London Borough of Greenwich – 69 Coleraine Road provides care and support to people living in a ‘supported living’ setting, so that they can live 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. At the time of the inspection the service was providing care and support to three people.

At our last inspection on 7 and 8 January 2016 we rated the service Good overall but required improvement in effective. At this inspection on 28 March 2018 the service is rated Good in all key question areas, therefore the overall rating of the service remained Good. The service demonstrated that they continued to improve and to meet the regulations and fundamental standards. The service had improved on the support they provided staff through regular supervisions and appraisals.

Staff knew of their responsibility to safeguards people in their care and told us they would report to their manager. Risks to people had been assessed, identified and had appropriate management plans in place. There were enough staff available to support people’s needs and the provider had safe recruitment practices in place. People were supported to take their medicines as prescribed by healthcare professionals. Staff followed appropriate infection control practices to prevent the spread of infection. There were effective systems in place to manage accidents and incidents and prevent them from happening again.

Before people used the service their needs were assessed to ensure they would be met. Staff were supported through induction, training, supervision and appraisals to deliver an effective service. People were supported to have adequate amounts of food and drink for their wellbeing. The Staff teams worked well within and outside the organisation and supported people to access healthcare services. 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 do support this practice.

People told us they were happy using the service. People and their relatives where appropriate were consulted about their care and support needs. People’s privacy and dignity were respected and their independence promoted. Staff understood the need to promote equality and diversity and support people without any discrimination.

Each person had a care and support plan in place which was available in formats that met their needs. People were supported with various activities that stimulated them. People told us they would report to staff or the registered manager if they were unhappy.

The provider had systems to monitor the quality of the service including, audits. People’s views were sought through surveys, residents meetings and staff meetings and the feedbacks were used to improve on the service delivery. Staff team worked well with health and social care professionals to deliver an effective service.

This announced inspection took place on 07 and 08 January 2016. We carried out an announced inspection of this service on 14 June 2013. A breach of legal requirement was found. We found there were not enough staff to meet people's needs on all shifts. As a result we undertook a focussed inspection on 12 February 2014; we found action had been taken by the provider and that there were enough staff to meet people's care needs.

London Borough of Greenwich – 69 Coleraine Road is a supported living service that provides personal care for up to five adults who have a range of needs including learning disabilities. At the time of our first day of the inspection four people were using the service and on the second day of inspection one person had moved to another home, therefore three people were using the service.

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 service knew how to keep people safe. We observed that people looked happy and relaxed. There were clear procedures in place to recognise and respond to abuse and staff had been trained in how to follow these. Risk assessments were in place and reflected current risks for people who used the service and ways to try and reduce the risk from happening. Appropriate arrangements for the management of people’s medicines were in place and staff received training in administering medicines.

There were enough staff to support people at the service and in the community. We observed staff had a good understanding of people’s needs and were able to support them. Staff supported people in a way which was kind, caring and respectful.

Staff received an induction and further training to help them undertake their role. However, staff had not received their annual appraisal and some of the staff had not received regular supervision in line with the provider’s policy.

People received enough to eat and drink and their preferences were taken into account. Staff helped people to keep healthy and well, they supported people to attend appointments with healthcare professionals when they needed to.

People’s care and support needs were regularly reviewed to make sure they received the right care and support. Care records focussed on people as individuals and gave clear guidance for staff.

Staff encouraged people to follow their own activities and interests. People and relatives told us they felt comfortable raising any concerns they had with the manager and knew how to make a complaint if needed.

The provider regularly sought people’s and staff’s views about how the care and support they received could be improved. Staff felt supported by managers. There was an effective system to regularly assess and monitor the quality of service provided.

All the people we spoke with told us that they were happy with the care services they received and had enjoyed their stay at the home. People told us that staff looked after them well and supported them as and when needed with their personal care needs and external health care appointments.

We found that there were enough staff to meet people’s care needs.

All the people we spoke with told us that staff looked after them well and supported them as and when needed with their personal care needs. They told us that staff supported them to maintain their independence and they were encouraged to go to a day centre, work, cook, clean and wash themselves if they were able. For example, a person told us “I went to the farm, I like planting”. Another person said “staff took me to the doctor, and I was happy with the medication”.

We found people were asked for their consent and the provider acted in accordance with their wishes. People’s care and support needs were assessed and regularly reviewed. Staff understood people’s care and support needs and knew how to protect them from the risk of harm. We saw there were not enough staff to meet people’s needs on all shifts. People’s personal records including medical records were accurate and fit for purpose. However, we were unable to access staff supervision and appraisals records at the time of our inspection.

All the people we spoke with told us that they were involved in their assessments and in developing their support plans, and that staff listened to and consulted them in decisions about their care and daily lives.

People told us that staff looked after them well and supported them as and when needed in their personal care needs and that their privacy and dignity was respected. One person said “I am happy” and staff were “nice”. Another person told us that “I tell them what I want to eat and they cook it for me”.