This unannounced inspection took place on 27 and 28 July 2017.

64 Charlton Lane is a supported living service that provides personal care for up to five adults who have a range of needs including learning disabilities. The people who used the service had a separate tenancy agreement with a housing association at this address. At the time of our inspection four people were using the service.

We previously carried out an unannounced inspection of this service on 15 May 2015. At that inspection we found the service was meeting all the regulations that we assessed.

The service had a registered manager in post. 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.

At this inspection we found that staff knew how to keep people safe. People who used the service told us they felt safe and that staff and the registered manager treated them well. The service had clear procedures to support staff to recognise and respond to abuse. The registered manager and staff completed safeguarding training.

Staff completed risk assessments for every person who used the service which were up to date and included detailed guidance for staff to reduce risks. There was an effective system to manage accidents and incidents, and to prevent them happening again. The service had arrangements in place to deal with emergencies.

The service carried out comprehensive background checks of staff before they started working and there were enough staff on duty to support to people when required. Staff supported people so that they took their medicines safely. However, we identified that staff did not monitor the medicine cabinet temperatures. We brought this to the attention of the registered manager; they procured new thermometer(s) and instructed staff to carry out regular temperature checks of medicine cabinets. We shall check this at our next inspection.

People commented positively about staff and told us they were satisfied with the way they looked after them. The service supported all staff through training and regular supervision. However, we found that four members of staff yearly appraisal was overdue, the registered manager told us that the staff appraisals were delayed due to the change of the manager and that they were now scheduled to be completed.

The service considered to have mental capacity for every person who used the service. At the time of inspection no one was subject to continuous control and supervision and people could leave the service. The registered manager and staff knew the requirements of the Mental Capacity Act 2005 and acted according to this legislation.

Staff assessed people’s nutritional needs and supported them to have a balanced diet. They supported people to access the healthcare services they required and monitored their healthcare appointments.

People or their relatives where appropriate, were involved in the assessment, planning and review of their care. Staff considered people’s choices, health and social care needs, and their general wellbeing. The care plans were person centred and reflected people’s current needs.

Staff supported people in a way that was kind, caring, and respectful. Staff also protected people’s privacy and dignity.

The service supported people to take part in a range of activities in support of their need for social interaction and stimulation. The service had a clear policy and procedure about managing complaints. People knew how to complain and told us they would do so if necessary.

There was a positive culture at the service where people felt included and consulted. People commented positively about staff and the registered manager. Staff felt supported by the registered manager.

The service sought

All the people we spoke with told us that staff looked after them well and supported them as and when needed to meet their assessed needs. For example one person told us “I like the food and staff”. Another person said “I do my own shopping, I like it”.

We found quality monitoring audits had taken place on a regular basis, and that learning from the audits and necessary changes were implemented to improve the service provision and delivery.

In this report the name of a registered manager appears who was not in post and not managing the regulatory activities at this location at the time of the inspection. Their name appears because they were still a Registered Manager on our register at the time.

All the people we spoke with told us that staff listened to and consulted them in decisions about their care and daily lives. They said that staff looked after them well and supported them as and when needed in their personal care needs. One person told us: “I like to make my own decisions about what to eat”. Another person said: “my bathroom is redone with new shower, new bath, new seats and new hand rails, I am happy”. People told us they were supported to maintain their independence and they were encouraged to go to a day centre, cook, shop, clean and wash themselves if they were able. People told us staff looked after them and they felt comfortable speaking to staff about any problems or worries they had. One person said: “I like my key worker” another person said “when I am sad, I tell staff”.

We found people's care and support needs were assessed and regularly reviewed. Staff understood people's care needs and knew how to protect them from risk and harm. Staff we spoke with felt they were adequately supported. There was no evidence that quality monitoring audits have taken place on a regular basis, or that learning from the audits was taking place or appropriate changes had been implemented.

In this report the name of a registered manager appears who was not in post and not managing the regulatory activities at this location at the time of the inspection. Their name appears because they were still a Registered Manager on our register at the time.

People we spoke with told us that they understood the care and treatment choices available to them, and that they were involved in making choices and decisions about their care. For example, one person told us that; “I pick the food: they cook for me” another person said “I choose what food I want and give it to them they make it“.

People told us that they had a copy of their care plan in their room, which set out their needs and the tasks that staff were required to carry out in respect of care and in supporting them.

One person told us: “I have a support plan upstairs, staff read for me”.

People told us that they received their medicine. One person told us that; “staff gives me tablets”. They told us that the staff attended to their needs. One person told us that: “I like tenant meetings” another person said: “I enjoy my key worker meeting, they are useful”.

People told us that they understood the support choices available to them. Staff consulted them and took their views into account in the delivery of their personal care.

People told us that staff looked after them well and that they felt safe and comfortable with the staff and manager. They told us that they received their medicine regularly.

People told us that they needed at least two staff during the morning shift and to ensure that they could go out more into the community.