We undertook this unannounced inspection on 28 February and1 March 2017. Support for Living – 79 Harrow View is a care home registered for a maximum of nine adults, some of whom may have learning disabilities or mental health care needs. At the time of our visit, there were eight people living in the home.

At our previous inspection on 19 March 2015 we rated the service as “Good” and there were no breaches of regulations. At this inspection we found the service remained Good.

People informed us that they were satisfied with the care and services provided. They had been treated with respect and felt safe living in the home. There was a safeguarding adult's policy and suitable arrangements for safeguarding people. The arrangements for the recording, storage, administration and disposal of medicines were satisfactory. People’s care needs and potential risks to them were assessed and care workers were aware of these risks. Personal emergency and evacuation plans were prepared for people and these were seen in the care records. This ensured that care workers were aware of action to take to ensure the safety of people. The premises were clean and tidy. Infection control measures were in place. There was a record of essential inspections and maintenance carried out. There were arrangements for fire safety which included alarm checks, drills, training and a fire equipment contract. Fire drills had been arranged. The garden was well maintained and seating was available for people. These ensured that people lived in a safe and pleasant environment.

There were enough care workers deployed to meet people's needs. They had received essential training and were knowledgeable regarding the needs of people. Teamwork and communication within the home was good. Care workers had received induction to enable them to care effectively for people. There were arrangements for support, supervision and appraisals from the company’s senior staff.

People’s healthcare needs were monitored and arrangements had been made with healthcare professionals when required. There were suitable arrangements for the provision of food to ensure that people’s dietary needs and special preferences were met. People informed us that they were satisfied with the meals provided and they could also cook their own meals. The CQC is required by law to monitor the operation of the Deprivation of Liberty Safeguards (DoLS) which applies to care homes. DoLS ensures that an individual being deprived of their liberty is monitored and the reasons why they are being restricted are regularly reviewed to make sure it is still in the person’s best interests. We were informed that all people who used the service had capacity to make their own decisions and no person’s liberty was restricted.

There were arrangements for encouraging people to express their views and experiences regarding the care and management of the home. Care workers were aware of the individual choices and preferences of people. Care workers prepared appropriate and up to date care plans which involved people and their representatives. Regular residents’ meetings and one to one sessions had been held for people and the minutes were available for inspection. The home had an activities programme to ensure that people received mental stimulation and were able to engage in social and therapeutic activities they liked. People knew who to complain to if they had concerns.

The service was well managed. Audits and checks of the service had been carried out by senior staff and the service manager. These were carried out monthly or weekly and included checks on care documentation, fire safety, medicines, and maintenance of the home. Evidence of these was provided. A satisfaction survey carried out in the previous year indicated that people were satisfied with the care and services provided. Care workers worked well together and they had confidence in the management of the home. They were aware of the values and aims of the

We carried out an unannounced comprehensive inspection of this service on 13 November 2014. A breach of Regulation 13 Management of medicines of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2010 was found. After the comprehensive inspection, the provider wrote to us on 29 January 2015 to say what they would do to meet legal requirements in relation to the breaches.

We undertook this focused inspection on 19 March 2015 to check that they had followed their plan and to confirm that they now met legal requirements. This report only covers our findings in relation to those requirements. You can read the report from our last comprehensive inspection, by selecting the 'all reports' link for Support for Living Limited - 79 Harrow View on our website at www.cqc.org.uk.

79 Harrow View is a home located in Harrow, North-West London and is registered to provide accommodation and personal care to nine adults who have mental health needs. The home has 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.

During our focused inspection on 19 March 2015 we found that the provider had taken the necessary steps to ensure that medicines were recorded, stored and administered safely.

This inspection took place on 13th November 2014 and was unannounced.

During our last inspection on 31 October 2013 we found no breaches of the regulations assessed.

