Miss Sunita Larka t/a Direct Care and Support Services provides personal care and support to people who have physical, learning or sensory disabilities. There were three people using the service at the time of this inspection who all lived in supported living schemes in the community. Supported living is where people live independently in specifically designed or adapted accommodation, but need some help and assistance to do so.

At the last Care Quality Commission (CQC) inspection in February 2015, the service was rated ‘Good’. At this inspection we found the service remained ‘Good’. The service demonstrated they met the regulations and fundamental standards.

People continued to be safe. Staff received training and support to help them protect people from the risk of abuse or harm. The provider ensured there was up to date guidance for staff to follow to minimise identified risks to people's health, safety and welfare. There were enough staff to keep people safe. The provider maintained appropriate arrangements to check the suitability and fitness of new and existing staff to support people.

People had a current support plan which set out how their care and support needs should be met by staff. These were reviewed regularly. Staff received relevant training so that they had the necessary skills to meet people’s needs effectively. Staff communicated with people using their preferred methods of communication. This helped them to develop good awareness and understanding of people's needs, preferences and wishes.

Staff supported people to be as independent as they could possibly be. People were encouraged to learn and maintain skills they needed for independent living. They were also supported to access services and support in the community to acquire new skills and learning such as attending college courses and volunteering opportunities.

People were supported to eat and drink enough to meet their needs. They were encouraged to stay healthy and helped to access healthcare services when they needed this. People that had medicines prescribed to them, received these promptly. Staff encouraged people to participate in activities and to maintain relationships with the people that mattered to them.

Staff were caring and treated people with dignity and respect. They asked people for their consent before carrying out any care or support and respected their wishes and choices about how this was provided. Staff ensured people’s privacy was maintained particularly when being supported with their personal care needs.

The provider and senior staff team provided good leadership. People and staff said they were approachable and managed the service well. The provider had strengthened management arrangements to improve accountability and support for staff at the individual schemes.

People and their relatives were happy with the quality of support received. They were encouraged to provide feedback about how the service could be improved. This was used to make changes and improvements that were required. The provider continued to maintain arrangements for dealing with complaints if people became unhappy or dissatisfied with the service.

Checks and reviews of the service continued to be made by senior staff and, along with learning from incidents and events, was used to improve working practices and processes so that people experienced good quality care and support.

Further information is in the detailed findings below.

At our last inspection in April 2013 we identified that the provider was not meeting one of the essential standards of quality and safety. The provider sent us an action plan to tell us how it was going to become compliant with the regulations. We carried out this inspection to check if the provider had made the required improvements.

We spoke with two people using the service at this inspection and two members of staff. We discussed the recruitment process with the registered provider and deputy manager. We checked employment records for five members of staff.

We found that recruitment processes had been strengthened and the required checks and information was available for staff working at the agency. This meant that people using the service were more fully protected from staff who may not be suitable to work with vulnerable adults.

People using the service told us they took part in interviews of new members of staff and enjoyed the experience. One person said, “I would like to do that again.”

At our last inspection in November 2012 we identified areas where the provider was not meeting the essential standards of quality and safety. The provider sent us an action plan to tell us how it was going to become compliant with the regulations. We carried out this inspection to review improvements.

We visited Fairview House and met with five of the six people living there. People we spoke to were pleased with the service they received. One person told us they liked “everything” about their supported living arrangements.

People told us they would talk to staff if they had any worries or concerns. People felt that staff listened to them and were very helpful.

People using the service had personalised support plans, which were current and outlined their agreed care arrangements. This meant staff had the information they needed to meet people’s individual needs.

Since our last inspection, staff told us that there had been improvements. They had attended more training which supported them in their role. The agency’s quality monitoring systems had been strengthened which meant that the provider knew what was working well and what needed improving. At this inspection however we found that there were inadequate arrangements to ensure that staff were appropriately recruited.

This inspection took place on 19 and 20 February 2015 and was announced. We told the service two days before our visit that we would be coming. At the last inspection of the service on 2 October 2013 we checked the provider had taken action to make improvements in respect of requirements relating to workers. We found this regulation had been met.

Miss Sunita Larka t/a Direct Care and Support Services provides personal care and support to people who have physical, learning or sensory disabilities and needs such as diabetes, autism and mental health needs. The majority of people receiving support live in small shared tenancies houses known as 'supported living schemes.' This is where people live in their own home and receive care and/or support in order to promote their independence. The head office is based at one of the supported living schemes. The provider has four supported living schemes in the London Borough of Sutton. At the time of our inspection there were 12 people living across the four schemes.

The service had a registered manager in post. A registered manager is a person who has registered with the Care Quality Commission (CQC) to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have a legal responsibility for meeting the requirements in the Health and Social Care Act and associated regulations about how the service is run.

People and their relatives told us they felt safe with the care and support provided by the service. Staff knew what action to take to ensure people were protected if they suspected they were at risk of abuse or harm. Risks to people’s health, safety and wellbeing had been assessed by managers. Staff were given appropriate guidance on how to minimise identified risks to keep people safe from harm or injury in their home and community.

There were enough staff to meet the needs of people using the service. The registered manager ensured prospective employees were suitable to work with adults whose circumstances made them vulnerable, by carrying out employment and security checks before they could start work. Staff received appropriate training and support and the registered manager ensured their skills and knowledge were kept up to date.

People’s consent to care was sought by the service prior to any support being provided. People and their relatives were supported to make decisions and choices about their care and support needs. Their care and support plans reflected their specific needs and preferences for how they wished to be cared for and supported in such a way as to retain as much control and independence over their lives. These were reviewed regularly by staff who checked for any changes to people’s needs.

People were encouraged to eat and drink sufficient amounts to reduce the risk to them of malnutrition and dehydration. Staff monitored people’s general health and wellbeing. People were supported to take their medicines as prescribed. Where they had any issues or concerns they sought appropriate medical care and attention promptly from other healthcare professionals.

People and their relatives told us staff looked after them in a way which was kind, caring and respectful. People’s rights to privacy and dignity were respected and maintained particularly when receiving personal care from staff. People were supported and encouraged to take part in social activities at home or out in the community, to go to work and to maintain social relationships that were important to them.

People and their relatives felt comfortable raising any issues, concerns or complaints with staff. The service had arrangements in place to deal with these appropriately.

The registered manager encouraged an open and transparent culture and people, their relatives and staff felt able to share their views and experiences of the service and how it could be improved. There were systems in place to monitor the safety and quality of the service and the registered manager took action if any shortfalls or issues with this were identified through routine checks and audits.