the colour scheme of the communal areas and of their individual bedrooms. We found that many areas of the home have been recently redecorated but not fully completed. People were pleased with their �home� and showed us around. We observed that they relaxed in the home by engaging in activities that they chose for themselves. For example some watched TV, some wrote, others talk to other people and staff and one dusted the lounge area.

Reports under our old system of regulation (including those from before CQC was created)