We undertook an unannounced inspection on 27 April 2017 of Residential Care Providers Limited – 157 Harrow View. Residential Care Providers Limited - 157 Harrow View is a small care home registered to provide accommodation and support with personal care for five people with learning disabilities and complex needs. At the time of this inspection, five 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 [CQC] 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.

People's health and social care needs had been appropriately assessed. Care plans were person-centred, and specific to each person and their needs. Care preferences were documented and staff we spoke with were aware of people's likes and dislikes. Care plans were reviewed and were updated when people's needs changed.

Relatives informed us that they were satisfied with the care and services provided. Relatives also told us that they were confident that people were safe in the home.

Systems and processes were in place to help protect people from the risk of harm. Staff had received training in safeguarding adults and knew how to recognise and report any concerns or allegations of abuse.

Systems were in place to make sure people received their medicines safely. Arrangements were in place for the recording of medicines received into the home and for their storage, administration and disposal.

We found the premises were clean and tidy. There was a record of essential maintenance carried out at the home. Bedrooms had been personalised with people's belongings to assist people to feel at home.

Staff had been carefully recruited and provided with induction and training to enable them to support people effectively. They had the necessary support, supervision and appraisals from management.

Staff we spoke with had an understanding of the principles of the Mental Capacity Act (MCA 2005). Capacity to make specific decisions was recorded in people's care plans.

The CQC is required by law to monitor the operation of the Deprivation of Liberty Safeguards (DoLS) which applies to care homes. The home had made necessary applications for DoLS as it was recognised that there were areas of the person’s care in which the person’s liberties were being deprived. Records showed that the relevant authorisations had been granted and were in place.

There were suitable arrangements for the provision of food to ensure that people's dietary needs were met.

Staff were informed of changes occurring within the home through daily handovers and staff meetings. Staff told us that they received up to date information and had an opportunity to share good practice and any concerns they had at these meetings.

There was a management structure in place with a team of care workers, deputy manager and registered manager. Staff spoke positively about working at the home. They told us management were approachable and the service had an open and transparent culture. There were systems in place to monitor and improve the quality of the service.

We undertook an unannounced inspection of Residential Care Providers Limited at 157 Harrow View on 19 and 20 March 2015.

This service is registered to provide accommodation and personal care for up to five people with learning disabilities. At the time of the inspection, five people were using the service. People had learning disabilities and complex needs and could not always communicate with us and tell us what they thought about the service. They used specific key words and gestures which staff were able to understand and recognise.

At our last inspection on 10 February 2014 the service met the regulations inspected.

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 taken steps to help ensure people were protected from avoidable harm and abuse. There were safeguarding and whistleblowing policies and procedures in place. Training records showed and staff confirmed they undertook training in how to safeguard adults. Care workers we spoke with were able to identify different types of abuse and were aware of what action to take if they suspected abuse.

The CQC monitors the operation of the Deprivation of Liberty Safeguards (DoLS). DOLS applies to care homes and protect the rights of people using services by ensuring that if there are any restrictions to their freedom and liberty, these have been agreed by the supervisory body as being required to protect the person from harm. During the inspection, people using the service were not restricted from leaving the home. There was evidence that showed people went out and enjoyed various activities and community outings.

The registered manager was aware of the Supreme Court judgement in respect of DoLS and records showed the registered manager had applied for DoLS authorisations. We saw the relevant processes had been followed and standard authorisations were in place for people using the service as it was recognised that there were areas of people’s care in which people’s liberties were being deprived.

People were cared for by staff who were supported to have the necessary knowledge and skills they needed to carry out their roles and responsibilities. Care workers spoke positively about their experiences working at the home. Care workers told us “I enjoy working here,” “The atmosphere is nice, there is good teamwork” and “It is very nice here. There is not one morning where I didn’t want to come to work.”

Positive caring relationships had developed between people who used the service and staff. People were treated with kindness and compassion. We observed people were relaxed and at ease. Care workers were patient when supporting people and communicated well with people in a way that was understood by them. Care workers were patient, waited for people to respond and treated people with a kind manner. Relationships between people and staff were caring and people appeared comfortable and at ease. We saw people being treated with respect and dignity.

Staff encouraged and prompted people’s independence. Daily skills such as being involved with household chores were encouraged to enable people to do tasks by themselves. People were supported to follow their interests, take part in them and maintain links with the wider community.

People received personalised care that was responsive to their needs. Care plans were person-centred, detailed and specific to each person and their needs. People were able to visit family and friends or receive visitors and were supported and encouraged with maintaining relationships with family members. There were arrangements in place for peoples’ needs to be regularly assessed, reviewed and monitored.

There was a clear management structure in place with a consistent team of care workers, senior care workers, deputy manager and the registered manager.

Systems were in place to monitor and improve the quality of the service. Checks were being carried out by the registered manager and any further action that needed to be taken to make improvements to the service were noted and actioned. There was an effective system in place to identify, assess and manage risks to the health, safety and welfare of people using the service and others.

Most of the people who used this service had complex communication needs and were unable to tell us directly of their experiences, so we observed the care and support provided, spoke with one person who used the service and spoke with one relative for feedback about the service. The support we observed was caring and compassionate, and we saw that the staff were aware of each person's needs and worked within their specific communication styles. The relative we spoke with was very positive about the service their relative received. They told us "The service is excellent. My relative is a different person to when they moved in - they are getting the best possible standard of support. The staff there are excellent".

We found that consent to care and support was obtained in line with government guidelines, and that support provided met people's needs and ensured their safety and welfare.

We saw that food and drink supplied by the provider was varied and nutritious, and took into account people's specific dietary needs. We found that the provider had taken steps to ensure people were safeguarded from the risk of abuse.

Staff were well-trained to meet the specific needs of the people who used the service, and we saw that they were qualified, skilled and experienced for their roles. We found that records were accurate and fit for purpose.

We used a number of different methods to help us understand the experiences of people using the service, because they had complex needs which meant that they were not able to tell us their experiences. We observed the people using the service and their engagement with staff. We also spoke with the relative of one person who used the service, three members of staff and the manager to find out about the service provided to people.

We observed that people felt comfortable with staff and that staff knew people’s needs well and engaged positively with them. For example staff understood the way people communicated and were able to support them according to their individual needs. People’s preferences, likes and dislikes were taken into account when they were cared for or supported.

People were supported to take part in the local community and to develop individual living skills. They were engaged in many social and recreational activities that took place within the local community. They were also supported to be independent in that their care records included areas such as helping in the kitchen, doing personal laundry, taking responsibility for their own personal care and appearance.

The service had effective quality management systems. These ensured that records and aspects of the service were reviewed and kept up to date and areas for improvement were promptly identified and addressed.

We talked to three people using the service. We observed some of the support that people using the service received, their general demeanour in the home and the interactions between them and care workers to get information about their experiences of using the service.

The service has systems to promote the involvement of people using the service in some aspects of the running of the home and in the management of their care and support. People are given information, where this is available, about their care for them to understand so that they can consent to the care and support that they received. Where they are unable to give consent, their representatives are involved in supporting people give consent or giving consent on behalf of people.

People were observed to be relaxed and comfortable in the home. They got on well with members of staff who understand their needs well and who were able to communicate with people using the service. Activities were arranged for each individual person according to their needs to keep them occupied, stimulated and to increase their confidence and independence in the local community.