17 Walsworth Road is registered to provide accommodation and personal care for up to six adults with learning disabilities. At the time of our inspection there were five people using the service, however, three of them were away on holiday.

At the last inspection, the service was rated Good.

At this inspection we found the service remained Good.

People using the service felt safe. Staff had received training to enable them to recognise signs and symptoms of abuse and felt confident in how to report them.

People had risk assessments in place to enable them to be as independent as they could be in a safe manner. Staff knew how to manage risks to promote people’s safety, and balanced these against people’s rights to take risks and remain independent.

There were sufficient staff, with the correct skill mix, on duty to support people with their needs. Effective recruitment processes were in place and followed by the service. Staff were not offered employment until satisfactory checks had been completed. Staff received an induction and on-going training. They had attended a variety of training to ensure they were able to provide care and support based on current best practice. They were supported with regular supervisions.

Medicines were managed safely. The processes in place ensured that the administration and handling of medicines was suitable for the people who used the service.

People were supported to make decisions about all aspects of their life; this was underpinned by the Mental Capacity Act 2005 and Deprivation of Liberty Safeguards. Staff were knowledgeable of this guidance and correct processes were in place to protect people. Staff gained consent before supporting people.

People were able to make choices about the food and drink they had, and staff gave support when required to enable people to access a balanced diet. There was access to drinks and snacks throughout the day.

People were supported to access a variety of health professionals when required, including dentists and doctors, to make sure they received continuing healthcare to meet their needs.

Staff provided care and support in a caring and meaningful way. They knew the people who used the service well. People and relatives, where appropriate, were involved in the planning of their care and support.

People’s privacy and dignity was maintained at all times.

People were supported to follow their interests and join in activities.

People knew how to complain. There was a complaints procedure in place which was accessible to all. Complaints had been responded to appropriately.

Quality monitoring systems were in place. A variety of audits were carried out and used to drive improvement.

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.

Further information is in the detailed findings below

We carried out this unannounced inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions and to pilot a new inspection process being introduced by the CQC which looks at the overall quality of the service. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, and to provide a rating for the service under the Care Act 2014. There were no outstanding breaches of legal requirements at their last inspection.

17 Walsworth Road is registered to provide accommodation and personal care for up to six adults with learning disabilities. The service had a registered manager in post. A registered manager is a person who has registered with the Care Quality Commission to manage the service and has the legal responsibility for meeting the requirements of the law; as does the provider.

We found that people who used the service were supported by a staff team who were skilled in their roles and who knew them well. There was an emphasis on establishing effective relationships and this was acknowledged by people who used the service, their relatives, staff and visiting professionals.

People were supported to maintain their hobbies and interests both in the home and out in the community. The service provided additional staff to accommodate people’s individual needs.

People had clear care plans in place which they were involved in developing and these were reviewed regularly. There were individualised risk assessments to enable people to live active and balanced lives which gave them their freedom and protected their rights.

We observed people who used the service throughout the day as many people had complex needs and were unable to verbally express their views of the service. We saw that people were engaging with the staff and expressing enjoyment in the activities they took part in.

People showed us their bedrooms. These were personalised and people, and their relatives, were involved in keeping their rooms in a way they liked. We saw from records, and relatives and professionals told us, that the service responded well to feedback and had systems in place for gaining that feedback.

People who used this service were not all able to communicate verbally but we saw they were well cared for and supported by staff. We spoke to those people who were able to talk to us. The provider ensured that people who used the service were treated with respect and were involved in planning their care, support and treatment so far as possible. The relatives we spoke to felt involved in all aspects of needs assessment, care planning and reviews of their relatives care. One relative we spoke with told us " If I died now I would be happy in the knowledge my relative will be well cared for in this home ".

The provider regularly reviewed the needs of the people who used the service in order to plan how care was provided and made changes to improve this on a regular basis. One person who used the service told us " My favourite time of the week is Friday evening when I go to the disco and have a great time ".

People who lived in this home were protected from abuse and unsafe use of medicines as the provider had clear protocols in place and staff were trained and confident to use these.

The provider had strong leadership in the home and relatives of people who used the service supported this by saying " I can raise any issues at any time,the ethos is excellent and that comes from the top ". Another relative we spoke with told us " I couldn't be happier and neither can my [relative], this home is like a wonderful family and I have a great relationship with staff ".

We previously inspected 17 Walsworth Road on 06 December 2012. During that inspection we found that the provider had a system in place for accounting for medicines but that this system was not followed properly. There were discrepancies between medication administration records and stock audits where medication items had been miscounted. This was because information was not accurately transferred from one record to the other.

We found that the provider was not compliant with this standard and required improvements to be made. The provider wrote to us and told us that a new system had been introduced which would prevent such errors and that they had become compliant with this standard by 07 January 2013.

When we visited on 31 January 2013 we saw documentary evidence to show that the new system had been implemented and communicated to staff. We also saw records which showed no errors in accounting for medication items.

People living at 17 Walsworth Road had complex needs which meant they were not able to tell us their experiences. However, we reviewed daily activity records and spoke to the relatives of two people.

When we visited on 6 December 2012 we found that arrangements were in place to ensure people living there or their representatives consented to their care and treatment. People could make choices about all aspects of their daily lives and they and their relatives were involved in annual reviews of their care plans and their contracts.

People were assessed when they first moved to the home and care plans were drawn up from this assessment. Daily activities and support plans reflected the individual needs of people living there. People's relatives spoke highly of the standard of care. One relative said, "I am very pleased with the care my relative is getting there.”

We found that there were arrangements in place for the recording, administration and storage of medicine. However these were not always followed and we noted that there were some discrepancies in the medication records.

There were sufficient numbers of staff on duty at all times and they were appropriately trained to provide support to meet the needs of people living at this service.

People's care plans and their daily diaries were stored appropriately. Daily records were used to record all aspects of people's lives and this enabled the staff to monitor the effectiveness of the support plans.

During our visit on 17 November 2011 we spoke with some of the people using the service. The people who were able to communicate verbally did not respond to our questions about their care and did not express an opinion although everyone appeared content. A visiting relative said that the care provided at the home was very good. They said that within a few days of entering the service their relative had described it as their home and always asked to go back when they went out on a visit. One relative who was visiting the home said that they had no concerns about the services provided and would not hesitate to make a complaint if they had one. They said that there were always enough staff on duty and that all the staff provided care in a professional way.