The inspection took place on 27 September 2016 and was unannounced. The previous inspection took place on 23 July 2013 at which time all the assessed standards were being met.

Support for Living - 62 Rosemont Road is a supported living service that provides care to three people with a learning disability. At the time of our inspection there were three people living at the service. The provider is Certitude, which has a number of supported living homes in London providing support for people with learning disabilities, autism and mental health needs.

The registered manager had recently left and the deputy manager was managing the service with support from the service manager. At the time of the inspection, a new manager had been appointed and was due to start the following week. After they started, we saw that they made an application to the Care Quality Commission to become the registered manager of the service. 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.

Appraisals were not up to date and team meetings were not held consistently but staff generally felt supported by the deputy manager and the new manager had begun to schedule dates for appraisals and team meetings.

There were procedures in place to safeguard people, staff knew how to respond if they suspected abuse, there were enough staff to support people using the service and risk assessments minimised harm to people using the service.

There were a number of regular maintenance and service checks carried out to ensure the environment was safe. Medicines were administered and stored safely.

People were supported to have enough to eat and drink and were able to have food and drinks when they wanted to.

People had access health care services and the service worked with other community based agencies.

We observed staff were kind, people’s dignity and privacy was respected and staff were able to give a good account of people’s individual needs and preferences.

An appropriate complaints procedure was available.

Relatives and staff indicated they could speak to the deputy manager about concerns.

During this inspection we spoke with four members of staff and one person living at the home. We could not speak with some people who use the service because they had complex needs which meant they were unable to share their experiences with us. We observed the way staff provided care to people, spoke with staff and looked at people’s records to find out about their experiences.

During our inspection in January 2013 we found that appropriate standards of cleanliness and hygiene were not being maintained, arrangements for medicines management were not always effective and some systems for quality monitoring were not effective. During this inspection we found that the provider had made the necessary improvements to address these shortfalls.

We observed that staff talked to people before providing care and support so people knew what was happening. All interactions we observed were positive and we saw that staff had a good understanding of people’s care needs and how best to support them.

People’s needs were assessed and care was planned to meet their needs, choices and preferences.

Prior to commencing work the provider ensured that all required checks on staff were carried out to make sure they were suitable to work with people who use the service.

Some people are verbal and can let us know their views by speaking to us. Whilst other people express their views in other ways such as pointing, gestures and the sounds they make. Therefore we spoke with some people and spent time observing the care and support the other people receive in the service.

We saw that people’s needs are assessed and recorded so that the staff team know how to support them safely and appropriately.

We observed that people using the service have opportunities to make choices about what they do in their lives and we saw that staff were aware of what people like and dislike. We saw that staff were able to support people with these choices as they understood the different ways people communicate.

We saw that people were supported by staff to go out into the community and meet other people.

People also spend time with others in social clubs and attend day centres which encourages them to develop skills and learn new activities.

We spoke with one person using the service, four staff and one relative. Some people using the service were not able to tell us directly about the care they received and experienced. During our visit we observed and found people were receiving care, treatment and support that met their individual needs and preferences. A relative we spoke with said that staff had a good understanding of the needs of their family member. They said “without exception there is no member of staff that I would be concerned about, they all do try really hard”. We saw that people were involved in the development and review of their care plan.

Arrangements were not in place to ensure that an appropriate standard of cleanliness and hygiene was being maintained.

Arrangements were in place for the management of medicines but these were not effective and robust. The home was being appropriately staffed to meet people’s needs.

The provider did have in place some systems for quality monitoring, however these were not always effective in identifying risks to people who used the service.

A complaints procedure was in place and the relative we spoke with said they were confident to raise any concerns and that they would be addressed.