This inspection took place on 14 November 2018 and was announced. Blenheim Avenue provides supported living and community based domiciliary care services, particularly to support people with learning disabilities from the Jewish community to live as independently as possible. Supported living is where people live in their own home and receive care and/or support in order to promote their independence.

At the last inspection in April 2016 the service was rated Good. At this inspection we found the service remained Good.

At the time of the inspection the service was providing support to 20 people who lived in their own home.

There was a registered manager in post and they were present during our inspection. 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 service has a registered manager in place and a team leader who has overall day to day responsibility for the service.

People continued to receive a safe service where they were protected from avoidable harm, discrimination and abuse. There were systems in place to recognise, report and ensure people were protected from harm. Each person had a risk assessment which identified possible risks and provided guidance for staff on how to minimise them. Staff had attended safeguarding training and knew how to report any incidents of abuse.

Incidents and accidents were recorded, monitored and lessons were learnt to ensure people were safe. People and their relatives were involved in the review of care plans. We noted staff had a good understanding of people's needs in the way they provide person centred care. People's equality and diversity was at the heart of the service ensuring people's race, age, sex, sexuality, faith, etc. were recognised and respected.

There were sufficient number of staff to meet people's needs. The service's staff recruitment processes were robust ensuring that staff were appropriately checked before they started work. The registered manager provided staff with training, support and supervision that enabled them to deliver effective care.

People's communication needs were included in their care plans. The registered manager also used easy read and pictures as ways of communication to help people access information.

Staff promoted people's independence and made sure that their choices and privacy were respected at all times. They worked well with external health care professionals, and people were supported with their needs and accessed health services when required. People were supported to have maximum control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice. The principles of the Mental Capacity Act (MCA) were followed.

The registered manager welcomed complaints and feedback from people and relatives. This was reviewed and used to solve any concerns and improve the service.

People at the service were supported to choose, prepare and enjoy meals that reflected their dietary and religious preferences.

There were established quality assurance and auditing systems in place to ensure the service was well run and people's needs were met.

This inspection took place on 12 April 2016 and was announced. We gave the registered manager 24 hours’ notice prior to the inspection. This was because the service was small and we needed to ensure that they were available during our inspection.

Blenheim Avenue provides supported living and community based domiciliary care services, particularly to support people with learning disabilities from the Jewish community to live as independently as possible.

At the time of the inspection the service was providing support to 20 people who live in their own home. This location covers a number of accommodations across Redbridge using both Blenheim and Southwood office hub for staff to work from. Supported living is where people live in their own home and receive care and/or support in order to promote their independence.

There was a registered manager in post and they were present during our inspection. 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 service has a registered manager in place and a team leader who has overall day to day responsibility for the service.

People felt safe using the service. They were protected from the risk of abuse because the staff were trained in safeguarding adults and the provider had systems in place to minimise the risk of abuse.

People were supported by staff who were kind and caring and knew them well. People were treated with dignity and respect by staff who understood their needs well. Staff received the training and support they needed to carry out their role.

Staff had a good understanding of risks associated with people's care needs and knew how to support them to be independent.

There were enough staff to support people safely. The organisation had an effective recruitment and selection procedure in place and carried out relevant checks when they employed staff.

Medicines were stored and administered safely. People were supported to take their medicines by staff as prescribed. People were supported to have their healthcare needs met.

The team leader and staff understood the principles of the Mental Capacity Act 2005 (MCA) and supported people in line with these principles.

People were protected from the risk of poor nutrition and staff were aware of people's nutritional needs. Care records contained evidence of visits to and from external health care specialists.

The provider had an effective complaints policy and procedure in place and people knew how to make a complaint.

The service had links with community services and other local organisation. The service had a positive culture that was person-centred, open and inclusive. The provider had a robust quality assurance system in place. People who used the service, family members and staff were regularly consulted about the quality of the service.

We considered all the evidence we had gathered under the outcomes we inspected. We used the information to answer the five questions we always ask:-

• Is the service safe?

• Is the service effective?

• Is the service caring?

• Is the service responsive?

• Is the service well led?

This is a summary of what we found.

Is the service safe?

People told us they felt safe. Relatives told us that they were happy with the service provided. They said people were safe and well cared for. Safeguarding procedures were in place and support staff understood how to safeguard people they supported. Staff had received training to ensure that they supported people safely. This included safeguarding vulnerable adults. People’s files included risk assessments relevant to each individual. They indicated the risks to the person and how these could be minimised to ensure that they were supported as safely as possible.

