Focus Project provides accommodation and treatment for up to six people. The service operates in partnership with a team from the NHS mental health trust and external agencies with the responsibility for providing rehabilitation and therapeutic treatment for men with personality disorders. Six people were using the service at the time of our inspection.

At the last inspection, the service was rated ‘Good’. We carried out this unannounced comprehensive inspection of the service on 10 February 2017. At this inspection, we found that the service had maintained its 'Good' rating.

People continued to be safe at the service. Appropriate systems remained in place to safeguard people from avoidable harm and to manage risks to their health. People’s needs were met by a sufficient number of suitably skilled staff who had been recruited in a safe manner. People received the support they required with their medicines.

People gave consent to care and treatment. Their care was delivered by staff who were well supported and trained to provide effective care. People managed their nutrition and hydration and received the support they required to develop their cooking skills and adopt a healthy lifestyle. They accessed healthcare services when needed to keep healthy.

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.

Staff were kind and caring and treated people with respect. People's privacy and dignity were upheld. Staff supported and encouraged people to develop their independent living skills.

People continued to receive care that met their individual needs and preferences. Staff encouraged people to pursue their hobbies and interests. People knew how to raise a complaint and were confident any concerns raised would be addressed quickly.

An open and positive culture was maintained within the service. People remained at the centre of the service. The registered manager continued to seek and act on people’s feedback about their care. Quality checks and audits remained in place to ensure shortfalls were identified and addressed to make improvements.

Further information is in the detailed findings below.

Focus Project at Akerman Road provides accommodation and treatment for up to six men. The service operates in partnership with a team from the NHS mental health trust with responsibility for providing rehabilitation and therapeutic treatment for men with personality disorders. At the time of our inspection six men were using the service.

Our inspection was unannounced. At our previous inspection on 23 October 2013 the service was meeting the regulations inspected.

The service had a registered manager as required by their registration. 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 worked closely with the community mental health team and the probation service to provide a joined up service to meet people’s needs. Assessments were undertaken to identify any risks to the person or to others, and to identify the support people required. People were consulted and involved in the assessment and care planning process. Plans were in place stating how people were to be supported to manage the risks they presented. Support plans were in place in relation to their personality disorder, mental health, physical health, financial and employment needs.

People were allocated a key worker who they met with regularly to discuss the plans in place for them whilst they were at the service and to review the progress they were making. The staff supported people to regain their independence and learn new skills. People were supported to gain employment and reintegrate into the community.

Staff received the training required to ensure they had the skills and knowledge to meet people’s needs, and to help keep people safe. Staff supported people to practice the techniques learnt during therapy sessions with the community mental health team to help them self-manage their behaviour.

Staff received support from their manager and from their peers. Individual supervision and group reflective practice was undertaken to provide staff with the opportunity to discuss how they supported people and to identify any learning to improve the support provided.

Regular monitoring was undertaken to ensure the quality of the service provided. Reports were made to all agencies involved in people’s care and to provide professionals with an update on any changes to people’s needs. Reports were made to the provider about the performance of the service to ensure people received the support they required and to identify any service level learning to improve the quality of service delivery.

The people using the service were encouraged to contribute to the making decisions about the running of the home. Staff supported them to gain skills in independent living by working closely with the NHS mental health trust and with services in the community.

One of the men said said there was “a healthy balance” between the restrictions set by the service to manage risk and flexibility to accommodate individual preferences. Someone else said “The staff are very helpful and supportive. They take time to listen.”

There were effective recruitment processes and a structured induction period for new staff.

Staff were allocated areas of responsibility to make sure the service was monitored appropriately. Incidents were discussed and action taken to reduce the likelihood of a reoccurrence.

The service operates in partnership with a team at the mental health trust with responsibility for providing rehabilitation and therapeutic treatment for men with personality disorders. There were five men living at the service when we visited.

The people we spoke with felt well informed and involved in their care. We were told, “There is nothing provided to us that we don’t agree with.” People using the service signed a contract at the beginning of their stay.

There was a detailed plan for reducing identified risk. There were regular meetings with the mental health team to discuss the treatment and support needs of people using the service. One of the people we spoke with described the service as “a landing place that puts you back on your feet”. Staff also spent time with people who needed support to develop daily living skills, such as managing finances.

There were appropriate arrangements in place for checking the safety and suitability of the premises. The records kept by the service were accurate and fit for purpose.

Staff were supported by a training programme, regular meetings with line managers and group support sessions.

The home has numerous events that involve people using the service, these include weekly community meetings where people can express their views.

The service works in partnership with mental health professionals from South London and Maudsley (SLAM) and Forensic Intensive Psychological Treatment Service (FIPTS) .

People told us of the problems encountered as a result of their conditions, and previous lifestyle choices. They value the service at Focus. One person described his experience since moving to the service, he said, " Before I moved here I could not have allowed myself to share my feelings of isolation and low self esteem, but this has changed since I participated in therapeutic behaviour sessions".

Another person spoken to said he was new to the service. He described feeling apprehensive when he moved in. He said, "the place is non institutional and staff made me feel included as soon as I moved in".