Care Assist in Harrow (Whitehall Road) provides accommodation and personal care to a maximum of six people with mental health needs. At the time of our inspection, there were six people using the service.

At the last inspection on 6 October 2015 the service was overall rated Good.

At this inspection we found the service remained Good.

People who used the service told us they felt safe in the home and around staff. We saw that positive caring relationships had developed between people who used the service and care workers. Care workers demonstrated a good understanding of how to recognise and report allegations of abuse.

Risks associated with people's care had been assessed and plans were in place to minimise the potential risks to people.

Appropriate arrangements were in place in relation to the recording, disposal and administration of medicines at the home. Medicines were managed safely.

We observed that the home was clean and that an appropriate standard of hygiene was maintained throughout the home.

Care workers had completed training in areas that helped them when supporting people. Care workers spoke positively about the training they had received. Care workers told us they were well supported by management and received regular supervision sessions and appraisals.

People were supported to have maximum choice and control of their lives and care worker staff supported them in the least restrictive way possible. The CQC is required by law to monitor the operation of the Deprivation of Liberty Safeguards (DoLS) which applies to care homes. DoLS ensure that an individual being deprived of their liberty is monitored and the reasons why they are being restricted is regularly reviewed to make sure it is still in the person's best interests. We found that the appropriate DoLS authorisations were in place.

People spoke positively about the food arrangements in the home. They explained that they had a choice of foods and ate what they liked and when they liked. Staff demonstrated a caring attitude towards people who used the service and ensured their dignity and privacy were maintained.

Care records were person-centred, detailed and specific to each person and their needs. Care preferences were also noted.

There was a management structure in place with a team of care staff, senior care staff and the registered manager. There was an open and transparent culture, and that the morale amongst staff was good. They also told us that staff worked well with one another and management. Care workers told us management was approachable and they did not hesitate about bringing any concerns to management.

Care workers were informed of changes occurring within the home through staff meetings and we saw evidence that these meetings occurred regularly. They told us that they received up to date information and had an opportunity to share good practice and any concerns they had at these meetings.

The home had a complaints policy and there were procedures for receiving, handling and responding to comments and complaints. A formal satisfaction survey had been carried out in February 2016 and feedback received was positive and no concerns were raised.

Management monitored the quality of the service and we saw evidence that regular audits and checks had been carried out to improve the service. Checks had been carried out in relation to audits and checks had been carried at regular intervals in areas such as care documentation, health and safety, equipment, cleanliness of the home, medicines and staff training.

At our last inspection of Care Assist in Harrow (Whitehall Road) on 6 October 2015 we found that there was a breach of legal regulation. We found people were potentially being deprived of their liberties because the home had not made attempts to identify whether any people were subject to restrictions on their liberty.

We undertook this announced focused inspection on the 15 March 2017 to check the provider had taken action and were now meeting legal requirements.

This report only covers our findings in relation to the effective topic area. You can read the report from our last comprehensive inspection, by selecting the 'all reports' link for Care Assist in Harrow (Whitehall Road) on our website at www.cqc.org.uk.

At our last inspection in October 2015 we rated the service good and in the four topic areas; safe, caring, responsive and well-led. The service was rated requires improvement in the topic area effective. The overall rating was good and the overall rating continues to be good after this inspection.

Care Assist in Harrow (Whitehall Road) provides accommodation and personal care to a maximum of six people with mental health needs. At the time of our inspection, there were six people using the service.

There was a registered manager in place. 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.

At this focused inspection on the 15 March 2017, we found the legal requirements had been met. The provider had taken action to address our concerns about following the requirements of the Mental Capacity Act (MCA) 2005 including the Deprivation of Liberty Safeguards (DoLS).

Records showed the registered manager had identified areas of people’s care in which their liberties were being deprived. We saw the relevant processes had been followed and standard authorisations were in place for people using the service.

This inspection took place on 6 October 2015 and was unannounced. Care Assist in Harrow (Whitehall Road) provides accommodation and personal care to a maximum of six people with mental health needs. At the time of our inspection, there were six people using the service.

The provider met all the standards we inspected against at our last inspection on 30 October 2013.

There was a registered manager in post at the time of our inspection. 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.

Positive caring relationships had developed between people who used the service and staff and during the inspection we observed people were treated with kindness and compassion. People who used the service told us they felt safe in the home and around staff. Systems and processes were in place to help protect people from the risk of harm.

