We undertook an inspection of Residential Care Services Limited on 29 August 2017.

Residential Care Services Limited is a domiciliary care agency registered to provide personal care services to people with learning disabilities. The service is situated in the London Borough of Brent. At the time of this inspection the service was providing care and support to10 people residing in supported living services at three locations.

At our last inspection of 28 August 2015 the service was rated Good.

At this inspection we found that the service remained Good.

The staff members we spoke with demonstrated a good understanding of how to identify and report suspicions of abuse. People had up to date risk assessments in place which included guidance for staff on how to reduce and manage risk. Medicines were well managed and recorded. There were sufficient staff members deployed to ensure that people’s support needs were met.

Staff members received training and supervision to ensure that they were skilled and competent in their roles. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible. The policies and systems in the service support this practice. People were involved in the planning and preparation of their meals and guidance was in place for staff supporting people with dietary needs. Staff supported people to ensure that their health care needs were met.

Staff members showed a caring attitude towards people and ensured that they were supported with dignity and privacy. People told us that they were happy with the support that they received from staff.

People’s support plans were up to date and included guidance for staff on how they to meet people’s needs and preferences. Individual records showed that people were supported to participate in a range of activities outside the home. The people we spoke with confirmed this. Support plans included information about people’s spiritual and cultural needs and we saw that these were met. A complaints procedure was in place and people told us how they would raise any complaints or concerns.

People told us that they knew the registered manager. We saw that the registered manager was familiar with people and communicated with them in ways that they understood. Staff members said that they felt well supported and could approach the registered manager at any time if they had a concern. There were a range of processes in place to monitor the quality of the service. Actions had been taken to address any concerns arising from these.

Further information is in the detailed findings below.

An inspector carried out a planned inspection and gathered evidence against the outcomes we looked at to help answer our five key questions; Is the service caring, is the service responsive, is the service safe, is the service effective, is the service well led?

Below is a summary of what we found. The summary is based on our observations during the inspection, discussions with people using the service, the staff supporting them and looking at records. If you wish to see the evidence supporting our summary please read the full report.

Is the service safe?

People told us they felt safe in the service. We found sufficient staff were available to deliver people’s care and support needs and they received the training required to provide safe, appropriate care and support. Appropriate checks had been carried out before staff started working with people to ensure they had the appropriate knowledge, skills and experience to meet people’s care and support needs.

People were protected from the potential for abuse and neglect as the provider had taken reasonable steps to ensure staff recognised the signs of abuse. Staff we spoke demonstrated their knowledge in recognising signs and symptoms of abuse and how to report concerns. The registered manager demonstrated how concerns were investigated with necessary actions identified, taken and followed up.

The provider had an effective system in place to analyse any incidents that occurred when providing care and support for people in their homes. Records were accurately maintained, which meant the risk of people receiving unsafe care was minimised.

Is the service caring?

People told us they were treated with respect and dignity by the staff. We found people were supported appropriately and sensitively by kind and considerate staff. We spoke with staff who told us about how they provided care and support. People we spoke with were positive about the caring nature of staff members supporting them. One person told us, “The person who helps me does treat me with respect.”

Is the service effective?

People’s health and care needs were assessed with them. We saw evidence to show people and their relatives or advocates had been involved in writing and agreeing their care plans. Specialist dietary and healthcare needs had been identified in care plans where required. People we spoke with told us they received the support needed. People’s care was subject to review so staff could ensure their needs were being met effectively.

Is the service responsive?

Staff we spoke with demonstrated they would report any concerns to the registered manager and were confident these would be addressed. This was confirmed by a staff member we spoke with who told us, “I recently noticed (a person who used the service) had developed a (health concern). I reported it straight away to the manager and we supported the person to access their doctor.”

We saw there was an effective complaints procedure in place. One person told us, “I don’t have any reason to complain but I know who to speak to if I did.”

Is the service well led?

People we spoke with, staff and relatives were positive about the management of the service. Staff told us they felt supported by the registered manager.

We found monitoring and reviews of the service were carried out regularly and highlighted actions were completed in a timely manner.

The agency was newly registered and at the time of this inspection it had only a few people who used the service. We spoke with two people who used the service who were living in sheltered accommodation for people with learning disabilities.. We also spoke to a relative of a person who used the service. They informed us that care staff treated people with respect and dignity and they were satisfied with the services provided. Their views can be summarised by the following comment from a person who used the service, “They are kind to me. They talk and discuss things with me and I am happy with the care. I have made improvements”.

People who used the service said they felt safe with care staff and no concerns were expressed. The agency had an appropriate safeguarding policy and procedure. Care staff had been provided with training on how to respond to allegations or incidents of abuse.

Staff had been carefully recruited. The recruitment records contained the required documentation. People who used the service and a relative stated that care staff were reliable and competent.

There were arrangements for quality assurance. Monitoring visits and spot checks had been carried out by senior staff of the company. There was evidence that people who used the service and staff had been consulted and informed of issues related to the running of the service.

We undertook an announced inspection of Residential Care Services Limited on the 28 August 2015.

Residential Care Services Limited is a domiciliary care agency registered to provide personal care services to people with learning disabilities. The services they provide include personal care, housework, assistance with medication and shopping. At the time of this inspection, there were three people using the service.

At our last inspection on 22 August 2014 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 [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.

Safeguarding and whistleblowing policies and procedures were in place and staff had undertaken training in how to safeguard adults. Care workers were able to identify different types of abuse and were aware of what action to take if they suspected abuse.

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 service. They told us “I enjoy it here. I like the job.”

People using the service and relatives spoke very positively about the service and care workers. People told us “I am happy, they are nice people” and “I am happy here. I like the staff. They are very nice.” Relatives told us “They have [person’s] care and their needs as their top priority” and “I do not have enough praise for this place.”

There were arrangements in place to obtain, and act in accordance with the consent of people using the service. The registered manager and care workers showed a good understanding of the Mental Capacity Act 2005 (MCA) and issues relating to consent. However there was limited information on people’s mental capacity levels. The registered manager told us she would review the care plans and include the reasons why people needed specific support as part of their daily lives.

Positive caring relationships had developed between people using the service and staff. We observed people were relaxed and at ease. Relatives spoke positively about the care workers and told us they were “Second to none, absolutely fantastic”, “Invaluable and ensure continuity of care” and “On the ball and very hands on.”

People’s independence was encouraged and promoted and people were supported to follow their interests, take part in them and maintain links with the wider community.

There was a clear management structure in place which consisted of a team of care workers, the registered manager and the provider. Care workers spoke positively about the registered manager and told us “[Registered manager] tells me what to do. She listens and is a good manager. She is very supportive.”

Systems were in place to monitor and improve the quality of the service.