78 Park Road provides personal care and accommodation for up to seven people in a domestic care home setting. The home was presented as an ordinary detached house over two floors with access to the first floor via stairs. People had single rooms. Communal space consisted of separate lounge areas and dining room. There was a private garden at the rear of the property. The home provides care for up to seven adults including people with learning disabilities or autistic spectrum disorder. The home is in Hampton, in the London borough of Richmond-upon-Thames.

78 Park Road is a ‘care home’. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection. At the time of inspection there were seven people living in the home.

At our last inspection in February 2016 we rated the service outstanding. At this inspection we found the evidence continued to support the rating of outstanding and 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.

The service 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.

The care service has been developed and designed in line with the values that underpin the 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.

People continued to receive a service that was safe. All aspects of people’s safety were very well managed, including the security of the home, individual risk assessments and medicines management. In addition, robust staff recruitment systems continued to be followed which ensured that people were supported by suitable staff.

The service was well maintained and clean and correct procedures were taken with regard to the storage and handling of hazardous substances. Staff adhered to good infection control practices.

The service continued to provide care that was extremely person-centred and staff were proactive in ensuring people were supported to live fulfilled and meaningful lives. “Person-centred” means that care was tailored to meet the needs and aspirations of each person, as an individual. The vision of the service was shared by the management team and staff and quality audits focused on how the home achieved good outcomes for people.

The provider continued to ensure staff were sufficiently supported to provide a range of excellent social opportunities for people, including work-related activities, community events and hobbies and involved families, relatives and the local community. As a result, people had genuine experience of autonomy and choice, as well as of feeling included in their wider community.

People continued to receive effective care, which was based on best practice, from staff who had the knowledge and skills they needed to carry out their roles and responsibilities. Staff received support and training which enabled them to care and support people effectively. Additional support was provided by external professionals or consultants engaged by the provider.

Staff continued to ensure that people's emotional needs were supported at sensitive moments in their life and had worked closely with them, their relatives and health care professionals to achieve the most positive outcomes for the individual.

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We carried out an inspection of 78 Park Road 29 February 2016. The inspection was unannounced. At the previous inspection of 17 January 2014 the service had met the regulations.

London Care Partnership 78 Park Road provides care and accommodation for up to seven people with learning disabilities. It is located in Hampton in the London Borough of Richmond-upon Thames. At the time of the inspection the home was fully occupied.

There was a registered manager at the service. 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 using the service, their relatives and health and social care professionals told us that people were kept safe within the service. We found staff members were aware of what steps they would take if they had concerns about people’s safety and we saw that they followed clear guidance on what steps to take if an incident or accident occurred at the service.

Although some people displayed behaviours that challenged the service, the provider took proactive steps to understand the possible causes of this and implemented methods to manage these behaviours. These methods included the use of a behaviour analyst and nationally recognised positive behaviour support techniques recognised and accredited by the British Institute of Learning Disabilities (BILD). These were incorporated into personalised support plans for each individual. The service also made use of other services such as speech and language services in order to ensure that people were able to communicate how they felt and be understood by the staff team.

Relatives of people using the service we spoke with were enthusiastic in their praise for the service and how well staff cared for, supported and responded to the needs of people living at the home. Relatives praised the home for the consistent support provided to people, which ensured their safety and for the person-centred care plans and activities which enabled people to live individual lives.

Relatives told us they were impressed with how the staff supported people in all aspects of their daily lives, including managing their healthcare needs and accessing activities, which included the use of specialists such as physiotherapists, behaviour analysts and speech and language therapists within the organisation to ensure that people who needed extra support were provided it quickly.

Staff spoke positively and knowledgeably about their work and the people they supported. Staff who were assigned as keyworkers to people worked closely with them to achieve goals in relation to their daily living skills.

Staff members went through robust recruitment procedures which included all mandatory checks, including a Disclosure and Barring Service (DBS) check. They took part in a thorough induction process before being given unsupervised responsibilities. Staff undertook mandatory basic training as well as additional training relevant to the support needs of the people living at the home.

Staff told us, and records confirmed, that they received ongoing support and were given both training opportunities and opportunities to progress within the organisation to more senior roles.

Staff had received training in the Mental Capacity Act (MCA) 2005 and Deprivation of Liberty Safeguards (DoLS), and they demonstrated a good understanding of the act and its application. Where people did not have the capacity to make decisions about their care, meetings were held with people, their relatives, and health and social care professionals to help ensure that any decisions were made in the best interests of people using the service.

The registered manager was familiar with the service’s vision and goals and supported staff well. Togeth

Due to communication difficulties we did not obtain the views from people who used the service regarding the outcomes we reviewed. We spoke with one relative during our visit and with two relatives by telephone after our visit. Our judgements were made based upon the care and support we saw staff provided to people who used the service, the views of relatives we spoke with and documented records.

Relatives of people who used the service told us that they were happy with the care provided at the home and commented, "Very pleased with the quality of care provided”, and “Absolutely delighted, this should be a model for all care homes”.

Care plans were person-centred, structured and detailed the care and support people required. People’s health was regularly monitored and included input from health and social care professionals. People were provided with a choice of suitable and nutritious food and were involved in menu planning.

Appropriate arrangements were in place for the management of medication. Staff were appropriately trained and supported by the management team. A variety of methods were used to seek feedback and monitor and improve service delivery. A relative we spoke with told us, “Always receptive to what we say”.

In this report the name of a registered manager (Greg Anstead) appears who was not managing the regulatory activities at the time of the inspection. Their name appears because they were still a registered manager on our register at the time.

During the inspection due to communication difficulties we spoke briefly with people using the service and did not get their views regarding the outcomes we looked at. Instead our judgements were made based the care and support we saw staff give, peoples' reactions to it and the views of relatives. We used the Short Observational Framework for Inspection SOFI. SOFI is a way of observing care to help us understand the experience of people using the service. We saw that staff treated people with dignity and

respect. They were encouraged and enabled to make their own decisions and choices, which included choosing activities they were interested in and improving their life skills. People were safe and protected by a competent and professional staff and management team.

The staff were friendly, supportive and there were enough of them to meet people's needs comfortably. People were comfortable in their interactions with staff and we saw them smiling laughing and enjoying themselves. Relatives told us "I have no complaints at all about the service" and Staff are excellent". They also said "This is the best placement my son has had" and "My son does the things he likes and enjoys".

The people who live at 78 Park Road were not able to tell us about their experiences. However we saw that they were well supported and cared for. The staff treated people with respect and offered them choices. There was a good range of information for people to help them have control over their lives and the running of the home. The people living at 78 Park Road were all young adults. The staff told us that people’s relatives were involved in planning and reviewing their care. The staff told us that they felt supported by the organisation and felt they had the training and information they needed to care for people living at the home.