9 Rosslyn Crescent is a ‘care home’. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection. 9 Rosslyn Crescent is a care home for four women with a learning disability located in the London Borough of Brent. The home is part of a national provider Voyage and a manager is registered with the Care Quality Commission.

At our last inspection on 26 November 2015 we rated the service Good.

At this inspection we found the service Good.

Staff demonstrated a good understanding of how to recognise and how to report any allegations of abuse. They told us that the registered manager would take any allegations of abuse seriously and deal with immediately. Risks to people in relation to their treatment or care, environment and equipment had been assessed and appropriate management plans were in place to mitigate such risks. Sufficient staff were deployed to ensure people’s needs were met. The registered provider followed safe recruitment procedures to ensure staff employed was suitable to work with vulnerable people. Medicines were managed and administered safely. Appropriate infection control procedures ensured people were protected from the spreading of infections. Accidents and incidents were monitored and discussed during staff meetings to ensure lessons were learned.

Appropriate assessments of need ensured care or treatment were provided with people’s requests, wishes and requirements in mind. Staff had the skills and knowledge to support people who used the service and were given the appropriate support to meet people’s needs. People who used the service had access to a well-balanced and healthy diet. Where people required input from a medical practitioner this had been sought and people received the required support to eat and drink. If required, additional healthcare support was sought to improve people’s health and wellbeing. People lived in a well maintained and nicely decorated homely environment. 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.

Relatives told us that people were treated with kindness and respect. Care staff we spoke with were observed to care for people by respecting their privacy, dignity and maintaining their independence. We observed people being asked to take part in activities and staff was able to read people’s gestures and sounds to ensure people were heard and their view about taking part and making that decision was heard.

People’s care was planned with people’s individuality in mind and this was responsive to people’s needs. People took part in a range of personalised and individual activities as well as in groups. People and relatives were encouraged to raise concerns, which were addressed and responded to appropriately by the registered manager. The home did not provide end of life care, but wishes in regards to serious illness and funeral arrangements were discussed with people and their representatives.

Care staff understood the vision of the registered provider and told us that the registered manager was supportive and approachable. Appropriate and effective quality assurance systems ensured the quality of care was monitored and improvement was made where required. People who used the service, relatives and stakeholders were encouraged to comment on the quality of care provided and any suggestions were followed up and actioned by the registered manager. The service worked well in partnership with external stakeholders such as the local learning disability team and local commissioners.

Further information is in the detailed findings below.

We carried out an unannounced comprehensive inspection of this service on 26 November 2015. A breach of legal requirements was found. After the comprehensive inspection, the provider wrote to us to say what they would do to meet legal requirements in relation to the breach of regulation 15 of The Health and Social Care Act 2008 (Regulated Activities) 2014. We asked the provider to refurbish the property to ensure the premises were fit for the purpose of carrying out the regulated activity.

We undertook this focused inspection to check that they had followed their plan and to confirm that they now met legal requirements. This report only covers our findings in relation to those requirements. You can read the report from our last comprehensive inspection, by selecting the 'all reports' link for 9 Rosslyn Crescent on our website at www.cqc.org.uk .

9 Rosslyn Crescent is a care home registered for four people with a learning disability located in the London Borough of Brent. During the day of this inspection the home had no vacancies. The home is part of a national provider Voyage.

The service did not have a registered manager, however the provider had made suitable arrangements to ensure day to day management cover was provided while they were recruiting for a new manager. 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.

During a tour of the premises we found that the registered provider had made reasonable adjustments and refurbished the premises to ensure it was fit for the purpose of carrying out the regulated activity.

We carried out this inspection on 26 November 2015. This inspection was unannounced.

The service met the regulations we inspected at their last inspection which took place on 8 November 2013.

9 Rosslyn Crescent is a care home registered for four people with a learning disability located in the London Borough of Brent. During the day of this inspection the home had two vacancies. The home is part of a national provider Voyage.

The service has a registered manager. 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 building was not always well maintained and redecorated and some improvements were needed to the maintenance of the décor, furnishings, carpets and window frames.

