Spring Grove Road is a care home for up to five adults who have a learning disability. The accommodation is provided in two semi-detached house which are connected via a shared garden. At the time of our inspection one person lived in one house and three people lived in the other. The home is managed by Voyage 1 Limited, a UK wide company providing social and healthcare to people with learning disabilities.

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 and associated Regulations about how the service is run.

The last inspection of the service was on 7 July 2015 and the service was rated Good.

This inspection took place on 9 May 2017 and the service remained Good.

People appeared happy and relaxed at the service. The staff were kind, caring and supportive. People were given choices and these were respected. Relatives told us that they were happy with the service people received. They told us individual needs were met, the service was well run and the staff were appropriately skilled and were kind.

People's needs were being met. The staff had assessed individual needs and had planned for these. Their care was regularly reviewed and their opinions and wishes were valued and part of care planning. People enjoyed a range of different social activities. People were supported to eat a varied and nutritious diet and they were involved in planning, preparing and shopping for food. People were supported to develop independent living skills and help to keep their home tidy. The staff worked with other professionals to monitor and meet people's health needs.

The staff had the training and information they needed to safely care for people. There were enough staff and they were skilled and competent. Some staff felt they would like more support and did not always feel listened to. We told the regional operations manager about this so they could talk with the staff about how they felt. They were already aware of the situation and were working with the staff team to address concerns people had.

People were cared for in a safe environment. They were supported to receive their medicines in a safe way and as prescribed. The families of people told us they were involved in the service and were able to discuss any concerns they had. They told us these were acted on and they felt people were safe and well cared for.

The provider had systems for monitoring the quality of the service and making changes when needed. The staff maintained appropriate records.

The inspection took place on 7 July 2015 and was unannounced. The last inspection of the service was on 5 September 2014. There were no breaches of Regulation at this inspection.

Spring Grove Road is a care home for up to five adults who have a learning disability. The accommodation is provided in two semi-detached house which are connected via a shared garden. Two people live in one house and three in the other. The home is managed by Voyage 1 Limited, a UK wide company providing social and healthcare to people with learning disabilities. The registered manager left the service in March 2015. The provider has employed an acting manager and was in the process of recruiting a permanent manager at the time of our inspection.

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 and associated Regulations about how the service is run.

There were appropriate procedures for safeguarding adults and the staff were aware of these.

The risks people were exposed to had been assessed and there were plans to reduce the likelihood of harm.

There were enough staff employed at the home and recruitment procedures were designed to make sure the staff were suitable.

People’s medicines were managed in a safe way.

The staff were appropriately trained and supported. They had the information they needed to carry out their roles.

People’s capacity to consent had been assessed and information about how they made decisions had been recorded. The provider had acted in accordance with their legal requirements under the Mental Capacity Act 2005 and the Deprivation of Liberties Safeguards because they had applied for authorisation to lawfully restrict people’s freedom to use the community without support.

Peoples’ health care needs had been assessed, monitored and met.

People were given a variety of nutritious and freshly prepared food. Their nutritional needs had been assessed and met.

The staff were kind, considerate and treated people with respect. They showed genuine fondness for the people who they cared for.

People had their needs met in a personalised way. Their needs were recorded and they were able to make choices about their daily lives. People took part in a range of different social and leisure activities and used the local community.

There was a suitable complaints procedure and the provider responded appropriately to complaints and concerns.

There was a positive and inclusive culture at the home.

The provider had systems for monitoring the quality of the service and mitigating against risks to people’s well-being.

The home was visited by one inspector to ask the five questions; is the service safe, effective, caring, responsive and well led? During the visit we were able to speak with two people who used the service, with three staff and the home manager. We read care support plans of five people who used the service.

Is the service safe?

People we spoke with told us they felt safe in the home. People, their relatives and observations made during our inspection told us staff working at the home were well trained and knew their roles.

People living in the home had assessments of possible risks to their health and welfare and these were reviewed at least monthly.Staff were aware of and understood the Mental Capacity act. [MCA2005]. The provider was meeting the requirements of the Deprivation of Liberty Safeguards to ensure people who might have limited capacity and place themselves at risk were protected from harm. Staff had followed the relevant application processes. People were looked after and cared for by staff who were suitably qualified, skilled and experienced. We checked staff supervision and training files and found the provider had made arrangements to ensure staff received training and sufficient supervision so that people received care which was safe and appropriate. There was a robust selection procedure in place to ensure staff had the right skills and experience to provide safe care.

Is the service effective?

People’s health and social care needs were assessed and they told us staff understood and provided the care and support they needed. People were involved in making decisions about their care wherever possible. We read in care support plans how staff used non-verbal communication to ascertain people's needs and desires. If people could not contribute to their care plan, staff worked with their relatives and other professionals to assess the care they needed.

Is the service caring?

People living in the home told us staff were kind and caring and treated them with respect. They also told us they were offered choices and that staff knew about their preferences and daily routines. People told us staff treated them with respect.

Is the service responsive?

People told us they enjoyed the activities provided. Where people were not able to make decisions about their care, staff worked with their relatives and other professionals to make sure ‘best interest decisions’ were agreed. When we visited we saw arrangements were in place to carry out an assessment of people’s capacity to make specific decisions, if this was necessary. There was evidence staff regularly consulted people who used the service about their care and modified the service where necessary.

Is the service well-led?

The service was well led and provided strong leadership and a positive culture. For example regular surveys ensured people’s views were obtained and regular audits ensured that the quality of service was monitored. Staff understood their roles and responsibilities. We saw the provider worked well together with other health and social care agencies to make sure people received the care, treatment and support they needed.

During our inspection there was one person using the service. They told us they liked living at the home and the food provided. We saw staff being respectful and talking to people in a friendly and caring way.

Part of this inspection was to follow up a Compliance Action imposed as a result of the findings of our previous inspection of the service. We found that the home had taken action to address this area and improve the service people received. Improvements included all staff being trained to give people support with medicines, and the monitoring of the storage temperature of medicines

During our visit we spoke with the two people who use the service. They told us that they got good support from the staff and that they could lead the lives they wanted to. They said that they were able to choose what they did each day and what meals were prepared at the home.

People told us that staff had time to spend with them, and we observed this happening at the service, where staff spent time talking with people in the lounge areas.

However, we found the arrangements for giving people their medication was not sufficient to meet the needs of the people who use the service.

People told us that staff supported them appropriately to meet their needs. They said that they were supported to access the community through attendance at church and the day centre as well as leisure activities in the local area. One person told us ‘I like living here. We go on trips which I enjoy’. They told us that they were involved in their care and were able to freely express their views about the service. They said that their views were listened to and acted upon.

A person using the service said that the food was good and that they were able to choose what they wanted to eat.

People living in the home had access to ‘Speak Out in Hounslow’ which is a local advocacy service. ‘Speak Out’ helps represent the views of people who need support to give their opinions about their care and the service in which they live.

Overall, people were very positive about their experiences of living in the home. However, we found some concerns related to support for staff and the security of the premises.