About the service:

People Who Care Harrow is a small domiciliary agency that provides supported living services people with learning disabilities and other cognitive impairments. At the time of our inspection the service was supporting four people living in a shared house.

People’s experience of using this service:

People told us they were happy with the support they received. They spoke positively about their support workers and the service’s manager.

The support provided by staff was person centred and reflected people’s individual needs. People’s support plans and risk assessments were person centred. They had been reviewed regularly and updated where there were changes in people’s needs.

Staff members were knowledgeable about people’s needs and preferences and how these should be supported. They understood their roles and responsibilities in ensuring that people were kept safe from harm or abuse.

People were supported to make decisions about their support. People told us that they were involved in developing their support plans.

The service was meeting the requirements of the Mental Capacity Act (2005). Information about people’s capacity to make decisions had been recorded in their care files. An authorisation under the Deprivation of Liberty Safeguards (DoLS) for one person had been made by the Court of Protection.

Staff communicated well with people. They supported a person who was unable to communicate verbally in ways which the person understood.

Staff were knowledgeable about people’s needs and preferences and how these should be supported. They understood their roles and responsibilities in ensuring that people were kept safe from harm or abuse.

Staff had received training in a range of core skills and this was updated regularly. Newly recruited staff members did not commence work until checks on their suitability had been carried out. Regular supervision from a manager had taken place to support staff to carry out their roles and responsibilities effectively.

Staff supported people to take their prescribed medicines safely. Accurate records of medicines administration had been completed.

People planned and shopped for their food. Staff supported people to cook and prepare meals where required. A person told us that they shopped for and prepared the meals that they preferred.

People had good healthcare support. When people were unwell staff had immediately contacted healthcare professionals. Staff had supported people to attend healthcare appointments. Where guidance had been provided in relation to people’s needs this was included in their support plans.

Regular quality assurance monitoring of the service had taken place and any actions arising from this had been addressed promptly.

People had been asked about their views of the service. These surveys showed high levels of satisfaction.

Rating at last inspection:

The service was rated Good (Report published 7 February 2017)

Why we inspected:

This was a planned inspection based on our rating at the last inspection.

Follow up:

We will continue to monitor intelligence we receive about the service until we return to inspect as part of our re-inspection programme.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

We carried out a comprehensive inspection of this service on 31 May and 29 June 2016 at which a breach of legal requirements was found. This was because the provider did not always ensure the proper and safe management of people's monies. After this inspection, the provider wrote to us to say what they would do to meet legal requirements in relation to this breach.

On 30 December 2016 we undertook a focused inspection to check that they had taken action in order to meet legal requirements.

This report only covers our findings in relation to the safety topic area. You can read the report from our last comprehensive inspection, by selecting the 'all reports' link for Harrow on our website at www.cqc.org.uk.

At our last inspection in May 2016 we rated the service good in the four topic areas; effective, caring, responsive and well-led and good as the overall rating. The service was rated requires improvement in the safe topic area.

People Who Care Harrow is a small domiciliary care agency that provides support to people with learning disabilities living at a supported living service. At the time of our inspection there were three people using the service.

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.

At our focused inspection on the 30 December 2016, we found that the provider had taken action to ensure that legal requirements were met. We found that people’s monies were managed safely so that they were protected from the risk of financial abuse.

This inspection took place on 31 May and 29 June 2016 and was announced. We visited the service on 31 May 2016 and found that the registered manager was on leave. We returned to the service on 29 June 2016 so that we could complete our inspection. The service was new and had not been inspected before.

People Who Care Harrow is a small domiciliary agency that provides support to three people with learning disabilities living at a supported living service.. At the time of our inspection there were no vacancies at the service. 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.

People who used the service that told us that they were satisfied with the support that they received. This was confirmed by a family member whom we spoke with.

People were protected from the risk of abuse. Staff members had received training in safeguarding, and were able to demonstrate their understanding of what this meant for the people they were supporting. They were also knowledgeable about their role in ensuring that people were safe and that concerns were reported appropriately.

However, we had concerns about the management of people’s monies. The records maintained for one person showed a balance of significantly less than the monies held. Monies withdrawn by a person from a personal account were returned by them to the service for safekeeping. However, staff had not recorded these.

Medicines at the service were well managed. People’s medicines were managed and given to them appropriately and records of medicines were well maintained.

Staff at the service supported people in a caring and respectful way, and responded promptly to meet their needs and requests. There were enough staff members on duty to meet the needs of the people using the service.

Staff who worked at the service received regular relevant training and were knowledgeable about their roles and responsibilities. Appropriate checks took place as part of the recruitment process to ensure that staff were suitable for the work that they would be undertaking. All staff members received regular supervision from a manager.

The service was meeting the requirements of The Mental Capacity Act 2005 (MCA). Information about people’s capacity to make decisions was recorded. One person was subject to Deprivation of Liberty (DoLS) authorisation issued by The Court of Protection. Staff members had received training undertaken training in MCA and DoLS.

Care plans and risk assessments were person centred and provided detailed guidance for staff around meeting people’s needs. Effective arrangements for supporting management of behaviours were in place. People’s cultural, religious and relationship needs were supported by the service and detailed information about these was contained in people’s care plans.

People participated in a range of individual activities throughout the week. Staff members engaged people supportively in participation in activities.

The service had a complaints procedure that was available in an easy to read version. This was discussed regularly with people. A family member told us that they knew how to make a complaint.

Care documentation showed that people’s health needs were regularly reviewed. The service liaised with health professionals to ensure that people received the support that they needed.

There were systems in place to review and monitor the quality of the service, and we saw that action plans had been put in place and addressed where there were concerns. Policies and procedures were up to date.

People who used the service, their relatives and staff members spoke positively about the management of the home.

We found one breach o