We undertook an unannounced inspection on 25 July 2017 of Residential Care Providers Limited –11 Kenton Road. Residential Care Providers Limited - 11 Kenton Road is a service providing accommodation and personal care for up to six people with learning disabilities and complex needs, in central Harrow. At the time of this inspection, six 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.

The registered manager was not available at the time of the inspection. The deputy manager of the service supported us with this inspection.

At the last inspection on 17 April 2015 the service was rated Good.

At this inspection we found the service remained Good.

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 when there were areas of people’s care in which their liberties were being deprived. Records showed that the relevant DoLS 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. The management consisted of a deputy manager, registered manager and the provider. 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 11 Kenton Road on 17 April 2015.

This service is registered to provide accommodation and personal care for up to six people with learning disabilities. At the time of the inspection, six 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 17 March 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 (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.

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. Careworkers we spoke with were able to identify different types of abuse and were aware of what action to take if they suspected abuse. All the relatives we spoke with felt people were safe in the home. They told us “[Person] is safe there and comfortable” and “Even when we go on holidays, we have the confidence that [person] will be looked after.”

The CQC monitors the operation of the Deprivation of Liberty Safeguards (DoLS). DOLS applies to care homes and protects 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 of working at the home. Care workers told us “I enjoy it a lot here. It’s like a second home to me”; “It’s very good here. Everyone helps. I have no concerns. There are very good staff and very good teamwork” and “We have very good teamwork here and worked very hard to achieve that.”

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 them in a way they understood. Care workers 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. Relatives told us “The staff and manager know [person] extremely well and they do the best they can for them.”

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 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.

As this was a follow-up inspection to ensure changes we required had been made, we did not speak with people who used the service or their representatives during our visit.

We found that people's personal records that had previously been inaccurate were now up-to-date and reflected the activities and needs of the person who used the service. Staff records had also been organised to ensure that information was clear and easy to find.

Most of the people who used this service had complex communication needs, so we spoke with one person and three relatives for feedback about their experiences. We also observed support taking place.

The people we spoke with were very happy with the support provided. One person said "They look after me very well. They help me to phone my friends and family, and take me out shopping. If something is bothering me we can have a meeting about it". Relatives we spoke with also expressed satisfaction at the service provided. One relative told us "It is very good. They do the best they can, and involve us all the way". Another said "My relative's needs are met and they are very happy. I can't ask for anything more".

We found that the provider took steps to seek consent before care was provided, and that care and support met people's needs in a safe way.

We saw that the service offered a range of healthy, nutritious foods, and that people were supported to eat and drink enough to meet their needs.

The service was offered in a safe, suitable environment, which the provider had adapted to better meet the needs of the people who used the service.

We saw that staff were thoroughly vetted before starting work, and were qualified, skilled and experienced for their roles. However, we found that the provider did not always keep people's personal records accurate and up-to-date.

People who use the service had complex needs which meant we were not able to engage fully with them to get their views about the service. We were able to talk with three members of staff and briefly with two people who use the service. We also observed the way people were cared for and supported in their daily life.

Staff were appropriately supported so they developed skills and competencies to care for and support people in their home. They had a good knowledge of each person’s needs and knew what to do to meet these needs. People’s support plans were comprehensive and appropriately addressed their needs based on their individual likes, dislikes and preferences. Where possible they were involved in developing and reviewing their support plans so they had an opportunity to express their views about the care they received.

People were supported to make choices in their daily life and their independence was promoted. They were also supported to build individual living skills, to maintain their cultural identity and to take an active role in the home and in the local community.

There were arrangements in place for the management of people’s medicines to ensure that people received their medicines as prescribed.

The provider had arrangements to monitor and assess the quality of the service people received so they were cared for appropriately. Where areas for improvements were identified, action plans were developed to address the necessary improvements.

People who use the service told us that they enjoyed living at the home. They also told us staff were kind and caring and there was activities for them to do.