We inspected this service on 13 June 2017. The inspection was announced.

108 Highlever Road is an older property divided into five separate rooms, each with en-suite wet room facilities. People have access to a comfortable communal lounge, a kitchen/dining area and a small courtyard garden. The service provides accommodation and personal care for up to five older people, some of whom have dementia. There were four people living at the address at the time of our visit.

During our last comprehensive inspection of this service which took place on 27 and 28 October 2015 we found a breach of the regulations in relation to good governance. This was because the provider had failed to notify us of a serious incident in accordance with their registration requirements.

After the inspection, the provider wrote to us to say what they would do to meet legal requirements in relation to the breach. We undertook a comprehensive inspection on the 13 June 2017 to check that they had followed their plan and to confirm that they now met legal requirements. At this inspection we found the provider had made improvements in relation to good governance and they were no longer in breach of the regulations.

The service had a registered manager in post. 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 registered manager was based at another Octavia Housing service in the local area and divided her time between the two service locations. She was supported in her duties by a full-time deputy manager.

The service received referrals from social workers based in the Royal Borough of Kensington and Chelsea. Social workers completed an initial care and needs assessments. This information was used to inform and develop people’s care plans. Relatives were asked to contribute to the care planning process where this was appropriate. This ensured people’s support needs could be identified and risk assessments completed before people moved into the service on a permanent basis.

People’s risk assessments covered a range of issues including guidance around falls and mobility, nutrition and personal care. Staff supported people to attend health appointments and there were protocols in place to respond to any medical emergencies or significant changes in a person’s well-being.

The provider had safeguarding policies and procedures in place and staff were able to describe the actions they would take to keep people safe. The registered manager and the deputy manager were clear about the action they would take to investigate and follow up any safeguarding concerns.

The service was meeting the requirements of the Deprivation of Liberty Safeguards (DoLS). The Care Quality Commission (CQC) is required by law to monitor the operation of the Mental Capacity Act 2005 (MCA) and DoLS, and to report upon our findings. DoLS are in place to protect people where they do not have the capacity to make decisions and where it is regarded as necessary to restrict their freedom in some way, to protect themselves or others.

Senior staff understood when a DoLS application should be made and how to submit one. No applications had been made to the relevant agencies as people using the service were not subject to restrictions.

People’s independence was promoted. People were supported to attend day centres during the week. There were opportunities for people to partake in a range of activities that were culturally appropriate and tailored to people’s individual needs and preferences.

Staff were aware of people’s specific dietary needs and preferences and offered people choices at mealtimes.

There were arrangements in place to assess and monitor the quality and effectiveness of the service. This included annual surveys, staff team meetings and auditing the administration of medicines.

Relatives

Care plans and risk assessment were reviewed in line with the service’s own guidelines and these were reviewed more frequently dependent upon the complexity of people’s needs.

People’s health and safety was protected when more than one provider was involved in their care and treatment, or when they moved between different services.

There were infection control policies in place and staff ensured that all protocols were followed. There were effective systems in place to reduce the risk and spread of infection.

There were enough qualified, skilled and experienced staff to meet people's needs.

People who use the service and their relatives were asked for their views on the service and they were acted on. For example, people recently chose what they colour they wanted to decorate the living room.

People told us that they were happy with the service being provided by staff at 108 Highlever Road. They told us they are ``quite nice really’’ and ``they do think of everything here’’. We saw people sitting comfortably at lunch and eating independently. Staff responded respectfully to people’s needs and provided assistance when required. It was evident that staff knew and understood the needs of the people who use the service.

People told us that they were happy with the service being provided by staff at 108 Highlever Road. They told us they liked the food and that staff were nice. We saw positive interactions between people who use the services and the staff and it was evident that staff know and understand the needs of the people who use the service.

This inspection took place on 27 and 28 October 2015 and was unannounced. The service was meeting all of the essential standards of quality and safety we checked the last time we visited in January 2014. During this visit we found a breach of the Care Quality Commission (Registration) Regulations 2009.

108 Highlever Road is an older property divided into 5 separate rooms, each with en-suite wet room facilities. People also have access to a comfortable communal lounge, a kitchen/dining area and a small courtyard garden. The service provides accommodation and personal care for up to five older people, some of whom have dementia. There were three people living at the address at the time of our visit.

The service had a registered manager in post. 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 registered manager was based at another Octavia Housing service in the local area and was not available during our visit.

The provider was not always notifying the Care Quality Comission of incidents which should have been reported to us in line with the provider’s registration requirements.

The service received referrals from social workers based in the London borough of Kensington and Chelsea. Social workers completed an initial care and needs assessments. This information was used to inform and develop people’s care plans in consultation with people and their family members (where appropriate). This ensured people’s support needs could be identified and risk assessments completed before people moved into the service on a permanent basis.

People’s risk assessments covered a range of issues including guidance around falls and mobility, nutrition and personal care. Staff supported people to attend health appointments and there were protocols in place to respond to any medical emergencies or significant changes in a person’s well-being.

Staff were familiar with the provider’s safeguarding policies and procedures and able to describe the actions they would take to keep people safe. We had received no safeguarding notifications from the provider since the last inspection took place in January 2014. During our visit the deputy manager told us about two incidents which should have been reported to CQC in line with the provider’s registration requirements. We have requested that in future all notifications are sent us in a timely fashion so that where needed, action can be taken.

The service was meeting the requirements of the Deprivation of Liberty Safeguards (DoLS). The Care Quality Commission (CQC) is required by law to monitor the operation of the Mental Capacity Act (2005) (MCA) and DoLS, and to report upon our findings. DoLS are in place to protect people where they do not have the capacity to make decisions and where it is regarded as necessary to restrict their freedom in some way, to protect themselves or others.

Senior staff understood when a DoLS application should be made and how to submit one. No applications had been made to the relevant agencies as people using the service were not subject to restrictions.

People’s independence was promoted. One person was supported to attend a day centre during the week. People took trips out and we were told that activities were organised on an ad hoc basis for those who wished to participate.

Staff were aware of people’s specific dietary needs and preferences and offered people choices at mealtimes. People’s opinions as to the quality and quantity of food provided were positive. Fruit and drinks were available at each meal and tea and snacks were served throughout the day or when requested.

There were arrangements in place to assess and monitor the quality and effectiveness of the service. This included annual surveys, staff team meetings and auditing the administration of medicines. People using the service expressed positive views about the service and the staff.