Hillview Merstham provides care and support to people living in a ‘supported living’ setting, so that they can live in their own home as independently as possible. People’s care and housing are provided under separate contractual agreements. The Care Quality Commission (CQC) does not regulate premises used for supported living; this inspection looked at people’s personal care and support. There were 11 people using the service at the time of our visit.

A registered manager was in post who was present on both days of the inspection. A registered manager is a person who has registered with CQC 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.

We inspected Hillview Merstham on 29 November and 11 December 2018. The inspection was unannounced on the first day and we told the provider when we would be returning for the second day.

Our previous inspection took place in November 2016 when we rated the service ‘Good’. At this inspection we found the evidence continued to support the rating of ‘Good’. There was no evidence or information from our inspection and ongoing monitoring that demonstrated any serious risks or concerns. This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection.

People using the service told us they liked living at Hillview Merstham and felt safe there. They said they were treated in a respectful and caring manner by regular staff members who knew them well and supported them effectively.

Appropriate numbers of support staff were allocated to help keep people safe with regular temporary staff used to cover vacancies. People spoken with were happy with the support provided by the staff working at Hillview Merstham.

We saw staff members had been safely recruited and had access to both mandatory and specialist training. Staff also received regular one to one supervision and additional support when required.

Staff understood how to help protect people from the risk of abuse. The service had procedures in place to report any safeguarding concerns to the local authority. People and staff were protected from potential risk of harm as the service had identified and assessed any risks to them and reviewed these on a regular basis. People had assessments which were individual to the person and their strengths and needs.

Medicines were administered in a safe way. Staff received training and a competency framework was in place to make sure they understood and followed safe procedures for administering medicines.

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. The principles of the Mental Capacity Act (MCA) were followed. Staff understood the importance of gaining people’s consent before assisting them.

The service completed a detailed personalised support plan for each person. They kept people’s needs under review and made changes as required.

People using the service felt able to raise any concerns or complaints. There was a procedure in place for people to follow if they wanted to raise any issues. Staff also said they felt comfortable in raising any concerns should they have any.

The service was well led. People using the service, their relatives and staff told us that they thought the service had improved under their leadership of the current management team and said they found them to be approachable and responsive. The registered manager monitored the quality of the service and made changes to improve the service provided when required.

We carried out an announced inspection of the service on 8 November 2016.

Hillview provides a supported living service to 12 tenants that live in one building who are living with a learning disability and or autistic spectrum disorder or mental health needs.

A registered manager was 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 were protected from harm. Staff had received safeguarding training and were aware of their responsibilities to protect people. They told us they would be confident to use the whistleblowing procedure in the service to report any poor practice they might observe or became aware of. Staff supported people to understand their rights with regard to safeguarding and information was available and presented in an appropriate format to support people’s communication needs.

Risks associated to people’s needs and the environment were assessed, planned for and monitored. Staff had been appropriately recruited, checks had been completed in relation to safety and suitability before they commenced their employment. Concerns were identified with regard to the staffing levels provided at night to support people. The provider took immediate action to increase staffing levels during this time and confirmed in writing after our inspection of the action taken.

People were given a choice of what staff supported them; staff were also carefully matched to support people to ensure the best outcomes for people who used the service.

Where people required support with their prescribed medicines, staff provided this appropriately, including assistance with the safe storage and management of medicines.

Staff received the essential training and support necessary to enable them to carry out their role effectively and safely and new staff received an induction.

Staff demonstrated a good understanding of the Mental Capacity Act (MCA) 2005. This legislation is designed to ensure people are supported to make their own decisions wherever possible. Staff demonstrated their commitment to ensuring people were always able to make choices about how they wanted their care and support to be provided.

Where necessary people who used the service received support from staff to ensure their nutritional needs were met. People were supported effectively to manage their health and accessed community health services when required.

People were supported by kind, caring and compassionate staff that showed respect and promoted independence.

People had access to independent advocacy information should they have required this support. People were involved in regular reviews of their care to ensure the support provided met their needs. Care records included details of people's achievements as well as their dreams and aspirations for the future.

People were supported by staff to pursue interests and hobbies important to them. Staff had a person centred approach to the care and support provided. Systems were in place for receiving, handling and responding appropriately to complaints.

People had regular opportunities to provide feedback on the care and support they received in order to continue to drive forward improvements in the service.

Robust quality assurance systems were in place in order to ensure that that people received high quality, safe and effective care and support.