This inspection took place on 24 February 2017 and was announced. This service was rated ‘good’ at our last inspection in February 2015.

This service provides personal care and support to people living in supported living schemes across the London boroughs of Hounslow, Richmond, Hillingdon, Kingston and Wandsworth. At the time of our inspection there were 45 people using the service. The service was required to have a registered manager in post and did not have one at the time of our inspection. However, a service manager was in post and was in the process of applying for their registration. We confirmed that this process was completed shortly after our visit and the manager's status was updated to registered. 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 manager of this service had worked for the same provider for a number of years and was already familiar with the service when they came into post.

People had built very good relationships with staff, who were friendly and respectful and who knew people well. The service used creative and innovative methods of supporting people to express their views and make choices about their care, including the use of accessible technology where needed. Staff made an effort to learn how to communicate with people whose first language was not English.

The service had a strong commitment to promoting people’s privacy, dignity and independence. People had access to private space whenever they needed it. Staff worked closely with people to build their confidence and learn to do more for themselves.

The provider used a person-centred approach to care planning based on evidence-based measures of quality of life. Support plans were personalised and centred around people’s preferences, views and experiences as well as their care and support needs. They took into account people’s history, family relationships and religious and cultural needs. People’s care and support was planned in such a way as to facilitate working towards their goals and ambitions. The provider recognised people’s achievements and encouraged them to always improve by setting new targets whenever their care was reviewed.

People received support to engage in a variety of activities to suit their tastes and abilities, both at home and in the wider community. This included taking more responsibility for their own household tasks but also pursuing their interests and hobbies, making new friends and finding new interests. Staff supported people to pursue education and employment opportunities and to join social groups. They actively supported people to strengthen existing friendships and arranged activities to help ensure people did not lose touch with their friends.

People were satisfied with how the service responded to their complaints and concerns. There was an accessible complaints procedure and records showed the manager dealt with complaints according to the procedure. Managers sought people’s feedback in accessible ways, giving equal opportunities to people who did not communicate verbally.

Staff took pride in the provider’s visible person-centred culture with a clear vision, strong values and a reputation for providing good support to people with learning disabilities. Leadership was accessible and people, staff and others involved with the service had opportunities to express their views about the service. Managers used people’s feedback to improve services in a variety of ways.

The registered manager used several tools to assess, monitor and improve the quality of the service including internal audits carried out by people who used similar services operated by the same provider. They assessed the quality of the service

This inspection took place on 3 and 13 February 2015 and was announced. This was the first inspection since this service registered with CQC on 17 September 2014.

Royal Mencap Society - Domiciliary Care Services - West London specialises in providing personal care and support for people with learning disabilities or autism. Some people had communication and physical health needs in addition. The service supports 25 people in seven supported living schemes as well as 10 people in their own homes. The supported living schemes were in the boroughs of Sutton, Merton, Kingston, Wandsworth and Hillingdon.

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.

Risks were generally managed well, except risks in relation to epilepsy for one person. Their support plan did not sufficiently consider how staff would manage risks should the person have a seizure at night time to keep them safe.

Systems were in place to review accidents and incidents to identify patterns to make sure the right support for people was in place.

People felt safe and were supported to understand how to stay safe. Staff received training with more advanced training in place for managers to help them understand their responsibilities in safeguarding people. The registered manager ensured safeguarding procedures were followed in keeping people safe.

Recruitment procedures were robust in checking staff were suitable to work with people at risk. Staffing numbers were sufficient to provide the right level of support to people. The induction for new staff, including the manager’s induction, was effective, as was the training programme in place. Staff felt supported and received regular supervision and appraisal.

Medicines management was safe with checks in place to ensure medicines were administered as prescribed. Medicines management was regularly audited by the manager and only staff assessed as competent administered medicines.

Staff understood issues of consent and the Mental Capacity Act (MCA) 2005, with decisions being made in people’s best interests, in line with the MCA when they lacked capacity. The Mental Capacity Act 2005 is in place for people who are not able to make some or all decisions for themselves.

People had a choice of food and could eat when they wanted to. Staff knew people’s likes and dislikes and provided them with support in relation to eating and drinking when necessary. People’s health needs were met and they were supported to access the health services they needed.

Staff were caring and respected and involved people in their care. People’s views were sought and reflected in their care plans. People were supported to access educational and social activities and to develop and maintain relationships that were important to them. People were also encouraged to participate in campaigns to promote the rights of people with learning disabilities.

An internal team, separate to the supported living schemes, investigated complaints, ensuring they were responded to appropriately.

People and staff were involved in the running of the service. People were involved in interview panels and a staff forum enabled staff to be consulted on regarding initiatives in the organisation as well as to put forward concerns or suggestions.

The registered manager, scheme managers and staff were aware of their responsibilities and professionals told us the schemes were well-led.