About the service:

• The Regard Partnership Limited – Tolworth Park Road is a care home is a ‘care home’. At the time of our inspection five people were living at the home, of varying ages.

People’s experience of using this service:

• People were not fully supported to engage in meaningful activities that were important to them and improved their social skills. Staff were not always fully responsive in engaging people in non tasked based activities.

• Improvements were needed to ensure the premises were updated to meet the needs of all the people living at the home, primarily affecting use of the bathroom facilities and space for night staff.

• We have made a recommendation in relation to supporting staff to understand how to safeguard people from abuse.

• People received their medicines in a safe way, with records being kept up to date and accurate.

• Risks to people were regularly assessed and the premises were maintained safely.

• People were cared for by staff that had been suitably vetted, and received regular training, supervision and appraisal.

• People received meals in line with their preferences and were supported to access healthcare services.

• Staff demonstrated a compassionate attitude towards people they cared for and treated people with privacy and dignity.

• Complaints were appropriately managed and responded to.

• Comments in relation to the management were overall positive with staff telling us they received a good level of support.

Rating at last inspection:

• At our last inspection of 04 January 2017 we rated the service as ‘Good’. (Report published 01 February 2017)

Why we inspected:

• This inspection was part of our scheduled plan of visiting services to check the safety and quality of care people received.

Follow up:

• We will continue to monitor the service to ensure that people receive safe, compassionate, high quality care. Further inspections will be planned for future dates.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

The Regard Partnership – Tolworth Park Road is a care home for six people with learning disabilities who require personal care. There were four people living in the home at the time of our visit. Some people had limited verbal communication.

When we last visited the home on 13 May 2015 the service was meeting the regulations we looked at and was rated Good overall and in all five key questions.

At this inspection we found the service continued to be Good.

There continued to be enough staff deployed to care for people well and staff recruitment processes continued to be robust so only suitable staff worked with people. Staff managed people’s medicines safely and staff understood how to safeguard people from abuse. The provider continued to manage risks to people and the premises well.

The provider continued to ensure staff received the necessary training, supervision and appraisal to care for people. Staff supported people to access the healthcare services they needed. People received choice in their food and drink. Staff worked in accordance with the Mental Capacity Act 2005 and gained consent from people before carrying out their care.

People were cared for by staff who were caring and who knew them well. People were treated with dignity and respect by staff and were encouraged to share their views on their care and had access to an advocacy service. Staff supported people to be as independent as they wanted to be.

People had access to activities they were interested in and received care centred on them as individuals. People’s care plans and personal goals were regularly reviewed and people, their relatives and others important to their care were involved in the reviews. A suitable complaints process was in place to ensure complaints were used to improve the service and that complaints records were clear.

A registered manager was in place who had a good understanding of their roles and responsibilities, as did staff. Thorough quality audits were in place to assess, monitor and improve the service. The registered manager and provider encouraged communication with people, relatives and staff well through a variety of means such as meetings, questionnaires and newsletters.

The service met all the fundamental standards. Further information is in the detailed findings section of the report.

This unannounced inspection took place on 13 May 2015. Tolworth Park Road is a care home which provides accommodation and personal care for up to six people with learning and physical disabilities. There were six people living at the home on the day we visited. The home was based in a single storey bungalow.

At the last inspection on 26 September 2013 we found the service was meeting the regulations we looked at.

The service had a registered manager at the time of the inspection. 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.

People were safe at the home. The provider took appropriate steps to protect people from abuse, neglect or harm. Training records showed staff had received training in safeguarding adults at risk. There were easy read versions of ‘protecting people at risk’ and ‘safeguarding people’ on display for people to access and read.

Care plans showed that staff assessed the risks to people's health, safety and welfare. Where risks were identified management plans were in place.

The provider had processes in place to ensure people’s finances were kept safe. We saw these processes in action when people were organising their money in the morning for the day ahead. The provider also conducted financial audits of people’s money and all of this helped to ensure peoples finances were kept safe.

We saw that regular checks of maintenance and service records were conducted. An independent fire risk assessment was conducted in February 2015 and the outcome was good because up to date checks were made of fire equipment to help keep people safe.

We observed that there were sufficient numbers of qualified staff to care for and support people and to meet their needs. We saw that staff were always near at hand to give assistance, chat, play a game or help people when required.

People were supported by staff to take their medicines when they needed them and records were kept of medicines taken. Staff received annual medicines training.

We saw the home was clean and free of malodours. The kitchen was clean and the equipment well maintained.

