This inspection took place on 24 February 2017 and was announced. This service was rated ‘good’ at our last inspection in February 2015. This service provides personal care and support to people living in supported living schemes across the London boroughs of Hounslow, Richmond, Hillingdon, Kingston and Wandsworth. At the time of our inspection there were 45 people using the service. The service was required to have a registered manager in post and did not have one at the time of our inspection. However, a service manager was in post and was in the process of applying for their registration. We confirmed that this process was completed shortly after our visit and the manager's status was updated to registered. 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 manager of this service had worked for the same provider for a number of years and was already familiar with the service when they came into post.
People had built very good relationships with staff, who were friendly and respectful and who knew people well. The service used creative and innovative methods of supporting people to express their views and make choices about their care, including the use of accessible technology where needed. Staff made an effort to learn how to communicate with people whose first language was not English.
The service had a strong commitment to promoting people’s privacy, dignity and independence. People had access to private space whenever they needed it. Staff worked closely with people to build their confidence and learn to do more for themselves.
The provider used a person-centred approach to care planning based on evidence-based measures of quality of life. Support plans were personalised and centred around people’s preferences, views and experiences as well as their care and support needs. They took into account people’s history, family relationships and religious and cultural needs. People’s care and support was planned in such a way as to facilitate working towards their goals and ambitions. The provider recognised people’s achievements and encouraged them to always improve by setting new targets whenever their care was reviewed.
People received support to engage in a variety of activities to suit their tastes and abilities, both at home and in the wider community. This included taking more responsibility for their own household tasks but also pursuing their interests and hobbies, making new friends and finding new interests. Staff supported people to pursue education and employment opportunities and to join social groups. They actively supported people to strengthen existing friendships and arranged activities to help ensure people did not lose touch with their friends.
People were satisfied with how the service responded to their complaints and concerns. There was an accessible complaints procedure and records showed the manager dealt with complaints according to the procedure. Managers sought people’s feedback in accessible ways, giving equal opportunities to people who did not communicate verbally.
Staff took pride in the provider’s visible person-centred culture with a clear vision, strong values and a reputation for providing good support to people with learning disabilities. Leadership was accessible and people, staff and others involved with the service had opportunities to express their views about the service. Managers used people’s feedback to improve services in a variety of ways.
The registered manager used several tools to assess, monitor and improve the quality of the service including internal audits carried out by people who used similar services operated by the same provider. They assessed the quality of the service against standards that were based on people’s feedback about the care and support they wanted from services. People were also involved in the recruitment and selection of new staff. The provider worked to challenge discrimination and stigma in a variety of ways, including supporting people to publish articles about their experience of discrimination.
Staff knew how to keep people safe, because there were detailed risk management plans to reduce risks. Staff supported people to make sure their homes were safe. They received suitable training in safeguarding people from abuse and there were procedures in place to protect people from financial and other abuse. Medicines were managed safely.
There were enough staff to keep people safe and appropriate arrangements for emergency staff cover. Recruitment processes were designed to ensure only suitable staff were selected to work with people.
People benefited from being cared for by staff who received suitable, good quality training that was relevant to their work. Staff received regular support from managers and had opportunities to learn and discuss good practice with their colleagues.
Staff were aware of their duties under the Mental Capacity Act 2005. They obtained people’s consent before carrying out care tasks and followed legal requirements where people did not have the capacity to consent.
Staff supported people to choose food they liked and to eat healthily. Staff ensured people had the information they needed to maintain a healthy lifestyle whilst respecting their choices about how they wanted to live. People had detailed plans to help staff and health professionals provide the care and support they needed to remain healthy and manage any existing health conditions.