We found people were cared for by suitably qualified, skilled and experienced staff who knew their needs well. People were supported to follow their own chosen routines and to take part in activities they liked, such as swimming, visiting places of worship, walking and Art.

The service showed good practice in supporting people with their physical and mental health needs and in making decisions for themselves.

The Registered Manager had been trained to understand when applications for Deprivation of Liberty Safeguards (DoLS) authorisations should be made, and in how to submit one. We found the location to be meeting the requirements of the DoLS.

We found people were cared for, or supported by, sufficient numbers of suitably qualified, skilled and experienced staff. Robust recruitment and selection procedures were in place and appropriate checks had been undertaken before staff began work.

Medicines were managed safely and staff received training in the safe administration of medicines.

Suitable arrangements were in place and people were provided with a choice of healthy food and drink ensuring their nutritional needs were met.

People’s physical health was monitored as required. This included the monitoring of people’s health conditions and symptoms so appropriate referrals to health professionals could be made.

People’s needs were assessed and care and support was planned and delivered in line with their individual care needs and staff knew people well. The care plans included risk assessments. Staff had good relationships with the people living at the home and the atmosphere was happy and relaxed.

We observed interactions between staff and people living in the home and staff were kind and respectful to people when they were supporting them. Staff were aware of the values of the service and knew how to respect people’s privacy and dignity. People were supported to attend meetings where they could express their views about the home.

A wide range of activities were provided both in-house and in the community. We saw people were involved and consulted about all aspects of the service including what improvements they would like to see and suggestions for activities. Staff told us people were encouraged to maintain contact with friends and family.

The registered manager investigated and responded to people’s complaints, according to the provider’s complaints procedure.

There were effective systems in place to monitor and improve the quality of the service provided. We saw copies of reports produced by the registered manager which included action planning to make improvements to the service. Staff were supported to raise matters to do with the service when they felt there could be improvements and they told us there was an open and honest culture in the home.

We found one breach of The Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see what action we told the provider to take at the back of the full version of the report.

People who used the service were unable to verbally communicate with us. We spoke to one support worker, a student nurse on placement, the registered manager and viewed records of two people who used the service.

We observed people using the service being offered a choice of activities. For example one person did not want her nails done, but instead was happy reading a magazine and listening to music.

Care plans were person centred and had recently been updated, in line with the organisations new care planning format.

People were offered a varied, healthy and culturally appropriate diet and the help from a dietician was obtained as and when needed.

Staff received training in the administration of medicines and regular checks undertaken by the manager and pharmacist ensured the medicines were administered safely and appropriately.

Staff were available in sufficient numbers to meet people's needs and extra staff were drafted in to enable people who used the service to access additional activities as and when required.

Complaints were dealt with promptly and staff were confident that the manager dealt with complaints appropriately.

People using the service had limited verbal communication skills. Therefore we undertook observations to understand how people were supported by staff and the type of service they received.

We observed people being treated with dignity and respect, staff ensured doors were closed and people were covered appropriately when supported with their personal care.

Care plans were provided in a user friendly and person centred format, people were involved in a regular review process. People benefited from varied activities, which were provided regularly. People were able to choose if they wanted to part take in activities and alternatives were provided if required.

People were protected from abuse and staff demonstrated good understanding of reporting and dealing with allegations of abuse.

Staff had varied opportunities to gain more skills and periodic training opportunities were offered, this ensured people were supported by a skilled and qualified workforce.

Regular checks and surveys about the service ensured people were able to contribute to their treatment or care and improvements were implemented where shortfalls were reported.

People living at 9 Rosslyn Crescent were not able to verbally communicate with us due to the level of their disability.

However we observed people using the service using the SOFI tool, which is an observation tool designed by the University of Bradford and the Care Quality Commission. We observed two people using the service over one hour and recorded our observations every five minutes. We felt that interactions between staff and people using the service were positive and people were generally involved in tasks. People's moods were good, with the exception of a few minor episodes of challenging behaviour. This was dealt with by staff swiftly and appropriately using behaviour intervention guidance designed by the staff and behaviour intervention specialists.

People using the service appeared relaxed in the presence of staff and made full use of all areas available to them at 9 Rosslyn Crescent.