We undertook an announced inspection of Pathways Independent Care and Autism Services (PICAS) on 2 May 2017 and 10 May 2017. The provider was given 48 hours’ notice because the location provides supported living and domiciliary care services and we needed to be sure that someone would be available to assist us with the inspection.

At our last inspection on 3 March 2016, we found four breaches of legal requirements. People who used the service were not sufficiently protected from the risk of abuse and their human rights were not always protected. We also found shortfalls with ensuring people received care that was responsive to their needs and notifying the Care Quality Commission of incidents that occurred within the service.

We undertook this inspection to comprehensively look at the whole service again and to check that they were now meeting legal requirements.

PICAS provides a supported living service to people living in their own homes in the London Boroughs of Redbridge, Newham and Hackney. Some people received personal care. At the time of the inspection, there were ten people were using the service. People either lived on their own or shared their accommodation with another person who used the service. The accommodation was maintained and owned by private landlords, who provided people with a long term tenancy agreement. People were visited and supported by staff from PICAS or had staff stay with them in their homes.

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.

We found that the provider had taken action to improve the service and we were assured that fundamental standards of quality and safety were being met. We advised that people’s records should be unique and individualised so they are not confused with another person.

People were supported to maintain healthy diets and ensure their nutritional requirements were met. They had access to treatment from health professionals and staff contacted them in emergencies.

There were recruitment procedures in place and staff were recruited safely. However, we have made a further recommendation about the provider’s recruitment processes. People were prompted to take their medicines as prescribed.

Staff respected people's privacy and choice. They told us they had support, training and supervision. They had knowledge of safeguarding and whistle blowing procedures and were able to describe the steps they should take to protect people from abuse and how to report incidents of abuse. We also recommended that there is more effective communication with local authorities when sharing information.

Records showed staff regularly attended staff meetings with the management team.

Where able, people made their own decisions regarding various day-to-day tasks including choices of food, activities and daily routines. There were systems in place to implement the requirements of the Mental Capacity Act 2005 (MCA) to ensure people’s human rights were protected.

Each person had a care and support plan which stated their support needs. The plans were regularly reviewed to reflect any changing needs.

People and relatives told us they knew how to make a complaint. They said staff listened to them and they were happy with the way the registered manager responded to complaints.

The registered manager had systems in place for auditing and monitoring the service to ensure quality was being maintained. People's finance and medicine records were regularly checked. A survey questionnaire was distributed to people, their relatives and social care professionals to ask them for their opinion about their experience using the service. The registered manager analysed