Grange (Whitefield) Care Services Limited provides support and personal care to people with learning disabilities, living in five supported living units in North London and Hertfordshire. There were 37 people using the service at the time of our inspection.

At our last inspection in May 2016 we rated the service good. At this inspection we found the evidence continued to support the rating of good 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 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.

There was good overall feedback about the service, from people using it and their relatives. We found people were treated with kindness and compassion, and that they were given emotional support when needed. The service ensured people's privacy and dignity was respected and promoted.

People’s needs were identified and responded to well. The service was effective at working in co-operation with other organisations to deliver good care and support. This included where people’s needs had changed, and where people needed ongoing healthcare support.

The support staff we spoke with demonstrated a good knowledge of people’s care needs, significant people and events in their lives, and their daily routines and preferences. They also understood the provider’s safeguarding procedures and could explain how they would protect people if they had any concerns.

Staff told us they really enjoyed working in the service and spoke positively about the culture and management of the service. Staff described management as supportive. Staff confirmed they were able to raise issues and make suggestions about the way the service was provided.

People were supported to have choice and control of their lives and staff supported them in the least restrictive way possible. People’s views on the service were regularly sought and acted on.

Staffing levels were sufficient to meet people’s needs. Recruitment practices were safe and relevant checks had been completed before staff worked at the service.

People participated in a range of social activities and were supported to access the local community.

The registered manager and staff ensured everyone was supported to maintain good health.

Staff were well supported with training and supervision which helped them to ensure they provided effective care for people.

The provider asked people and those important to them, such as their relatives or professionals, for feedback about the quality of the service.

The registered manager and staff knew what they should do if anyone made a complaint.

Person centred care was fundamental to the service and staff made sure people were at the centre of their practice. Care plans focused on the whole person, and assessments and plans were regularly updated.

The service was well led. There was a clear set of values in place which all of the staff put into practice. The management team had developed quality assurance checks, to make sure standards of care were maintained. There was an open culture and staff said they felt well motivated and valued by all of the managers.

This inspection was undertaken on 25 and 26 May 2016. We gave the provider two days’ notice that we would be visiting their head office. We gave the provider notice as we wanted to make sure the registered manager was available on the day of our inspection.

The Grange (Whitefield) Care Services Limited provides support and personal care to people with learning difficulties, living in five supported living units in North London and Hertfordshire. There were approximately 33 people using the service at the time of our inspection.

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 and associated Regulations about how the service is run.

People told us they were well treated by the staff and felt safe and trusted them.

Staff could explain how they would recognise and report abuse and they understood their responsibilities in keeping people safe.

Where any risks to people’s safety had been identified, the management had thought about and discussed with the person ways to mitigate those risks.

The service was following appropriate recruitment procedures to make sure that only suitable staff were employed at the service.

Staff we spoke with had a good knowledge of the medicines that people they visited were taking. People told us they were satisfied with the way their medicines were managed.

People who used the service and their relatives were positive about the staff and told us they had confidence in their abilities and staff told us that they were provided with training in the areas they needed in order to support people effectively.

Staff understood that it was not right to make choices for people when they could make choices for themselves and people’s ability around decision making, preferences and choices were recorded in their care plans and followed by staff.

People told us they were happy with the support they received with eating and drinking and staff were aware of people’s dietary requirements and preferences.

People confirmed that they were involved as much as they wanted to be in the planning of their care and support. Care plans included the views of people using the service and their relatives. Relatives told us they were kept up to date about any changes by staff at the office.

People and their relatives told us that the management and staff were quick to respond to any changes in their needs and care plans reflected how people were supported to receive care and treatment in accordance with their current needs and preferences.

People told us they had no complaints about the service but said they felt able to raise any concerns without worry.

The service had a number of quality monitoring systems including yearly surveys for people using the service and their relatives. People we spoke with confirmed that they were asked about the quality of the service and had made comments about this. They felt the service took their views into account in order to improve service delivery.

People who use the service have complex needs and could not talk to us about their experience. We spoke to the relatives of people who use the service and gathered their views on the care that their family members received. They spoke highly of the service and were happy with the staff and the care that they received. One relative told us “We have good communication with the service and the staff are very understanding”.

Staff had received appropriate checks before they began work and had all gone through an induction program before starting work. Staff confirmed that they had received relevant training in person centred care and were able to apply this in their day to day work with people they cared for.

There were systems in place to monitor the quality of the service, including regular spot checks and an effective complaints procedure.

At the time of our visit there were 23 using the agency. People who use the service have complex needs and could not talk to us about their experience. We contacted a number of relatives, but manage to speak with two. Relatives we spoke with expressed their satisfaction of the service verbally and in comments sent in to the provider. They were happy with the service provided by the agency and felt their relatives were treated with dignity and respect. Comments about staff range from “very attentive,” to “some will go the extra mile.” We contacted social care professionals but were unable to speak to anyone.

Staff confirmed that they had received training as part of their induction based on six values of care, including privacy, choice, dignity and independence. Staff knew the importance of respecting people’s preferences and likes and dislikes, such as allowing people to choose the clothing their wanted to wear.

There were systems in place to ensure that people were protected from abuse and that they received the care they needed. Systems were in place to monitor and to make improvements to the quality of care and support provided by the agency.

Staff felt supported by the manager, and received training relevant to them.