We inspected Tudor Avenue Residential Care Home on 2 October 2017. The inspection was unannounced. At the last inspection on 21 September 2015 the home met all the key questions and received an overall good rating. A change of registered provider from the London Borough of Richmond-upon-Thames to Support for Living Limited took place in 2016. Our inspection is the first inspection of the service under the new registered provider.

Tudor Avenue is a care home that supports up to six people with a learning disability and additional physical disabilities or complex health needs. The home is managed by Support For Living Limited and is situated in Hampton in the London Borough of Richmond-Upon-Thames.

The home 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 and associated Regulations about how the service is run.

People and their relatives thought the home was a good place to live and people were happy there. When we visited people were supported to choose the activities they wanted to do and when they wished to do them. People were supported and encouraged to participate in community based activities and to maintain contact with friends and family.

Relatives felt that the home provided a caring environment with good support from external health professionals and that staff had a very caring attitude.

Relatives and staff knew how to raise concerns and told us they felt confident they would be resolved. Relatives told us that communication with the staff and management team was good.

People felt safe living at the home and were able to move freely without risk of accidents because the staff ensured that appropriate risk assessments were carried out and that the premises were free of hazards. The home was well maintained, furnished, clean and provided a safe environment for people to live and staff to work in.

Medicines and other health care regimes were managed appropriately, with accurate records being maintained.

Throughout our visit people’s body language and their interaction with staff and each other was positive and relaxed.

There were comprehensive records that were kept up to date. The care plans contained clearly recorded and up to date information which was regularly reviewed. This enabled staff to support people in the way they preferred.

The staff knew the people they worked with and understood their roles and responsibilities. They had the appropriate skills and training required to meet people’s needs and they were focussed on providing care and support for each person as an individual. This was delivered in an enabling, friendly and professional manner. Staff training and supervision emphasised providing care in a person-centred way. Staff spoke positively about working in the home and confirmed they received training and support.

Staff understood the requirements of the Mental Capacity Act 2005 and the need to ensure that as far as possible they received people's informed consent to the care and support provided.

People were protected from nutrition and hydration associated risks by being provided with balanced diets that also met their likes and preferences. People with complex nutritional needs and special assistance with feeding were provided with support in a respectful and dignified manner.

There was an open and inclusive atmosphere in the home. Staff were able to contribute to the vision for the home through regular team meetings. The provider carried out regular audits to monitor the quality of the service and to plan improvements.