We carried out this inspection on 17 May 2017. The inspection was unannounced. At the last inspection on 3 February 2015 the service was rated ‘Good’. At this inspection we found that the service remained ‘Good’.

Chiswick Care Limited is a residential care home providing personal care and support for up to six people with learning disabilities and mental health issues. At the time of this inspection there were six people living at the service.

People were observed to be happy and comfortable living at the service. Interactions between people and staff were positive. Relatives confirmed that people were safe and appropriately supported at the home. Staff knew how to recognise abuse and clearly explained the steps that they would take if abuse was suspected.

Care plans contained detailed information and guidance on people’s individual risks and how people were to be supported to mitigate identified risks associated with their care and support needs.

Safe recruitment processes were in place to assure the provider that only staff deemed safe to work with vulnerable adults were recruited.

People were observed to be supported with their medicines safely and appropriately. Medicine administration, recording and storage was appropriate to ensure the safe management of medicines.

Staffing levels were determined according to people’s needs and requirements to ensure people received appropriate and timely care and support.

Staff received an induction followed by training in a variety of areas in order to be able to carry out their role effectively. Staff confirmed that they received appropriate training and support through the supervision and appraisal process.

The service always ensured that people were assessed as having capacity and were supported to have maximum choice and control of their lives. Staff were observed supporting people in the least restrictive way. The provider had policies and systems in place to support this practice.

Weekly menus were discussed and planned with people to ensure that meals prepared were of their choice and preference.

People were supported with all aspects of their health care needs in partnership with people and their relatives where appropriate and referrals were made where required.

People were supported and enabled to maintain their independence as far as practicably possible. Staff knew the people well and supported them in a way which focused on their capabilities and abilities.

Some people had been living at the service for over 10 years and had established positive caring relationships with all staff members including the registered manager. The ethos of the service was that they were one big family living together.

Care plans were person centred and outlined the person’s care and support needs which were based on their own choices and preferences.

People had individualised activity plans based on their interests, hobbies and preferences. These included participation in activities such as going to the gym, attending day centre, taking part in quizzes and annual holidays.

People were observed to have different methods in which they communicated and staff and relatives confirmed that if people were not happy they would definitely be able to draw attention to raise their concerns. Relatives were confident in raising any concerns and were assured these would be dealt with immediately.

Relatives confirmed that they knew the registered manager well and that communication between all senior managers and staff was very positive. Staff also confirmed that the registered manager was approachable at any time and that they were appropriately supported in their role.

Appropriate systems and processes were in place which monitored and checked the quality of care that was provided. This included health and safety checks, medicine audits and satisfaction surveys. Records confirmed that these were reviewed and analysed so that the service could learn and make improvements to the delive

This unannounced inspection took place on 3 February 2015. The inspection was carried out by one inspector. Chiswick Care Limited – HSCA provides accommodation and support to six people with learning disabilities. At the time of our inspection five people were using the service.

At our last inspection on 4 November 2013 the service met the regulations inspected.

There was 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.

People who used the service told us they felt safe in the home. Relatives of people who used the service told us that they were confident that people were safe in the home. The provider had taken steps and arrangements were in place to help ensure people were protected from abuse, or the risk of abuse.

People were cared for by staff who were supported to have the necessary knowledge and skills they needed to carry out their roles and responsibilities. Care staff spoke positively about their experiences working at the home and the support they received from the registered manager and their colleagues.

We saw positive caring relationships had developed between people who used the service and staff and people were treated with kindness and compassion. People were being treated with respect and dignity and care staff provided prompt assistance but also encouraged and promoted people to build and retain their independent living skills.

People received personalised care that was responsive to their needs. Care plans were person-centred, detailed and specific to each person and their needs. We saw that people’s care preferences were also reflected. People were consulted and activities reflected people’s individual interests, likes and dislikes. People were supported to follow their interests, take part in them and maintain links with the wider community.

Systems were in place to monitor and improve the quality of the service. The home had an effective system in place to identify, assess and manage risks to the health, safety and welfare of people using the service and others.

The home had arrangements for quality assurance. This included a satisfaction survey, checks on medicines, health and safety and care documentation by the registered manager. Professionals who provided us with feedback stated that they were satisfied with the quality of care provided and there were no concerns regarding communication.

We found the premises were clean and had been recently renovated. The home had an infection control policy and measures were in place for infection control. There was a record of essential inspections and maintenance carried out.

We found the provider asked people for their consent before offering people care or support.

We spoke with one person who used the service and they said "Staff are nice and I get on well with them. They look after me and give me advice and are friendly." One person's relative said "They are like a family, it is a well run home."

We spoke with two members of staff and both were able to discuss the needs of people they supported and give examples of how to support them based on their care plan.

We saw evidence that in one person's care plan it was recorded they should not eat pork because of their religious needs. Staff we spoke with said that they tried to ensure food on the menu took into account people's preferences.

Two members of staff we spoke with said that a weekly check was done on the whole building and any concerns were reported to the manager. We saw copies of the weekly checks for several months and where actions had been completed these had been noted on the form. The checklist looked at areas such as the heating, lighting and carpets. They told us that any concerns would be reported back to the manager.

We found that the provider completed the appropriate checks before people started work with them. Staff we spoke with also confirmed the checks they had gone through.

We spoke with people who use the service. They told us they were happy living in the home. For example, one person said, “I really like it here”. People told us they took part in a range of activities both inside and outside the home throughout the week. Feedback from relatives showed they were satisfied with the service provided. A typical comment from a relative was, “it is excellent, my son is very happy here.”

Staff received appropriate training to enable them to provide the support to people that they needed. They demonstrated the knowledge and skills needed to protect people from possible abuse. The manager regularly monitored the service to make sure that an appropriate standard of care and support was provided to people who use the service.