Staff had the skills, experiences and a good understanding of how to meet people’s needs. People were cared for by staff who received appropriate training and support.

The service had taken appropriate action to ensure the requirements were followed for the Mental Capacity Act 2005 (MCA) and Deprivation of Liberty Safeguards (DoLS). These safeguards ensure that a service only deprives someone of their liberty in a safe and correct way, when it is in their best interests and there is no other way to look after them. An easy read version of what MCA and DoLS meant was on display for people to read.

People were supported to eat and drink sufficient amounts to meet their needs. We saw that meals were planned according to people’s wishes and that menus changed on a daily basis to offer choice to people.

Detailed records of the care and support people received were kept. Staff took appropriate action to ensure people received the care and support they needed from healthcare professionals. Easy read versions of different health care processes were available for people to help them understand what may happen to them.

People were supported by caring staff. The majority of the staff had worked at the home for many years and knew the people well. Staff enabled people to make decisions by taking the time to explain things to people and to wait for the person to make a decision.

People were encouraged to join in with household tasks, such as doing their own laundry, setting the table for dinner and helping to prepare and serve food.

The home held monthly house meetings and everyone who lived at the home was encouraged to attend. The agenda and minutes were in an easy to read format. People also had the opportunity to attend the local Learning Disabilities Parliament, held twice a year which included information sharing sessions and an open forum time. Kingston's Learning Disability Parliament is run by people with learning disabilities and supported by the local authority.

Advocacy services were available when required. This gave people the support where needed for them to make decisions and the opportunity to speak to an independent person about any aspect of their life that the wanted to discuss. An easy read survey was given to people every three to six months and the advocacy service could help people complete the questionnaire if help was required.

People’s privacy and dignity were maintained. We observed when providing personal care this was done in the privacy of people’s rooms.

People’s needs were assessed and information from these assessments were used to plan the care and support they received. People we spoke with knew about their care plans and had been involved in their development. Care plans were in an easy read format, written in the first person and comprehensive. This comprehensive information about people helped staff to understand a person’s needs and respond accordingly.

Many of the activities that people attended were organised by the local Mencap organisation. (Mencap is a national charity for people with learning disabilities) A list of activities and dates were sent to the home and people could choose which to go on and book themselves a place. Events included an open bus tour of London, crazy golf, cycling and bowling.

The provider had arrangements in place to respond appropriately to people’s concerns and complaints. There was an easy read version of the complaints procedure and people told us they knew who to make a complaint to and said they felt happy to speak up when necessary.

We could see that people who lived at the home knew who the deputy manager and staff were by name and could freely chat with them at any time. The registered manager and deputy both worked in the home with people. This helped to ensure people were cared for by staff and managers that were involved in the running of the home and available to people when needed.

The home had policies and procedures in place and these were readily available for staff to refer to when necessary. Many of the policies were also available in an easy read format so that people could read and understand them.

The provider had systems in place to assess and monitor the quality of the service. In addition to an annual survey, health and safety and quality assurance audits were conducted by the provider and the home conducted weekly health and safety checks of the environment, people’s rooms and equipment. Both types of audits generated action plans which were discussed and actions signed off once completed.

During our inspection, we spoke with relatives of people using the service. They told us their family members were involved in their care. Some of the comments included "they enjoy the meetings", "they are happy there" and "they say what they think". One person using the service that we spoke with told us "I like it here". One staff member told us "we always ask people what they would like to do".

We looked at three care plans during our inspection. These contained risk assessments and care needs assessments which identified different areas of support for people using the service. These were reviewed every six months or sooner if required. Staff read any changes to the support plans and signed them to indicate they understood them.

We saw evidence that each person had their own guidelines with regards to meal preparation and how they needed to be supported. A menu diary book was kept in which staff recorded the meals that people had eaten.

We saw that the provider had taken steps to ensure the home had been adapted for people with reduced mobility with the use of hand rails. There was step free access between the bedrooms and the communal areas of the home.

Relatives that we spoke with were positive about the staff at the home. One person said "the staff are regular". Another person said "staff listen to any concerns". We spoke with care workers who told us that they had received training which helped them to carry out their jobs more effectively.

Comments from people who use the service included "I am happy living here", "I have all I need in my room", "I do what I want to", "I go out to the day centre" and "I like watching my television".

People told us that staff gave them the help they needed, listening and providing support, speaking with them appropriately and respecting their privacy.

People said that they like the food saying "they cook what I like", "the food is good" and "I eat what I want".