This inspection took place on 8 February 2017 and was unannounced. When we last visited the service on 9 February 2015 the service was meeting the regulations we looked at and was rated Good overall and in all five key questions.

Morton Gardens DCA is a supported living service for three people with learning disabilities and some physical needs. A supported living service is one where personal care is provided as a separate package of care which is not linked to the accommodation. There were three people living in the service at the time of our visit. Some people had limited verbal communication.

The service has a registered manager in place. A registered manager is a person who has registered with the Care Quality Commission to manage the service and shares the legal responsibility for meeting the requirements of the law with the provider.

The provider had not ensured a hoist used for supporting a person to transfer had been fully tested and was safe to use. While the registered manager understood the majority of their role and responsibilities well they were not aware of regulations which required them to ensure the hoist was fully tested and safe to use. This meant the person was not protected against risks associated with this piece of equipment. However, the registered manager agreed to put a schedule of appropriate checks in place to meet the relevant regulation concerning lifting equipment.

Staff received training in how to protect people from abuse and how to respond if they suspected people were being abused to keep them safe. Medicines were managed safely, although the registered manager told us they would put in place more detailed guidance for staff to follow relating to ‘as required’ medicines and homely remedies. Homely remedies are medicines which can be purchased over the counter, without prescription. The registered manager managed risks to people well, ensuring risks to individual were assessed with risk management plans in place for staff to follow in mitigating risks. Staffing numbers were sufficient to meet people’s needs and staff were recruited through robust processes to check they were suitable to work with people.

People received choice in the food they ate and staff supported people to maintain healthy weights. Staff supported people to access the healthcare services they required and to monitor their health. Staff received the support and training they needed to give them the skills and knowledge to meet people’s needs. Staff understood how to support people in line with the Mental Capacity Act 2005, ensuring they gained people’s consent when people were able to give consent.

Staff were caring and communicated well with people, according to people’s individual communication preferences. Staff treated people with dignity and respect and supported people to keep in contact with their relatives and friends. People were involved in making decisions about their care.

Each person had an individualised activities programme in place tailored to their interests. People were engaged in activities most days of the week. These included hydrotherapy, dancing and cycling. The registered manager ensured people’s care plans were up to date so information was reliable for staff to follow in caring for people. People were encouraged to give feedback on the service and a complaints procedure was in place for the registered manager to follow in responding to any complaints.

Staff understood their roles and responsibilities well. A range of suitable audits were in place to assess and monitor the quality of service delivery. Resources and support were available to develop the team. People, relatives and staff were encouraged to communicate openly by the registered manager.

This was an unannounced inspection and took place on 9 February 2015. At our previous visit in June 2013, we judged that the service was meeting all the regulations that we looked at.

Morton Gardens is a service providing personal care and support for three people with learning disabilities living in supported living accommodation in the Sutton area.

The service has a registered manager in place. 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 the associated Regulations about how a service is run.

Relatives of people told us they felt their family member was safe living at Morton Gardens. Staff knew how to protect people if they suspected they were at risk of abuse or harm. Risks to people’s health, safety and wellbeing had been assessed and staff knew how to minimise and manage identified hazards in order to keep people safe from harm or injury.

There were enough properly trained and well supported staff to meet people’s needs. Relatives of people told us, and we saw that staff had built up good working relationships with people. Staff were familiar with people’s individual needs and the choices they had made about the care they wanted to receive.

People received their medicines as prescribed and staff knew how to manage medicines safely.

Relatives told us staff were kind and caring, and our observations and discussions with staff supported this. We saw they treated people with dignity, respect and compassion.

People had a varied and nutritious diet and choice of meals.

Staff supported people to keep healthy and well through regular monitoring of their general health and wellbeing.

People were encouraged to maintain relationships that were important to them. There were no restrictions on when people could visit the home and staff made all visitors feel welcome.

People had access to their local community and could choose to participate in a variety of in-house and community based social activities. We also saw staff encouraged and supported people to be as independent as they could and wanted to be.

Care plans were in place which reflected people’s specific needs and their individual choices. Relatives of people were involved in developing and regularly reviewing their relations’ care plans and we saw people were supported to make decisions about their care and support.

People using the service and their relatives were encouraged to give feedback on the service as there was an effective complaints system in place.

Relatives said they thought the registered manager encouraged feedback and sought to develop and improve the service for people. Staff told us they felt well supported and enjoyed working in a positive environment.

Staff told us they were clear about their roles and responsibilities. They had a good understanding of the ethos of the service.

Systems were in place to monitor the safety and quality of the service and to get the views of people about the service.

At the time of our inspection the service was providing support and personal care to two people residing within a supported living environment. We used different methods to help us understand the experiences of people who use the service as both people were unable to communicate verbally with us in a significant way.

We were able to speak to the representative of one person using the service. They told us, "I am very happy with the care and support they provide. Staff are all very caring and I have never had any cause for concern or complaint ". People who use the service and their representatives understood the care and treatment choices available to them. People took part in an initial assessment meeting before joining the service, to discuss the services available and the best ways to support them. This information was documented in their plans of care.

There were comprehensive care planning arrangements in place in the service, which included up to date care plans and risk assessments, and the involvement of people and their representatives in their plans of care was evident. The provider had arrangements in place to protect people from abuse. Staff had up to date training in safeguarding people from abuse, and a safeguarding policy was in place.

During our inspection we spoke with two members of staff. Staff told us they were supported in their jobs and daily communication with senior members of staff and management was good and effective. Staff members informed us that the training programme available to them was good and during supervision sessions managers ensured that all training was up to date and was appropriate to the needs of people who use the service.

At the time of our inspection the service was providing personal care to two people in a supported living home. People using the service were unable to speak with us due to their complex needs. We were able to speak to representatives of both people using the service. One person said to us ‘you can’t fault the care’. They told us the staff were ‘very kind people’. Another person said about the service ‘judging by other places, it is fairly good’.

We looked at the plans in place to provide care and support to people using the service. We found there were instructions and guidance for staff about how to meet people’s specific care and support needs. We also saw that risks to their health, safety and wellbeing had been identified with a plan in place for how any known risks were managed and mitigated by staff. However we found that the plans and risk assessments in place were not being updated as regularly as they should be to ensure these were up to date and accurate.

We looked at staffing levels and found there was enough staff at the time of our inspection, to meet the needs of people using the service. The registered manager told us they undertook regular monitoring checks to assess the quality of care provided by staff.

This service has only been operating since the end of February 2011. One person was using this service but they were not present at the time of our visit. The agency provides full support to this individual who is living in a property set up for Supported Living. This property is owned by a family member of the provider.

The provider confirmed that people living in the property would have the right to choose other domiciliary care services should they so wish.

We looked at the records kept about the individual receiving support and sought feedback from involved care professionals.

Positive feedback was received from one care professional who told us that they have been pleased with the support the person is receiving. They stated that ’Morton Gardens DCA have been very supportive to the service user and have fully engaged outside agencies such as health and social care to fully meet their needs. The staff are efficient in keeping in contact with myself and family members and have created an individualised support plan for this service user. We recently held the four week review and there were no concerns around the support Morton Gardens DCA provide’.