There were enough staff to meet people’s individual care needs and this was confirmed by staff we spoke with. On the day of the inspection we observed that staff did not appear to be rushed and were able to complete their tasks. People who used the service told us that staff always had time to speak with them.

There were arrangements for the recording of medicines received into the home and for their storage, administration and disposal. People told us that they received the medicines on time and had no concerns regarding this.

We noted that the service had recently employed a number of new staff and at the time of the inspection they were still in the process of completing necessary training. Staff confirmed that they had received an induction and said it had been useful. Staff spoke positively about their experiences working at the home. They said they felt supported by management within the home and said that they worked well as a team. We noted that staff had not received regular supervision sessions consistently over the last year. However, we noted that in recent months staff had started to receive supervision sessions.

People’s health and social care needs had been appropriately assessed. Care plans were person-centred, detailed and specific to each person and their needs. Care preferences were also noted. Identified risks associated with people’s care had been assessed and plans were in place to minimise the potential risks to people.

Staff we spoke with had a basic understanding of the principles of the Mental Capacity Act (MCA 2005). Capacity to make specific decisions was not recorded in people’s care plans and there was a lack of information about consideration of specific decisions they needed to make.

The CQC is required by law to monitor the operation of the Deprivation of Liberty Safeguards (DoLS) which applies to care homes. DoLS ensure that an individual being deprived of their liberty is monitored and the reasons why they are being restricted is regularly reviewed to make sure it is still in the person’s best interests. During this inspection we found that people were potentially being deprived of their liberties because the home had not made attempts to identify whether any people were subject to restrictions on their liberty.

People spoke positively about the food in the home and told us that there was a variety of food available. Staff were aware of special diets people required either as a result of a clinical need or a cultural preference.

People spoke positively about the atmosphere in the home and we observed that the home had a homely atmosphere. Bedrooms had been personalised with people’s belongings to assist people to feel at home.

We found the home had a management structure in place with a team of care staff and the registered manager. The home had an open and transparent culture. Staff were encouraged to have their say and were supported to improve their practice.

The service had a system in place to monitor and improve the quality of the service which included resident’s meetings, staff meetings and a programme of audits and checks. However, we noted that the service had not carried out a satisfaction survey in 2015 and discussed this with the registered manager. She explained that one would be carried out by the end of 2015.

We found the premises were clean and tidy. The home had an Infection control policy and measures were in place for infection control.

We found a breach of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see what action we told the provider to take at the back of the full version of the report.

We found suitable arrangements in place for obtaining the consent of people who used the service. Records showed that the provider requested consent when supporting people with various aspects of their care such as people's mental health needs and medicines.

We looked at the files for three people who used the service. These showed that people's needs were assessed before they entered the service and this assessment was used to develop people's care plans. One person who used the service told us that they cooked halal food with staff.

One person's relative told us "Staff are polite and have a genuine care for the people" and "They (staff) are very good."

We found that there were suitable arrangements in place for the obtaining, recording, administration and disposal of medicines.

Staff we spoke with said they had attended various training sessions including First Aid, Infection Control and Dementia Awareness. Records showed that staff received regualar supervision both in a group in on a one to one basis.

One person told us that if they wanted to make a complaint they would speak to the manager or one of the company directors. We found the provider had a complaints policy in place which detailed the procedure the provider would use to deal with complaints.

People told us that they were kept informed of events and that they were invited to meetings appropriately. They also told us that they felt listened to and were generally very positive about the service. One person told us that they were very happy with the service itself and described the staff as "first class". We found that care plans were drawn up to reflect individual needs and that the provider had appropriate plans in place to deal with emergency situations that may reasonably be expected to arise.

There was also evidence staff members could successfully identify the appropriate course of action in response to potential safeguarding concerns and there was a whistle blowing policy in place. We saw evidence that there were sufficient numbers of skilled staff employed to care for the people who use the service and that there was a key worker system in place. The provider was also able to demonstrate that there was effective system to monitor the quality of the service.

People said that they were treated with respect and that they received the personal care they needed. They were satisfied with the vocational and social activities they could do. People said they felt safe. They were confident that any complaints would be acted upon and that they could have a say on improvements to their care and home.

People told us that staff listened to them. Comments from people about the staff included "They help me if I need it", and "they listen to me".