Three C's Support

Three C's Support provides care and support to young people and adults who are living with a learning disability and have mental health needs, people were supported in supported living accommodations in the London Boroughs of Hackney and Lewisham.

The supported Living settings in Newham, Merton and Wandsworth were no longer part of this Location.

We assessed the service against ‘Right support, right care, right culture’ guidance to make judgements about whether the provider guaranteed autistic people and people with a learning disability respect, equality, dignity, choices, independence and good access to local communities that most people take for granted.

The assessment took place over 1, 2 and 4 July 2026. We undertook site visits on these dates and included an out of hours visit. We completed this inspection to follow up on enforcement action taken after our September 2025 inspection, when we rated the service Inadequate, having identified significant shortfalls across the service and breaches of five regulations in relation to providing people with person centred care, safeguarding, staffing, dignity and respect and good governance.

Since the last assessment, the provider had implemented a new management structure giving clearer oversight of the quality and safety of people's support.

At this assessment, we found the provider had taken steps to improve the service. They had introduced new systems to strengthen quality assurance and oversight, improved medicines management, addressed environmental risks and reviewed staffing arrangements. The provider also introduced governance meetings and additional audits to improve oversight and identify risks.

However, the provider had not yet fully embedded these improvements or applied them consistently across all settings. Quality assurance systems and audits did not always identify the concerns we found, including in medicines management, safeguarding oversight, record keeping and risk monitoring. We recognise that the provider needed further time to implement these systems fully, embed them in staff practice and demonstrate that improvements could be sustained.

The provider had introduced electronic care records and we noted some improvement in the recording of information relating to people’s care. However, further work was needed to ensure records were consistently accurate, person-centred and up to date. Care records were often task-focused and did not consistently describe people’s wellbeing, experiences or outcomes.

Overall, the provider had made sufficient improvements for the rating to move from inadequate to requires improvement. However, they remained in breach of the regulation relating to good governance, and we identified 2 further breaches in relation to need for consent and safe care and treatment. Further work was required to ensure improvements were consistently implemented across all settings, embedded in staff practice and sustained over time, and that people received safe, effective and person-centred care.

People received compassionate and reliable support from regular staff who knew them well and understood their needs and preferences. Staff described the new managers as approachable and responsive. The new service manager responded positively to feedback and acted on concerns we identified during the assessment.

This service has been in Special Measures since September 2025. The purpose of special measures is to ensure that services providing inadequate care make significant improvements. The provider demonstrated improvements have been made. The service is no longer rated as inadequate overall or in any of the key questions. Therefore, this service is no longer in Special Measures.

At our last assessment we found the provider was in breach of 5 regulations. At this assessment we found the provider was no longer in breach of the regulations relating to person-centred care, safeguarding, staffing, and dignity and respect. However, the provider continued to be in breach of the regulation relating to good governance, and we identified 2 further breaches. These were in relation to need for consent and safe care and treatment. We have asked the provider for an action plan in response to the concerns found at this assessment.

Choice Support Three C's provides care and support to young people and adults who are living with a learning disability and have mental health needs. At the time of this inspection, 54 people were supported in supported living accommodations in five London boroughs, namely Hackney, Lewisham, Greenwich, Merton and Newham.

Choice Support merged with Three C’s support in April 2024. Prior to this, under the provider of Three C’s the service was rated Good in February 2019. This assessment was undertaken between 9 September and 23 September 2025. The rating of the service is now Inadequate.

We undertook this assessment following concerns we received about the quality of the care provided and failure to safeguard people. we have assessed the service in line with Right support, right care, right culture guidance We identified significant shortfalls across the service and breaches of 5 regulations in relation to providing people with person centred care, safeguarding, staffing, dignity and respect and good governance. In instances where CQC has begun a process of regulatory action, we may publish this information on our website after any representations and/or appeals have been concluded, if the action has been taken forward.

Although organisational policies and systems for quality assurance were in place governance systems were ineffective, resulting in extremely poor oversight of people’s care and a failure to safeguard them from ongoing abuse. Leadership and management were poor and inconsistent. Staff lacked training and did not receive an adequate induction or support through regular supervision. Staff felt vulnerable at times due insufficient staffing levels and felt unsupported by the provider and wider management team. This had contributed tolow staff morale. Risk assessments did not reflect the care people needed

There was lack of meaningful activity available to people to engage with. Restrictions were imposed on people which were not always based on people’s individual needs but due to insufficient staffing levels.

We were told by staff, relatives and partner agencies that there were not enough staff to meet people’s needs, preferences and manage risk.

The environment and cleanliness of properties varied but some exposed people to significant risks.

Record keeping needed to be improved. Partnership working needed to be improved to ensure people’s support was joined up and that the service was working together effectively with other organisations.

Given the multiple serious and ongoing issues the provider was taking steps to drive improvement. This included a voluntary suspension within one London Borough. Although a comprehensive and detailed improvement plan had been initiated, the actions that directly impacted on the quality and safety of people’s support had not yet been implemented.

Our overall findings, as reflected throughout this inspection report, highlight that the culture of the service needed to be addressed to ensure this influenced better experiences for people. Stable and consistent management was needed to make and sustain the improvements required.

This service is being placed in special measures. The purpose of special measures is to ensure that services providing inadequate care make significant improvements. Special measures provide a framework within which we use our enforcement powers in response to inadequate care and provide a timeframe within which providers must improve the quality of the care they provide.