We undertook this announced inspection on 23 January 2019. Care Management Group - Brent Supported Living is a supported living service providing personal care support for people with profound and multiple learning disabilities. Accommodation is provided by Brent Council. At the time of our inspection, the service was caring for three people with very complex needs.

This service provides care and support to people living in a ‘supported living’ setting, so that they can live as independently as possible. People’s care and housing are provided under separate contractual agreements. CQC does not regulate premises used for supported living. In respect of supported living, this inspection looked at people’s personal care and support.

At our last inspection on 29 June 2016 the service met the regulation we looked at and was rated GOOD. At this inspection the service met the regulations we looked at and is again rated GOOD.

The service has a registered manager. A registered manager is a person who has registered with the Care Quality Commission (CQC) to manage the service. Like registered providers, they are registered persons’. Registered persons have legal responsibility for meeting the requirements of the Health and Social Care Act and associated regulations about how the service is run.

People who used the service did not provide us with feedback regarding the care and services provided. This was due to difficulties associated with their learning disabilty. We spoke with two relatives of people who used the service. They told us us that they were satisfied with the care and services provided for people. Care professionals also told us that people were well cared for.

There was a safeguarding adults policy and suitable arrangements for safeguarding people from abuse. The service was committed to anti-discrimination and upholding the human rights of individuals. There was a policy on ensuring equality and valuing diversity. Support workers recognised the importance of treating all people with dignity and respect.

The service had been able to care effectively for people with complex needs. Support workers were knowledgeable regarding the individual needs of people. People’s care needs and potential risks to them had been assessed and documented. Comprehensive and up to date care plans were in place. Relatives and representatives of people had been consulted regarding people’s care needs.

People were encouraged to be as independent as possible and to engage in social and therapeutic activities. The service had organised a variety of activities for people.

People's hydration and nutritional needs were met. Their healthcare needs had been attended to by healthcare professionals. There were suitable arrangements for ensuring that people received their medicines as prescribed.

Regular reviews of care had been carried out with people, their relatives and professionals involved to ensure that people received appropriate care. No complaints had been recorded since the last inspection in 2016. The registered manager explained that none had been received.

Support workers were committed and diligent in their work. They had been carefully recruited. They had the necessary training, support, supervision and appraisals from the registered manager. There were enough support workers to meet people's needs. Teamwork and communication within the service was good.

Audits and checks of the service had been carried out by the registered manager and senior staff of the company. These included checks on care documentation, medicines administration and health and safety checks of premises. Relatives and care professionals spoke highly of staff and told us that they found the service to be well managed.

We undertook this announced inspection on 29 June 2016. Care Management Group - Brent Supported Living is a supported living service providing personal care support for people with profound and multiple learning disabilities. Accommodation is provided by Brent Council. At the time of our inspection, the service was caring for five people with very complex needs.

At our last inspection on 16 September 2014 the service met the regulation we looked at.

The service has a registered manager. A registered manager is a person who has registered with the Care Quality Commission (CQC) to manage the service. Like registered providers, they are registered persons’. Registered persons have legal responsibility for meeting the requirements of the Health and Social Care Act and associated Regulations about how the service is run.

People who used the service did not provide us with feedback regarding the care and services provided. This was due to difficulties associated with their learning disabilty. We were able to speak with three relatives of people who used the service. They informed us that they were satisfied with the care and services provided. They informed us that people had been treated with respect and they were safe when cared for by support workers of the service. There was a safeguarding adults policy and suitable arrangements for safeguarding people from abuse.

Support workers were knowledgeable regarding the individual needs of people. They were gentle, caring and attentive towards people. People’s care needs and potential risks to them were carefully assessed. Support workers had been provided with guidance on how to minimise potential risks to people. They prepared appropriate and up to date care plans which involved people and their representatives. People’s healthcare needs were closely monitored and they had been attended to by healthcare professionals. Support workers worked well with healthcare professionals and communication with them was good. This was confirmed by professionals we contacted. There were suitable arrangements for ensuring that people received their medicines as prescribed. Audit arrangements were in place and these indicated that people had been given their medication.

