This inspection took place on 5 and 12 October 2017. The provider was given 48 hours’ notice because the location provides a domiciliary care service in people’s own homes and we needed to be sure that someone would be available to assist with the inspection.

The Ridgeway is registered to provide personal care to people in their own homes. At the time of the inspection they were providing a supported living service to four people who lived together in a shared house. Supported living is where people live in their own home and receive care and/or support in order to promote their independence.

The service 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 and associated Regulations about how the service is run.

People received a safe service. Systems were in place to minimise risk and to ensure that people were supported as safely as possible. Staff were aware of their responsibilities to ensure people were safe and what to do if they had any concerns. They were confident that the registered manager would address any concerns.

People were treated with respect and their privacy and dignity was maintained. They were supported by a caring staff team who knew them well.

Systems were in place to ensure that people received their prescribed medicines safely. Medicines were administered by staff who were trained and assessed as being competent to do this.

Staff received the support and training they needed to give them the necessary skills and knowledge to meet people’s assessed needs, preferences and choices.

People were protected by the provider’s recruitment process, which ensured that staff were suitable to work with people who need support.

People were encouraged to develop their skills and to be as independent as possible. They were supported by staff to carry out daily living activities such as shopping, cooking, cleaning and laundry.

People were actively involved in developing their support plans and agreeing how they should be supported. Care records contained detailed information about people’s needs, wishes, likes, dislikes and preferences.

The registered manager and the provider monitored the quality of service provided to ensure that people received a safe and effective service that met their needs.

Staffing levels were sufficient to meet people’s needs and to enable them to do be supported flexibly and in a way they wished.

People were encouraged to make choices and to have as much control as possible over what they did and how they were supported. Systems were in place to ensure that their human rights were protected.

Staff felt the registered manager was approachable and supportive and gave them clear guidance.

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008 and to pilot a new inspection process being introduced by CQC which looks at the overall quality of the service. 

This was an unannounced inspection. At our previous inspection in October 2013, the provider was found to be meeting the required standards.

The Ridgeway provides supported living services with personal care for up to four adults with learning disabilities and complex needs, including physical disabilities, communication difficulties and visual impairments. The service is located in Romford in the London Borough of Havering. People and their relatives were complimentary about the service. One person told us, “Staff are kind to me. I like the chats”. Another person said, “I like it here. The staff are nice.”

There was a registered manager in post at the time of our inspection.  A registered manager is a person who has registered with the Care Quality Commission to manage the service and has the legal responsibility for meeting the requirements of the law; as does the provider.

People told us they were happy because staff understood their support needs and provided them with the support they required. All three relatives we contacted were complimentary about the service. One of them commented that the support their relative received was “second to none”, and another said “the list of positives is endless.”

Staff knew people’s support needs and we observed positive interactions between people and staff. We saw staff being kind and thoughtful, involving people in conversations and treating them with dignity and respect.

Where required people, their relatives and advocates were involved in making decisions about their support. Healthcare professionals such as general practitioners (GPs), dentists, opticians, psychologists and psychiatrists were also involved in people’s care.

Staff had the skills, knowledge and experience to support people with learning disabilities and complex needs. They understood people’s communication needs and supported people to make choices about the food they wanted to eat and activities they wanted to participate in.

People told us that they were supported to be independent and our observations confirmed this.  For example, we observed that people were supported to carry out household tasks and all four people using the services were supported to access the local community during our inspection.

Support plans were detailed and written in easy read formats with pictures to support people’s understanding. These addressed people’s individual needs and provided staff with guidance on how to support people appropriately in a safe and dignified way.

Systems were in place to protect people from potential harm or abuse. Staff had completed safeguarding vulnerable adults training. Staff discussed with people using the service at each monthly tenant’s meeting how to stay safe and reminded people of what to do if they did not feel safe. People told us they would speak to the registered manager or staff if they had any concerns.

People and their relatives knew the management team and told us they felt comfortable speaking with them. Staff told us their managers were approachable and treated them as part of the team.     

The service was providing care to four people with learning disabilities. We spoke with two people during the inspection. One of the people we spoke with using the service was unable to communicate verbally. They could communicate by using their body language. Two people were at an activities centre. People using the service said they were happy at the home. One person said, "I enjoy it here. I like the other tenants." People told us they liked the staff and enjoyed the activities on offer at the home. The provider assessed people's individual needs and preferences to ensure their care was safe and people's rights were protected. The staff communicated with people's health care and social care professionals when appropriate.

There were systems in place in place for obtaining, and acting in accordance with, the consent of people who use the service in relation to the care and treatment provided to them. Before people received any care or treatment they were asked for their consent and the provider acted in accordance with their wishes.

People were protected against the risks associated with medicines because the provider had appropriate arrangements in place to manage medicines. There were enough qualified, skilled and experienced staff to meet people’s needs.

We saw systems in place to check whether a good quality service was being provided. We found that the provider took actions in response to the findings of their audits and the information provided by people who used the service. This included monthly tenant meetings.

People said that they were treated with dignity and respect and that they could make choices about their daily lives. One person told us "I wanted to go shopping today" and we saw that staff had supported this person to do so. We found that care plans were in place for people and that health care needs were being met. People had access to health care professionals and we saw this on the day of our visit. We saw good interactions between people using the service and staff and people were happy with the care they received. We saw that staff supported people well and they showed a good understanding of how to support people.

People said that they felt safe living at the home. We found that the service had a safeguarding vulnerable adults policy which was updated annually. All staff had read the service's previous safeguarding policy and were in the process of reading the current policies. One member of staff's knowledge around safeguarding was insufficient however this member of staff had recently returned from maternity leave and was in the process of re-induction into the service.

There were sufficient staff to meet people's needs and staffing levels were flexible depending on people's needs. People told us that they liked the staff. One person said "they're all nice." We found that the service had a complaints procedure which had been produced in written, pictorial form and Braille. One person said "I would tell them if anything was wrong, I know my rights."