This unannounced comprehensive inspection took place on 19 September 2018. London Borough of Greenwich – 58 The Village provides care and support for people living in a care home. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection. 58 The village provides accommodation and personal care to a maximum of six adults and older adults with learning disabilities in one adaptable building. At the time of this inspection five people were living at the home.

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.

At our last inspection on 27 April 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.

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.

The provider had safeguarding policies and procedures and staff knew of their responsibility to protect people from abuse. Risk to people had been identified, assessed and had appropriate risk management plans in place. People’s medicines were managed safely. There were appropriate recruitment practices in place and there were sufficient numbers of suitable staff to support people’s needs. People were protected from the risk of infection because staff followed appropriate infection control practices. Accidents and incidents were reported, recorded and monitored to drive improvements.

People’s needs were regularly assessed to ensure they would be met. People were supported to maintain good health and had enough nutritious food in sufficient amounts to eat. People were supported to use healthcare services and the staff worked in partnership with health and social care professionals to provide a joined-up service. People’s individual needs were met by the design, decoration and adaptation of the home. 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 supported this practice. Staff were supported through induction, training, supervision and appraisals to ensure they delivered an effective service.

People were supported by staff that were kind, respectful and caring towards them. People were involved in making decisions about their care and support. People’s privacy and dignity was respected and their independence promoted. People’s communications needs were assessed and met and were supported to use assistive technologies to promote their communication and independence where required.

Each person had a care plan that provided staff with guidance on how their needs should be met. Staff understood the Equality Act and supported people in a caring way. People were supported to participate in activities that interested them and maintained relationships that were important to them. The provider had a complaint policy and people knew how to make a complaint if they were unhappy. People were supported to plan for their end of life care needs and wishes.

There was a registered manager

This inspection took place on 27 April 2016 and was unannounced. There was a registered manager in place 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.

London Borough of Greenwich 58 The Village is a residential home for up to six adults with learning disabilities. At the time of our inspection there were six people using the service.

Staff had regular monthly supervisions and were safely recruited with necessary pre-employment checks carried out. Records showed that annual appraisals had not taken place since 2014, however the registered manager had appraisals planned for 2016 and staff were supported to carry out their roles appropriately.

Medicines were managed, stored and administered safely. There were regular medicine audits in place. Staff had completed medicines training and the home had a clear medicines policy in place which was accessible to staff. The home maintained adequate staffing levels to support people both in the home and the community.

Procedures and policies relating to safeguarding people from harm were in place and accessible to staff. All staff had completed training in safeguarding adults and demonstrated an understanding of types of abuse to look for and how to raise safeguarding concerns.

Risks to people using the service were assessed reviewed, recorded and managed appropriately. Detailed and current risk assessments were in place for all people using the service. Risk assessments were linked to communication passports so that the ways to mitigate risk to people were clear.

We saw friendly, caring and supportive interactions between staff and people and staff knew the needs and preferences of the people using the service. Care plans were person centred and pictorial and we saw that people had regular keyworker sessions.

People’s capacity and rights to make decisions about their care and treatment where appropriate were assessed in line with the Mental Capacity Act 2005 (MCA 2005). These safeguards are there to make sure that people are receiving support are looked after in a way that does not inappropriately restrict their freedom. Services should only deprive someone of their liberty when it is in the best interests of the person and there is no other way to look after them, and it should be done in a safe and correct way.

People were supported to eat and drink. People were involved in planning their weekly menus and were supported to prepare their own meals. People were supported to maintain good health and have access to healthcare services.

People’s concerns and complaints were investigated and responded to in a timely and appropriate manner. There was evidence that regular compliance audits took place and issues identified were actioned promptly. The registered manager was seen to be accessible to people, and staff spoke positively about the support available to them.

At our inspection at London Borough of Greenwich - 58 The Village on 13 March 2014, we followed up a compliance action we had taken following our inspection on 20 August 2013. We found that the provider had made the required improvements to staffing arrangements in the home. We found that staffing levels were assessed to meet individual needs including at night. There was enough management staff in place, appropriate arrangements were in place to cover sick and vacant staff, and staffing levels were adjusted to meet the level of support people required.

Some of the people who used the service had communication difficulties and not all were able to answer questions about the care and support they received. We observed how staff cared for people for example during their meal times and we spoke with relatives of people who used the service. People we spoke with told us that they were happy living at London Borough of Greenwich - 58 The Village. When we asked two people what they liked about the home they pointed to staff. Another person told us that staff took them for their holidays which they enjoyed. Relatives we spoke with told us that staff were “caring” and “brilliant” with people. People and their relatives told us that they were involved in the planning and reviewing of their care.

We found that each person had a care plan in place with relevant risk assessments to meet their needs. Staff were aware of their responsibility to protect vulnerable adults from abuse. People were cared for in an environment that was safe and comfortable. Support for staff was in place including staff training, supervision and team meetings, however, we found shortfalls in the staffing levels at the home.

During our inspection we met with four of the five people who lived at the home. We asked people how they were involved in the service. One person told us that they helped choose the menu's for mealtimes while another person said "I like cooking and I help prepare meals in the kitchen". Relatives also felt consulted and told us about the annual satisfaction survey and their contact with the home.

We asked relatives to tell us about the care and welfare of their loved ones. One relative said "the staff make sure that appointments are made". We asked people living at the home what they thought about the food, people told us that they enjoyed their food and liked to get involved. One person responded "It's lovely, really nice".

On the day we inspected the home we met a domestic cleaner who had been arranged to provide a one off 'deep clean' for the home. We spoke briefly to the cleaner who did not regularly attend to the home's domestic needs. During our inspection we looked at all parts of the home at 58 The Village and found that the home was in need of attention and some repair.

While staff were attending training, there had been a change in the process of booking training and this had led to challenges in staff being able to access training. We found gaps in some staff training profiles and staff told us "it has been difficult to book in for training".