There were arrangements for encouraging people and their representatives to express their views and make suggestions regarding the care and management of the service. Regular reviews of care had been carried out with people, their relatives and professionals involved to ensure that people received appropriate care. Where possible, people were encouraged to be as independent as possible and to engage in social and therapeutic activities. Support workers did the shopping and meal preparation. Menus had been prepared following consultation with people’s representatives and the dietician.. Support workers ensured that people’s nutritional needs were met and people’s weights were monitored monthly.

Support workers had been carefully recruited and provided with a comprehensive induction and training programme to enable them to care effectively for people. They had the necessary support, supervision and appraisals from the registered manager. There were enough staff to meet people's needs. Teamwork and communication within the service was good. Support workers were aware of the values and aims of the service and this included treating people with respect and dignity, providing efficient and high quality support.

Audits and checks of the service had been carried out by the registered manager and senior staff of the company. These included checks on care documentation, medicines administration and health and safety checks of premises. Complaints made had been promptly responded to. Healthcare professionals provided positive feedback regarding the management of the service. They indicated that the service was well organised, staff were capable and their clients had benefitted from the care provided.

A single inspector carried out this inspection. We spoke with two relatives and two members of staff. We reviewed the care records in place and looked at how the service was managed in relation to the standards we inspected.

The focus of the inspection was to gather evidence to answer the five key questions : is the service safe, effective, caring, responsive and well-led?

Is the service safe?

The service was safe because people's needs were well documented and comprehensive guidance was given to staff on how to meet these needs.

The service responded appropriately to issues and incidents which arose in a way that continued to ensure people receiving support were kept safe, for example by ensuring actions highlighted in the registered manager's unannounced inspections were completed promptly.

Is the service effective?

The service was effective because we observed very positive interactions between people receiving support and staff.

We were also told by relatives that they felt the service was effective in meeting their family member's needs.

Is the service caring?

The service was caring because it worked hard to ensure people's needs were comprehensively met, even where such needs were complex and challenging for the service.

The service was caring because the registered manager worked hard to maintain positive relationships with family members; this in turn benefitted people receiving support as well as their families.

Is the service responsive?

The service was responsive because it ensured that as people's needs changed, they were able to access the equipment and services they needed and support strategies and guidance were also changed.

The service showed it was responsive in the way it handled a recent complaint.

Is the service well-led?

The service was well-led because there were well-developed systems in place to assess and monitor the quality of the support being provided.

We saw evidence of the registered manager leading the service effectively and valuing the people receiving support and staff.

The four people who used this service had significant communication needs and were unable to tell us of their experiences verbally, so we observed the care they received. We also spoke with three relatives of people who used the service. The care we observed was kind, compassionate and enhanced dignity. A relative told us "the care provided is very good". Another relative said "I feel very welcomed, any time I like I can come and visit, day or night" and "I have no objections to [my relative] living there, they are always looked after. Sometimes there are small things though". One relative told us "[my relative] is very happy and content. They always get the help they need" and "[staff] don’t necessarily tell us everything about day-to-day life but we’re always involved in the big decisions".

We found that the provider had a system in place to ensure government guidelines were followed to gain consent to care and support. We saw that people were cared for in ways that met their needs and protected their rights, and that people's complex health support needs were met through cooperation and coordination of care with other providers.

People's medicines were stored and administered safely and appropriately, and their personal information and other records were useful, appropriate and held securely.

We found that the provider had followed guidelines for safer recruitment, and that staff were skilled, qualified and adequately experienced to meet people's needs.

We used a number of different methods to help us understand the experiences of people using the service, because the people using the service had complex needs which meant they were not able to tell us their experiences. We used a Short Observational Framework for Inspection (SOFI) to observe how they spent their time during our inspection. SOFI is a specific way of observing care to help us understand the experience of people who could not talk with us. We also spoke to two family members of the people to seek their views about people’s experiences.

We observed that staff interacted with people in a caring and sensitive way and people appeared relaxed in their presence. We saw that people were spoken to in a respectful manner and treated with respect. A parent commented “My son is happy living here” and another told us “I don’t have any complaints about the service”.

Our observations indicated that people had positive experience and good interactions with staff. They were encouraged to make choices regarding their food and drinks.