We carried out this announced inspection on 20 February 2019. Tower Hamlets LD Service is a supported living service for adults with a learning disability. The service is based in a large house with communal kitchen and bathroom facilities. At the time of this inspection the service was providing personal care to three people.

At our last inspection on 26 July 2016 we rated the service ‘good’. At this inspection we found the evidence continued to support the rating of ‘good’ and there was no evidence or information from our inspection and ongoing monitoring that demonstrated serious risks or concerns. This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection. “The care service has been developed and designed in line with the values that underpin the Registering the Right Support and other best practice guidance. These values include choice, promotion of independence and inclusion. People with learning disabilities and autism using the service can live as ordinary a life as any citizen.”

The service had a registered manager. 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 were supported to achieve their goals. This included improved access and involvement in the local community, varied activities and access to paid employment. People were involved in all aspects of the running of the service and told us they felt staff treated them with dignity and respect and were listened to.

People continued to be able to speak up about the service they received and what they would like to achieve in future and the service advocated for people’s future care needs. Information was provided to people in line with accessible information standards and people felt confident raising concerns with managers.

People continued to be safeguarded from abuse and risks to people were well managed. Medicines were safely managed and there were enough staff to meet people’s needs. Safer recruitment processes were operated with the involvement of people who used the service.

Support workers felt well supported by managers and received regular training and supervision to carry out their roles. People had the right support to maintain good health and eat well and healthily. The service supported people to meet their cultural needs and to communicate well with support staff.

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 supported this practice.

Managers were more confident in ensuring standards were met and worked well with people who used the service and other agencies to improve the service and deliver better outcomes for people.

We carried out on this inspection on 26 and 27 July 2016. We gave the provider 48 hours’ notice of this inspection. This was the first inspection since the provider registered with the Care Quality Commission to provide this service in February 2015.

Tower Hamlets LD Service is a supported living service for people with learning disabilities, which provides personal care for three people who live at the service, with another three people who received support from the service but not with personal care. The service is a large house on Old Ford Road with eight bedrooms including a staff sleep-in room, a staff office downstairs, two kitchens, a shared garden, two shower rooms and a bathroom. One bedroom was unused at the time of our inspection and one person was in hospital.

The service had a registered manager. 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.

The provider had plans in place to manage risks to people, which were reviewed regularly. There was a robust system of health and safety checks to ensure that the service was safe, and when incidents and accidents had occurred these were appropriately recorded and necessary actions were taken.

Staff operated in a person-centred way, ensuring that people’s care plans reflected their needs, and supported people to achieve their goals, which included increasing their independence and going on holidays and day trips with staff support. People were involved in the running of the service, including being given roles by the provider to support health and safety and the security of the building. People were supported to make choices about their home through regular house meetings. We saw that people were treated with respect by staff who promoted their privacy and dignity. Issues of consent and mental capacity were dealt with appropriately by the provider, who had correctly applied to the local authority when they thought people may be deprived of their liberty.

The provider ensured that it met people’s needs and supported people to speak up through regular keyworking sessions and by reviewing care plans and people’s levels of support. People had communication passports in place, and the provider was using accessible communications and objects of reference to ensure people could communicate their wishes. People were supported to achieve good health outcomes, through the use of health action plans and hospital passports and by providing people with accessible information about their health. Staff had sought specialist advice and planned to meet people’s changing needs. People were supported to eat a balanced diet which met their health needs, make choices about their food and develop their independence.

Managers maintained good systems of audit and provided a strong presence in the service and good leadership through team meetings and supervision. People knew how to make complaints, and complaints were investigated and appropriate actions taken in response.

Medicines were stored and administered safely, although we found that the way the service documented medicines and assessed people’s needs was not always in line with best practice. We have made a recommendation about how the provider manages medicines.