Is the service effective?

People’s care needs were assessed with them and they were involved in developing their plans of care. People’s care plans were up to date and reflected their current needs. They were not put at unnecessary risk.They also had access to choice and remained in control of decisions about their care and lives. We spoke with four people who used the service and asked them for their views about the care and support they received. They were positive about their experiences and described support staff as "good" and "helpful." One relative told us "he seems happy with the support he receives. He has a care plan, we have had discussions about his needs. They provide the care he needs." Another relative said "on the whole he gets the help he needs, they look after him well, there is no problem with it." Support staff had a good understanding of how to meet people's individual needs and were aware of their preferences. This meant that support staff had current information and details to enable them to effectively meet people’s needs.

Is the service caring?

We spoke with people who used the service. We asked them for their opinion about the staff that supported them. One person told us "everything is ok here. They help us." Another person told us that if they didn't like something that staff did, they would tell them straight away. They told us that staff had enough time to deliver the planned care. People's preferences and diverse needs were recorded and daily notes showed that care and support was provided in accordance with this. People's religious and social needs were identified and support staff assisted them to follow these. For example, going to the synagogue and celebrating Jewish festivals. People were also supported to be part of the wider community. They went out to work, college, clubs and outings, with staff support whenever needed.

Is the service responsive?

Support staff we spoke to were knowledgeable about the needs of people they supported and how to meet them. They told us that if they identified that people's needs had changed, they reported this to the office and the manager re-assessed the person's needs and updated their care plan and risk assessments. They described how they identified if a person was unwell and the action that they took if this happened. We saw that care plans included information about people's likes, dislikes and preferences. These had been recently reviewed and updated to ensure they had up to date information about people’s needs and how these should be met.

Is the service well-led?

The service had a quality assurance process in place. Sufficient systems were in place to monitor the quality of the service provided to ensure that people received safe, quality care. Annual customer satisfaction questionnaires were sent to people and their representatives to seek their views and opinions about the service in order to find out where improvements were needed. Staff told us they were clear about their roles and responsibilities. They were supported by the management team to provide good, quality care and were encouraged to complete relevant training which enabled them to carry out their roles effectively.

People knew how to make a complaint if they were unhappy. A pictorial complaints procedure was in place and staff asked people if they had any complaints when they had individual meetings with them. Relatives told us that they did not have any concerns but were confident that the manager would resolve any issues raised. People also told us they were regularly contacted by the manager to check if they were satisfied with the care that they received and were always asked if they had any concerns or complaints. One person who used the service said "I know who to go to if I had a problem." A relative told us "I can go to them (manager) any time and a 100% they deal with it." This helped to ensure that people received a good quality service at all times.

People who used this service and their relatives told us that they were happy with the care and support that the agency provided. People were supported to access health and social care professionals when required with their consent. They told us that the staff listened to them and knew what they were doing when assisting them with their needs.They were satisfied with the support that they received from staff with their medication.

People said "yes I can choose what I want to do. I am able to do a lot for myself." Another person said "they ask us what we want help with and listen to us." Relatives spoken with were satisfied with the support provided by the staff to their loved ones.

People had regular contact with the provider and felt comfortable to raise any issues or concerns with them. They were confident that any concerns would be addressed by the manager to their satisfaction. Appropriate records were kept which were kept securely where required.

People were supported to access health and social care professionals when required with their consent. They were happy with the care that they received from care workers who knew what they were doing. People we spoke with told us that their views about the service were sought by the manager and any issues raised were dealt with. People said "you can't fault them they are all really lovely." "very satisfied often the care workers go beyond their call of duty." "They are a very good bunch of staff and Norwood is a very good organisation. We celebrate the Jewish festivals which I really like."

Relatives spoken with were satisfied with the support provided by the care workers to their loved ones.

People who used the service spoke highly of the agency. Comments from people who used the service included , “I like the staff, they help me a lot”.

“Yes I feel safe with them”.

“They are kind and look after me”.

A relative said, “On the whole she is being looked after very well. The staff are very good”.

Another relative said, "They look after him very well, they have brought him on to be more independent. They monitor his health very well. I can always talk to staff if anything is bothering me. They are always there”.