79 Harrow View is a home located in Harrow, North-West London and is registered to provide accommodation and personal care to nine adults who have mental health needs. During our inspection on 13th November 2014 there were two vacancies at 79 Harrow View. The home has 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.

Staff working at 79 Harrow View understood the needs of the people who used the service and we saw that care was provided with respect and compassion. People who used the service told us they were happy with their care. People had good access to health care professionals, which ensured their mental and physical health was regularly monitored and assessed.

People were protected from the risk of abuse. The provider had taken reasonable steps to identify the possibility of abuse and prevent abuse from happening. Staff knew how to safeguard the people they supported.

Risks to people’s safety were identified and managed effectively and there were enough staff on each shift to make sure that people were protected from the risk of harm.

Robust recruitment procedures were followed to make sure that only suitable staff were employed to work with people in the home.

Although people who used the service told us that they were administered medicines safely we saw that the recording of medicines was not safe. We saw that care staff did not always sign when medicines were administered and showed a lack of understanding of common side effects of medicines taken by people who used the service. This meant people did not receive medicines safely, and appropriate systems and storage arrangements did not ensure the safe administration and storage of medicines. This was a breach of Regulation 13 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2010. You can see what action we told the provider to take at the back of the full version of the report.

Staff were appropriately trained and skilled and provided care in a safe environment. They all received a thorough induction when they started work and fully understood their roles and responsibilities, as well as the values and philosophy of the home.

The staff had also completed extensive training to ensure that the care provided to people was safe and effective to meet their needs.

Throughout our inspection we saw examples of good care that helped make 79 Harrow View a place where people felt included and consulted. People were involved in the planning of their care and were treated with dignity, privacy and respect.

The registered manager assessed and monitored the quality of care consistently. The provider encouraged feedback from people who used the service, care staff, relatives and outside professionals, which they used to make improvements to the service.

At the time of our inspection, the home was providing care for nine people.

People who used the service received appropriate care and support that met their individual needs and were treated with dignity and respect. One person who used the service told us, “they take a real interest in you as a person”.

There were processes in place to protect people who used the service from harm. The staff were trained to recognise the signs of abuse and to report concerns in accordance with the home's procedures.

Staff were supported to provide care and treatment to people who used the service and were trained, supervised and appraised appropriately.

There were systems in place to monitor the quality and safety of the service and accurate and appropriate records were maintained.

People confirmed they had visited the home before deciding to move in. They told us they could give their views about the home and could make requests for things they wanted. Comments from people about the home included, “This is the best place I have ever lived in” and “the home felt the right place for me to live in”.

People said they met with a member of staff, known as their keyworker, on a regular basis and could discuss any issues they might have.

They said if they had any concerns they would report these to staff. They also said staff were competent and “professional”.

Those people asked said they felt safe living in the home and had good relationships with the other people living in the home and staff.

People told us staff were respectful towards them, offered them choices and took account of their views. However we found that there was a lack of systems in place to assess and monitor the quality of the services being provided to people.

We looked at the care records of four people spoke with staff and people using the service. People told us the “staff are very nice and do amazingly well”, “I feel very well looked after and feel like I can talk to anyone here”. Another person told us “I am looked after very well and the staff give support and accommodate for all my needs”.

People also told us, ” because of the excellent care that I receive here, I would recommend this home to other people".

Another person told us “my choices are respected and it’s very peaceful here”. One person said, “I have no complaints and I can trust people”.

We looked at how people were involved in their care and found that people were able to contribute decisions and views not only about their own care but also the way in which the service is operated.

From the care records we looked people's care was not planned and delivered in a way that met the needs. of people. For example care plans were not updated regularly and there was an absence or care plans and risk assessments, however we did find people were supported to maintain a healthy diet.

We looked at recruitment practices and found the service had a system which ensured only appropriate people were recruited.

We observed the cleanliness of the home and found people were cared for in a hygienic environment.

We found the service did not have systems in place for monitoring the quality of care being delivered.