This inspection took place on 21 June 2016 and was unannounced.

Olive House is a care home registered to accommodate one person. Its services focus mainly on caring for adults who have a learning disability. The service is situated in High Barnet, in a residential area. The provider, P & P Community services Limited also manages four similar services across London.

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 2008 and associated Regulations about how the service is run.

At the last inspection, the service was rated as overall Good.

At this inspection we found the service remained Good.

We observed some good interaction between staff and the person using the service and staff respected the person’s choices and preferences.

People were safe from the risk of abuse because staff knew the signs to look for and what action to take should they suspect any abuse, including reporting any concerns to the relevant authorities.

Risk assessments identified risks and how these should be mitigated. Medicines were managed safely.

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.

There were sufficient numbers of staff on duty to meet people’s needs. Staff felt supported in their role and received training relevant to their job.

People’s nutritional needs were met and staff knew their likes and dislikes and preferences for care.

Further information is in the detailed findings below.

We carried out an unannounced inspection on the 5 June 2015.

Olive House is a care home registered to accommodate one person. Its services focus mainly on caring for adults who have a learning disability. The service is situated in High Barnet, in a residential area. The service consists of four flats, three with five bedrooms and a bedsit for one person.

At the time of our inspection there was a registered manager in position. 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.’

At our last inspection in November 2013 we found the service was meeting with the standards inspected.

We observed how care was being delivered and saw some excellent interactions between staff and the person using the service. We saw that staff were caring, kind and showed compassion.

People were treated with dignity and respect and their privacy maintained. We saw that staff spoke in a calm manner and explained what they were doing before supporting the person using the service.

People were given choice and their individual needs were being met by the service, this included working with other healthcare professionals. The person using the service was involved in their day to day care and made decisions about what type of care they wanted.

People’s nutritional needs were met by the service and they were encouraged to take part in meal preparations.

Staff supported people to maintain their safety. Assessments were undertaken to identify any risks to identify any risks to a person’s safety and management plans were in place to address those risks. Staff received appropriate training and regular supervision. They told us they felt supported by their manager.

People confirmed that they felt safe and supported by staff. There were sufficient numbers of staff on duty to meet people’s needs. People received their medicine as prescribed and medicine management systems were in place.

We saw that the provider had a number of auditing systems to monitor the quality of the service. Audits included areas such as cleanliness and infection control, and health and safety of the building.

We previously inspected Olive House on 30 May 2013 and found non-compliance with standards relating to care and welfare of people who use the service and the assessment and monitoring of the quality of service provision. We found minor concerns with the planning and delivery of care, including financial support and for behaviours that challenged, where the support plan had not been updated. We also found minor concerns with the provider's systems to identify, assess and manage risks to the health, safety and welfare of the person using services and others. This was because incidents were not effectively analysed, to identify and support necessary changes to care practice.

We carried out a compliance review to check compliance against the action plan produced by the registered manager had been implemented. During this visit we found that the service had made improvements. Since our visit in May 2013 we saw that the care plan had been updated and a new risk assessment implemented for “spending money and financial ability.” There was a contract for supporting the person to manage their finances, which was signed by them in July 2013. This was confirmed by the person receiving care and support who told us that the care was, “good really.” Service risk assessments were in place and covered areas such as, infection control and fire safety.

We spoke with a social worker who told us that they were happy with the way staff worked with the person using the service. They told us that the person had settled “a lot,” and that the service appears to be “doing their best” to meet the person’s needs.

We spoke with the one person using the service. They spoke with us about many things, but to protect their confidentiality, we have summarised their comments within this report.

The person using the service told us they were happy with the support provided by staff. They gave examples of a range of activities in the local community which they took part in. They generally felt safe at the service, and they knew how to contact the manager if they had concerns.

We found that the provider ensured that the person using the service was supported by suitably qualified, skilled and experienced staff, who supported them from the risks of inadequate nutrition and dehydration, and protected them from the risk of abuse.

However, we found minor concerns with the planning and delivery of care, including for financial support and behaviours that challenged, because planning and delivery were not always consistent in aiming to meet the person’s individual needs and ensure their welfare and safety.

We also found minor concerns with the provider’s systems to identify, assess and manage risks to the health, safety and welfare of the person using services and others. This was because incidents were not effectively analysed, to identify and support necessary changes to care practice.

We spoke with the one person using the service. They told us, “it’s a good service.” They explained many different ways staff supported them where needed, to make decisions about their care and support, and to lead an independent life. They chose and prepared their meals, and decided on trips out and when to do things. Their comments were listened to and acted on.

Staff understood the importance of enabling the person using the service to be independent where possible. They were respectful and friendly in their interactions with the person using the service, knew how to communicate with them, and understood their needs.

Staff received appropriate professional development and support. However, we found that a staff member had recently worked alone at the service a number of times, before the provider had acquired satisfactory references relating to their previous employment. This put the person using the service at unnecessary risk.

The person who uses the service said they were satisfied with the care and they could talk to the staff. They said they were happy living at the home. They said their relatives and social workers visited them at the home. From observations it was clear that the person who uses the service was relaxed when interacting with the staff. The staff communicated with the person who uses the service with respect and dignity.