This was an unannounced inspection and took place on 31 May and 2 June 2017.

The home at Curtis Road provides personal care and support for up to four adults who have a physical and/or learning disability. The service is managed by United Response and the building is owned by Thames Valley Housing Association. The home is in Whitton, Middlesex.

At the time of our inspection 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.

At the last inspection on 24 February 2015 the home met all the key questions and was rated good in each with an overall good rating.

As people using the service had limited verbal communication one relative spoke on their behalf and we based our findings on observation of care provided and people’s response to it. A relative told us they thought that people enjoyed living at the home and how staff treated and supported them. Staff supported people to choose their activities and when they wanted to do them. There was a variety of activities provided at home, within other homes in the organisation and the community. People were kept safe living at Curtis Road and doing activities within the local community. When we visited the home was warm, welcoming and friendly with people coming from and going to activities. There was positive interaction between people using the service and staff during our visit.

The home’s records were up to date, accessible and covered all aspects of the care and support people received, including their choices, activities and safety. People had fully completed care plans and the information was regularly reviewed. This enabled staff to perform their duties in an efficient and professional manner. People’s health needs were addressed and people using the service had access to GP’s and other community based health professionals, through staff. The staff team helped people to choose healthy meal options and maintain balanced diets whilst meeting their likes, dislikes and preferences. This enabled them to be protected from nutrition and hydration associated risks. Our observations showed that people liked the choice and quality of their meals.

People were familiar with the staff that supported them as most of the staff had been in post for a long period of time and the staff were very aware of people’s, likes, dislikes, preferences and routines. People using the service were well supported and enjoyed the way staff delivered their care. Skilled staff provided care and support in a friendly and professional way that was person centred. The staff were well trained and readily available to people using the service. Staff said they liked working at the home and had received good training and support from the manager.

A relative said the management team was approachable, responsive and listened to them. The quality of the service provided was consistently monitored and assessed.

This was an unannounced inspection that took place on 24 February 2015.

The home provides personal care and support for up to four adults who have a physical and/or learning disability. The service is managed by United Response and the building is owned by Thames Valley Housing Association. The home is in Whitton, Middlesex.

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.

In July 2013, our inspection found that the home met the regulations we inspected against. At this inspection the home met the regulations.

Relatives told us the home provided a good service and they enjoyed living there. People chose the activities they wished to do. These were group and individual based. The staff team provided the care and support they needed to do them. Curtis Road was well maintained, furnished, clean and provided a safe environment for people to live and work in. The home’s atmosphere was warm, comfortable and enabling.

The records were comprehensive and kept up to date. This included care plans that contained clearly recorded, fully completed, and regularly reviewed information that enabled staff to perform their duties.

The staff we spoke with were very knowledgeable about the people they worked with and field they worked in. They had appropriate skills, training and were focussed on providing individualised care and support in a professional, friendly and supportive way. They had access to good training, support and career advancement. People were enabled by staff to enjoy themselves, in a safe way and there was a lot of smiling and laughter during our visit.

Relatives said they were encouraged to discuss health needs with staff and people had access to community based health professionals, as required. Staff knew when people were experiencing discomfort and made them comfortable. People were protected from nutrition and hydration associated risks with balanced diets that also met their likes, dislikes and preferences. Relatives were positive about the choice and quality of food available. They also said the management team at the home were approachable, responsive, encouraged feedback from people and consistently monitored and assessed the quality of the service provided.

During our inspection we met four people who lived at Curtis Road. We haven’t been able to speak with people using the service because people using the service had a number of complex needs meaning that it was difficult for people to tell us about their experiences. We spoke with the relatives and one said "staff are marvellous and go beyond the duty of care".

One staff member told us "we have worked with people living here for a long time and are in contact with people's relatives on a regular basis, and involve them in consent". Staff were familiar with the needs of individual people and conveyed their understanding of people's support plans.

We asked senior staff about local partnerships. They confirmed that information was shared with appropriate people to safeguard and protect people during transfer and discharge between services. We asked to view the home and observe how cleanliness and infection control was managed. We looked at the kitchen, bathrooms and living spaces. The home was clean and well maintained.

While inspecting the home we talked with staff and asked four of the six staff about their training needs. Between them, the staff we spoke with described a comprehensive and varied training programme.

We asked to speak with relatives of two people using the service. One relative said "we've never had to make a complaint and I don't think we ever will". We gathered evidence about the service by reviewing compliment cards and the complaints log.

We spoke with a relative of someone living at the home who explained how staff provides support and care to people living at Curtis Road. “The manager and staff are excellent” “The staff who work at the home have been there a long time, they seem to understand peoples needs very well”

Because the people who live at Curtis Road have complex needs, we weren’t able to speak with people, which meant that they were not able to tell us about all of their experiences.

We talked with three staff and the manager to gain insight and understanding of how people were cared for and kept safe, they told us that they know each of the people who live at the home very well and use a key worker approach to provide consistent care.

Staff gave detailed accounts of the support that people received and how they felt they have contributed to the well-being of people living at the home. We heard accounts of the way people’s lives were enriched through a varied and interesting selection of community activities.

The people who lived at the home were not able to tell us what they felt about the service. However, we met all four people and they appeared happy, relaxed and well cared for.

Representatives of the people who lived at the home, staff and others told us that they thought the service was well run. They said that people had the care and support they needed. One person said, ''we fully believe that Curtis Road runs very well, and we know of nothing which needs to be performed better''. Another person told us that there was an ''excellent standard of care'' at the home.