This inspection took place on 2 November 2017 and was announced. Short notice was given to the service as it is a supported living service for people with learning disabilities and mental health issues. The staff needed to ensure people using the service were happy for us to visit them in their own apartments. This was the second comprehensive inspection completed on the service. The previous inspection was completed in June 2015 and rated the service overall –Good, with requires improvement in well-led, but no requirements were issued. Since the last inspection improvements had been made to show that the service fully monitored and analysed accident and incidents for any trends. They also ensured surveys completed were collated and themes and suggestions were actioned.

St Anne’s Apartment is an extra care supported living service that provides care and support to adults with a learning disability and mental health needs. This service provides care and support to people living in ‘supported living’ settings, so that they can live as independently as possible. People’s care and housing are provided under separate contractual agreements. CQC does not regulate premises used for supported living; this inspection looked at people’s personal care and support.

The service is staffed 24 hours and had the governing ethos of a service that is flexible, a home for life whilst supporting people to be autonomous and independent. There were 14 people using the service at the time of our inspection. The age range of people receiving support varied from 21 – 80 plus years.

People who used the service lived in their own flats. Five flats were two-bedded, and five flats were single-bedded flats. There was also a communal dining area and kitchen along with outside gardens. The flats were located in two buildings with the service’s office in one of these buildings. The Care Quality Commission (CQC) inspects the care and support the service provides, but does not inspect the accommodation they live in.

St Anne’s Apartment’s belongs to the organisation the Frances Taylor Foundation. The Frances Taylor Foundation is part of the UK charity the Poor Servants of the Mother of God. As a faith based charity the underlying principles of care and respect for each individual informs all of the organisations work. The charity has services across London, Sussex and Merseyside.

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.

People said the loved living at St Anne’s apartments, felt safe and well cared for. One person said “This is the best place I have ever lived. I love it here. I don’t want to move.”

The service was exceptionally responsive to people needs wishes and future goals. They worked collaboratively with people, other professionals and organisations to ensure people had their diverse needs and wishes met. People had fulfilling lives doing what they enjoyed and being challenged to try new things.

People were at the heart of the service and staff worked hard to ensure a person centred approach kept people engaged, healthy and active. People were treated with kindness, respect and compassion. Their diversity and uniqueness was celebrated. Staff had developed strong bonds and good relationships with people and understood what was important to them.

There were sufficient staff with the right skills and experience to ensure people’s needs and wishes were being met. Staffing covered a 24 hour period with people having specific hours as well as some shared care hours to enable them to be active and have fulfilling lives. Staff had comprehensive training and support to enable them to do their job effectively and safely.

We inspected St Anne’s Apartment’s on the 22 and 23 June 2015 and this was an announced inspection which meant the provider knew we were coming. St Anne’s Apartment is an extra care supported living service that provides care and support to adults with a learning disability and mental health needs. The service is staffed 24 hours and had the governing ethos of a service that is flexible, a home for life whilst supporting people to be autonomous and independent. There were 12 people using the service at the time of our inspection. The age range of people receiving support varied from 21 – 85 years old.

People who used the service lived in their own flats. Five flats were two bedded and two were single bedded flats. There was also a communal dining area and kitchen along with outside gardens. The flats were all located within one building along with the services office. The Care Quality Commission inspects the care and support the service provides, but does not inspect the accommodation they live in.

St Anne’s Apartment’s belongs to the organisation the Frances Taylor Foundation. The Frances Taylor Foundation is part of the UK charity the Poor Servants of the Mother of God. As a faith based charity the underlying principles of care and respect for each individual informs all of the organisations work. The charity has numerous services across London, Sussex and Merseyside.

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.

Systems were in place for the recording of incidents and accidents. However, incidents and accidents were not monitored overall for any emerging trends and themes. Feedback was regularly sought from people, support workers and relatives. In March 2015, satisfaction surveys were sent out to support workers and relatives, however, the feedback had not been collated to monitor for any trends or identify how improvements to the service could be made. Despite the above concerns, people received the care that met their needs. However, we have identified the above as areas of practice that needs improvement.

People were thoroughly involved in the inspection. People invited us into their flats to talk about the care and support they received. People had written us letters and support workers had spent time with people explaining the inspection process and informing people of the role of the Care Quality Commission.

People spoke passionately about living at St Anne’s Apartments. One person told us. “This is one of the best services I’ve been in. It’s the staff that make the difference.” Another person told us, “This place was a God send for me and my family.”

There were enough qualified, skilled and experienced support workers to meet people's needs. Staffing levels were calculated according to people’s changing needs and ensured continuity of one to one support. Thorough recruitment practice was followed to ensure support workers were suitable for their role. People were involved in the recruitment process, sitting on interview panels and posing questions they wished to ask potential support workers.

People received an outstanding level of support that met their psychological needs. The ethos of the care was very much person centred and people received support that enabled them to reach their goals, learn new skills and promote their well-being.

Support workers provided the support that people required which enabled them to manage their medicines safely; people were encouraged to self-medicate and stored their medication in a locked cabinet in their flats.

People received support with meal preparation, food shopping and menu planning. Support workers worked with people to promote their independence with cooking or provided full assistance when needed. Support workers had received training on the Mental Capacity Act 2005 and always sought and obtained people’s consent before they provided support. When people declined or changed their mind, their wishes were respected.

The registered manager and the support workers approach promoted an environment where people could develop new skills. They promoted people’s independence, encouraged them to do as much as possible for themselves and to make their own decisions. Support workers and people spoke highly of the registered manager. One support worker told us, “She’s the best manager I’ve ever had.”