53 West Park provides personal care and support to people living in supported living settings, so that they can live in their own home as independently as possible. People’s care and housing are provided under separate contractual agreements. CQC does not regulate premises used for supported living; this inspection looked at people’s personal care and support. People using the service lived in their own rooms or bed sits within a large house with a communal kitchen, living room and a garden. At the time of the inspection there were nine people using the service and eight people receiving the regulated activity personal care.

People using the service had learning disability or autism and or mental health needs The support service has been developed and designed in line with the values that underpin the Commission’s 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.” Registering the Right Support CQC policy.

At our last inspection on 23 and 24 March 2016 we rated the service Good overall and well led requires improvement because there was no registered manager. At this unannounced inspection on 10 October 2018 we found the evidence continued to support the rating of Good overall and well led remained Requires Improvement. This was because although there had been some improvement and a registered manager was now in place who understood the requirements of them and we received positive feedback about their leadership.

There were however, some aspects of the quality monitoring that needed improvement to ensure they were effective in relation to the storage of some medicines, some records and updating the fire risk assessment. Action was taken to address some of these issues during and following the inspection

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.

Improvement was needed because actions identified from audits were not always promptly acted on. The registered manager told us they had been without a deputy manager until recently but now one was appointed she was confident they could address the shortfalls found. We will check on this at our next inspection.

People told us they felt safe and were supported to be safe in the community. Staff understood how to protect people from abuse or harm. Risks to people were assessed and guidance provided to staff to reduce risk. There were processes in place to learn from accidents and incidents.

People were supported and encouraged to keep their rooms and shared communal areas clean and staff had training on how to reduce infection risk. Medicines were safely managed and administered.

There were enough staff to meet people’s support needs. Staff received sufficient training supervision and support to fulfil their roles and responsibilities. There was a range of training provided that helped them support people’s individual needs.

The service worked in an inclusive way and prior to joining the service people's needs were carefully assessed in partnership with service users, their families and health and social care professionals where relevant.

Staff and the registered manager understood their roles and responsibilities under the Mental Capacity Act (MCA) 2005. 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 support this practice. Staff told us and we saw they sought the consent of people before they delivered care and support.

People were encouraged and supported to meet their dietary and nutritional needs and provide them with sufficient

This announced inspection took place on 23 and 24 March 2016. We carried out an announced inspection of this service on 17 July 2013, and found a breach of legal requirements because medicines were not managed safely. As a result, we undertook a focussed inspection on 17 December 2013. We found the provider had taken action so that the medicines were managed safely.

Care Management Group - 53 West Park is a supported living service that provides personal care for up to eight 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 six people were using the service.

There was no 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. The previous registered manager left the service in August 2015. The service appointed a new manager in November 2015, who had applied to CQC to become a registered manager but had left the service in March 2016, before the registered manager’s registration process was concluded. The service had a deputy manager working in capacity of an acting manager since March 2016 and supported by the service manager and the regional director. The regional director told us, the acting manager would act up as home manager for period of two months in order to continue provide continuity to the service, service users and staff and gain confidence in senior management role in the home, the service would be recruiting home manager at the end of April 2016, new manager will make a CQC application following the appointment. This requires improvement to ensure a registered manager is in post.

The service knew how to keep people safe. The service had clear procedures to recognise and respond to abuse. The acting manager and staff completed safeguarding training. Staff completed risk assessments for every person who used the service with detailed guidance to reduce risks. The service had a system to manage accidents and incidents to reduce reoccurrence. The service had systems to monitor the safety of people’s accommodation to minimise risks to people.

The service had enough staff to support people. The service carried out satisfactory background checks of staff before they started working. The service had arrangements to deal with emergencies. Staff supported people so they took their medicine safely.

The service provided induction and training to staff to help them undertake their role. The service supported staff through supervision and appraisal.

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.

Staff supported people to eat and drink sufficient amounts to meet their needs. Staff supported people to access healthcare services they required and monitored their healthcare appointments.

Staff considered people’s personal choices, general wellbeing and activities. Staff supported people to make day to day life choices and maintain relationships with their family and friends. Staff supported people in a way which was kind, caring and respectful. Staff protected people’s privacy, dignity and human rights.

Staff prepared care plans for every person that were tailored to meet their individual needs. Staff reviewed people’s care plans and updated to reflect their current needs.

The service had a clear policy and procedure about managing complaints. People knew how to complain and would do so if necessary.

The service sought the views of people who used the services and their relatives to improve the service.

At our inspection on 17 December 2013, we followed up a compliance action that we had taken following our inspection on 17 July 2013. We found the provider had made suitable improvements to ensure the safe use and management of people's medicines. This included appropriate arrangements in relation to the recording, administration and recording of medicines. One person told us they were supported by staff to manage their medicines and were happy with this arrangement. A staff member also told us that the refresher training and updated procedures related to medicines management were helpful in informing their practice.

Some people using the service were not available at the time of our inspection, and the two people we spoke with told us they liked living within the service. One person said: “I can make decisions about how to spend my time and love everything about living here”. Another person said that “staff are polite and kind”. Both individual’s felt that staff were always available to provide support when needed.

We found that the provider had suitable arrangements in place for obtaining people’s consent to care and treatment. Records we saw showed that people had been involved in developing and reviewing their support plans and care was being delivered as planned. We found there was adequate staff available to meet people's individual needs .However, we found that medication records were not always accurate and fit for purpose and the provider did not always have suitable arrangements in place to manage medicines. People’s comments and / or complaints were responded to appropriately.

People who used the service told us about how they were supported by staff to maintain their independence in areas such as cooking and laundry. Two people told us that over a period of time they had been encouraged to manage their own medication and they were now independent with this. People told us they were offered choices and we were told about a number of different daily activities and trips that people had attended.

People told us they got on well with the staff and that they were approachable and they would inform the staff if they had any problems. We saw that there was a good rapport and positive interactions between staff and people who used the service.

One person told us about how they were supported to go to college and they hoped to begin an apprenticeship scheme. We heard about another person who had recently started voluntary work.

People told us their privacy and dignity was respected.