This inspection took place on 16 November and was unannounced.

Fellows Court provides a supported living service for people living in one block of flats. At the time of our inspection there were 35 people using the service.

At the last inspection in October 2015, we found breaches of the legal requirements in relation to how people's medicines were managed and staffing levels. The provider submitted an action plan detailing how and when they would make the required improvements. These actions have been completed and we found the provider was meeting the relevant requirements in relation to managing medicines and staffing levels.

The service had a registered manager. 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 told us they felt safe from abuse. They knew the type of behaviour that was unacceptable and who to contact if they had any concerns about their safety. Staff knew how to protect people against abuse and how to report any concerns.

There was a sufficient number of suitable staff to keep people safe and meet their needs. However, we found that people did not always receive support from the required number of staff.

People received their medicines safely because there were appropriate systems in place for storing, administering, recording and disposing of medicines which staff consistently followed.

People were cared for by staff who had the necessary skills and experience to support them effectively. The provider supported staff through regular supervision and relevant training.

Staff understood the general principles of the Mental Capacity Act 2005 and the specific requirements of the Deprivation of Liberty Safeguards and how they applied to people in their care.

People were supported to eat nutritious meals and had enough to eat and drink. People received the support they needed to maintain good health.

Staff were caring and treated people with respect and kindness. People’s privacy and dignity were maintained by staff. People were satisfied with the care and support they received. They received care that met their individual needs and were involved in making decisions about their care

People received consistent care from a regular team of staff. The management and staff knew people well. They knew their habits and preferences and understood what was important to them.

People were supported and encouraged to express their views. People knew how to and felt able to raise concerns or make a complaint. There were appropriate arrangements in place for recording, investigating and responding to people's complaints.

There were comprehensive systems in place to assess and monitor the quality of care people received at provider and service level. Where areas for improvement were identified, action plans were devised and the required improvements were made.

This was an unannounced inspection and took place on 16 and 19 October 2015.

Fellows Court provides a supported living service for people living in one block of flats. It is located in the Croydon area.

The service had a registered manager. 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 and associated Regulations about how the service is run.

The service was registered with a new provider on 13 August 2015. This is the first inspection with the new provider in place.

Some people and their relatives said they were happy with the service provided at Fellows Court, whilst others expressed concerns about the support received. The main areas of concern raised were regarding the numbers of staff available to meet people’s needs, particularly as the level of their needs was increasing and they were becoming more dependent. People told us they were happy with the way staff carried out their duties although they were stretched to give support in a timely way. People said they felt safe using the service. During our visit there was a welcoming, friendly atmosphere and people came and went doing activities and interacting positively with staff and each other.

We checked the medication records for five people using the service and found gaps in the recording of medication administered to them. The sample of other records we looked at varied in the level and quality of information recorded, particularly regarding people’s care plans, assessments and risk assessments. This was due to the provider currently introducing new systems, re-assessing people’s needs, the previous provider removing information on termination of the service and the local authority commissioning team forwarding some assessments and care plans that did not accurately reflect people’s needs. This made it difficult for the provider to identify the number of staff required to meet people’s needs and for staff to carry out their tasks as effectively as possible.

People said and staff told us that they were encouraged to discuss their health needs with staff and had access to GPs and other community based health professionals, as required. People were supported to choose healthy and balanced diets that also met their likes, dislikes and preferences. This enabled them to be protected from nutrition and hydration associated risks. They said they were very happy with the choice and quality of meals provided.

People knew who most of the staff that supported them were and the staff knew them, their likes and dislikes. Some new staff had been employed that people were becoming more familiar with. During our visit people said they were provided with information about the change of provider and their options. People told us that staff had appropriate skills and provided care and support in a professional, friendly and supportive way that was focussed them as individuals. This was reflected in the staff care practices we saw. Staff had received training from the previous provider and a training induction programme was being prepared by the new provider for current and new staff. People said staff and the manager were approachable and accessible to them although sometimes they had to wait. Staff said they had previously liked working at the home and had received good training, although they were uncertain if this would continue in the future as the new provider was currently in consultation with them.

The quality of the service provided was consistently monitored and assessed. The errors in recording of medication and missing information regarding people’s care plans, assessments and numbers of staff had been identified by the new provider’s systems.

The provider’s website had not been updated with current details.

We found breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 in relation to medicine administered not being accurately recorded and there being an insufficient number of staff to meet people’s needs. You can see what action we told the provider to take at the back of the full version of the report.