We undertook an unannounced inspection on 27 January 2017 of Nisacraft Care (London). Nisacraft Care (London) is a care home that provides personal care and accommodation for up to 3 people who have learning disabilities.

At the last inspection on the 17 November 2014 the service was rated Good.

At this inspection we found the service remained Good.

Since the last inspection, the registered manager had left. The home was being managed and supported by a deputy manager and the provider. The deputy manager has submitted an application to apply to become registered manager for the home.

We found there were some systems in place to monitor and improve the quality of the service. However there was no effective auditing of the quality of service being provided. The provider told us she will look at adopting a new quality assurance tool for the service.

People's health and social care needs had been appropriately assessed. Care plans were person-centred, and specific to each person and their needs.

People are supported to have maximum choice and control of their lives and staff support them in the least restrictive way possible; the policies and systems in the service support this practice.

Relatives informed us that they were satisfied with the care provided. Relatives also told us that they were confident that people were safe in the home. However they raised some concerns about the variety and quality of food, the lack of activities and the cleanliness of the home. The deputy manager told us they regularly liaised with relatives about any issues they may not be happy with but would address these concerns.

Systems and processes were in place to help protect people from the risk of harm and abuse. Staff had received training in safeguarding adults and knew how to recognise and report any concerns or allegations of abuse. Systems were in place to make sure people received their medicines safely.

There was a record of essential maintenance carried out at the home. Bedrooms had been personalised with people's belongings to assist people to feel at home.

Staff had been carefully recruited and provided with induction and training to enable them to support people effectively. They had the necessary support, supervision and appraisals from management.

Further information is in the detailed findings below

We undertook an unannounced inspection on 7 November 2014 of Nisacraft Care (London). The inspection was carried out by one inspector. This care home provides support to three people with learning disabilities. At the time of our inspection three people were using the service.

At our last inspection on 5 September 2013 the service met the regulations inspected.

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.

The provider had taken steps and arrangements were in place to help ensure people were protected from abuse, or the risk of abuse. Care workers were aware of what action to take if they suspected abuse.

CQC is required by law to monitor the operation of the Deprivation of Liberty Safeguards (DoLS) which applies to care homes. While no DoLS applications have been submitted, appropriate policies and procedures were in place. People were not restricted from leaving the home and

people identified as being at risk when going out in the community had risk assessments in place and we saw that if required, they were supported by staff when they went out. The registered manager told us she would contact the local authority to establish whether anyone in the home would need applications for DoLS authorisations.

People were cared for by staff that were supported to have the necessary knowledge and skills they needed to carry out their roles and responsibilities. Care workers spoke positively about their experiences working at the home.

We saw positive caring relationships had developed between people who used the service and staff and people were treated with kindness and compassion. People were being treated with respect and dignity and care workers provided prompt assistance but also encouraged and promoted people to build and retain their independent living skills

People received personalised care that was responsive to their needs. We saw that people’s care preferences were reflected. Care plans were person-centred, detailed and specific to each person and their needs.

People were consulted and activities reflected people’s individual interests, likes and dislikes and religious and cultural needs were accommodated. People were supported to follow their interests, take part in them and maintain links with the wider community. However there were instances that because there was only one member of staff in the home, people who used the service could not all go out together and one person was always left to remain at the home.

We found the home had a clear management structure in place with a team of care workers, registered manager and the provider who worked closely with the home. Care workers spoke positively about the registered manager and the culture within the home.

Systems were in place to monitor and improve the quality of the service. The home had an effective system in place to identify, assess and manage risks to the health, safety and welfare of people using the service and others.

People told us or indicated that they received the care they needed and wanted and they were positive about the staff that supported them. Staff had a good understanding of the varied communication needs of people living in the home.

We saw that people were central to their care plan and took a lead in how their care was delivered. There was detailed information in people's care plans about the individual support and care people wanted and needed. People received treatment and advice from a variety of health and social care professionals.

Staff knew about their roles and responsibilities in meeting the needs of people who use the service and they supported people in a friendly and respectful manner.

We saw people made a number of choices. These included deciding what they wanted to eat, whether they wanted to go out and what they wanted to do. People’s independence and skills were promoted and supported by staff.

Staff received the training they needed to meet people’s varied needs.

Records were accurate and up to date.

During our visit to Nisacraft Care (London), we spent time talking to the people using the service to gain their views about what it was like living in the home. Some people spoke English and Gujarati others communicated by sounds and gestures. Observation of people’s interaction with staff and other people using the service was an important aspect of our visit to the home. People told us or indicated by gestures and signs they were happy living in the home. People kindly showed us their bedrooms and told us they had their bedroom decorated and furnished in the way they wanted.

People told us the food provided in the home was good, and people spoke positively of the varied activities they took part in and enjoyed. These included dancing, watching films, cooking, shopping, and attending places of worship. They spoke of having celebrated their birthdays and religious festivals.

During our visit people showed signs of ‘well being’. People were seen to be relaxed, they smiled and laughed, were well dressed, talked freely with staff and with other people using the service and participated in activities of their choice.

Staff told us they enjoyed their job of supporting and caring for people at Nisacraft Care (London). They confirmed they knew people using the service well, there was good teamwork and they felt well supported by the manager.

At the time of our inspection, the home was providing care for two people.

People who used the service received appropriate care and support that met their individual needs and were treated with dignity and respect. One person who used the service told us “I am happy here, this is my home”.

There were processes in place to protect people who used the service using services from harm. The staff were trained to recognise the signs of abuse and to report concerns in accordance with the home's procedures.

The staff were supported to provide care and treatment to people who used the service and were being trained, supervised and appraised appropriately.

There were systems in place to monitor the quality and safety of the service and accurate and appropriate records were maintained.