The inspection took place on 8 and 9 February 2018 and was an announced inspection. We informed the provider 48 hours in advance of our visit that we would be inspecting. This was to ensure there was somebody at the location to facilitate our inspection. This was the first inspection of Lorenco House since its registration on 27 November 2016.

Lorenco House is an "extra care" housing provision operated by One Housing Group Limited in Tottenham, North London. This service provides care and support to people living in specialist ‘extra care’ housing. Extra care housing is purpose-built or adapted single household accommodation in a shared site or building. The accommodation is rented, and is the occupant’s own home. People’s care and housing are provided under separate contractual agreements. CQC does not regulate premises used for extra care housing; this inspection looked at people’s personal care and support service.

Lorenco House consists of communal facilities including a restaurant, a bar with cinema / activities room, garden, hairdresser and spa facilities, facility to store and charge mobility scooters, laundry facilities and a guest suite. The service is for people living with dementia, learning disabilities or autistic spectrum disorder, mental health, physical disability, sensory impairment, older people and younger adults. At the time of our inspection 45 people were living at Lorenco House and receiving a personal care service.

The service had a registered manager in post. 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 in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

People told us they felt safe with staff and staff knew how to safeguard people against harm and abuse. The provider maintained clear risk assessments informing staff on how to provide safe care. People were appropriately supported with medicines management. The provider followed safe recruitment practices to ensure people were supported by suitable staff. Staff told us there was a need for staff replacement cover and the provider was in the process of recruiting and appointing new staff. Staff followed infection control practices and prevented cross contamination and spread of infection.

The provider assessed people’s individual needs and developed care plans that were detailed and regularly reviewed. People’s needs were met by staff who were sufficiently trained. Most staff had been on all required training and where gaps existed we saw that staff had been booked onto at least two training sessions between now and the end of October 2018. We have made a recommendation about staff training on sensory impairment. Staff told us they felt supported and received regular supervision to do their jobs effectively. People’s nutrition and hydration needs were met and told us they were supported by staff to access healthcare appointments as and when requested.

People told us they liked their flats which met their needs. However, we found the service did not have appropriate adaptations to meet the needs of people with sensory impairment. We have made a recommendation about building adaptations to meet the needs of people with sensory impairment. Staff understood the need to give people choices and seek their permission before supporting them.

People told us generally staff were caring and helpful and treated them with dignity and respect. Staff supported people to remain as independent as they could. People’s care plans detailed information about their likes and dislikes, background, religious needs and required care support. However, the provider did not record information on people’s end of life care choices. We have made a recommendation about the management of people's end of life care wishes.

The provid