This inspection took place on 16 May 2018 and was announced. The provider was given 48 hours’ notice as the service is a small home for adults with a mental health diagnosis who are often out during the day. We needed to be sure someone would be in during our inspection.

This was the service’s first inspection since it registered with us in 2016.

Forward Support Ltd is a ‘care home’. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

Forward Support Ltd is a terraced house in north London. It can accommodate up to six people. At the time of our inspection six people were living in the home.

There was a registered manager in post. 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 was exceptionally effective in assessing people’s needs and choices and supporting them to achieve goals and outcomes. The registered manager was proactive and innovative in developing training to facilitate the most effective care for people who used the service.

The registered manager and support workers were committed to supporting people in innovative ways in order to promote optimal health and wellbeing in a collaborative and personalised manner.

People were supported to have access to healthcare services and receive on-going support. Referrals to healthcare professionals were made appropriately and a multi-disciplinary approach was adopted to support people.

Newly recruited staff received an induction and shadowed more experienced members of staff. Training for staff was specifically designed and relevant to their role and was provided on a regular basis and updated when needed. Support workers told us the quality of training was good.

People were supported with maintaining a balanced diet and the people who used the service chose their meals and these were provided in line with their preferences. One person who had a passion for cooking enjoyed cooking for everyone at the home and they were encouraged and supported to do so. People told us they enjoyed the food.

The service was safe and people were protected from harm. Staff were knowledgeable about safeguarding adults from abuse and what to do if they had any concerns and how to report them. Safeguarding training was given to all staff.

Risk assessments were thorough and personalised. Staff knew what to do in an emergency situation.

Staffing levels were meeting the needs of the people who used the service and staff demonstrated they had the relevant knowledge to support people with their care.

Recruitment practices were safe and records confirmed this.

Medicines were managed and administered safely. The service completed audits on a regular basis.

Support workers demonstrated an understanding of the Mental Capacity Act (2005) and how they obtained consent on a daily basis. Consent was recorded in people's care plans.

People told us they had the freedom to leave and access the home without restriction.

Positive relationships were formed between support workers and the people who used the service and staff demonstrated how they knew the people they cared for well. People who used the service told us support workers were caring and treated them with respect.

Care plans were detailed and contained relevant information about people who used the service and their needs such as their preferences. Care plans were reviewed regularly, with any changes being recorded.

Concerns and complaints were listened to and records confirmed this. People who used the service knew how to make a complaint.

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