Living Ambitions Limited - 330 Guildford Road

At the last inspection of 330 Guildford Road on 12 June 2017 we rated the service good. However, we found a breach of regulation of the Health and Social Care Act 2014 as the service did not ensure people were treated with dignity and respect. We also found other areas that required improvement. These included the safety and maintenance of the environment, deployment of staff to ensure people always received the support they needed from staff and staff following risk management plans for people. Following the last inspection, the provider sent us an action plan on how they would improve. At this inspection, we found that the service had made the required improvement and complied with our regulations. We have rated the service Good.

There was a registered manager in post who had worked at the service for several years. 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 understood people's needs and treated them with respect, kindness and dignity. Staff communicated with people in the way they understood.

There were sufficient numbers of staff on duty to meet people's needs. Staffing levels were determined by looking at people's needs and activities including appointments. Risks to people were assessed and managed appropriately to ensure that people's health and well-being were promoted. Action plans to manage risks were in place and staff followed them.

The environment was safe and well maintained. Health and safety checks were carried out regularly. Staff followed infection control procedures to reduce risk of infection. There were suitable facilities and adaptations available for people to use.

Staff had been trained in safeguarding people from abuse. Staff demonstrated that they understood the signs of abuse and how to safeguard the people they supported in line with the provider's procedures.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems at the service supported this practice. Staff understood their responsibility under the Mental Capacity Act 2005 and Deprivation of Liberty Safeguards.

People received their medicines safely. Medicines were administered to people appropriately; clear records were maintained and medicines were stored safely. Staff follow infection control procedures.

People had access to a range of healthcare services to maintain good health. The service liaised effectively with professionals to ensure people received a well-coordinated service. Staff were trained, supervised and had the skills and knowledge to meet the needs of people.

People's nutritional needs were met. Staff supported people to eat and drink healthy and sufficient amounts for their wellbeing. People's individual care needs had been assessed appropriately. People received support tailored to their individual needs. People and their relatives were involved in planning their care and their views considered. People's needs and progress were reviewed regularly to ensure it continued to meet their needs.

People were encouraged to follow their interests and develop daily living skills. There were a range of activities which took place within and outside the home. People were encouraged to be as independent as possible. Staff communicated with people in the way they understood. Staff supported people to maintain relationships that mattered to them. Care records noted people's religious, cultural and sexual needs.

Relatives and staff told us that the service operated an open and transparent culture. The service held regular meetings with people and staff to gather their views about the service provided and to consult with them about various matters. The service learned from incidents and accidents and when things go wrong. The registered manager reviewed incidents and accidents and took actions to reduce the chances of them happening again.

People knew how to make a complaint if they were unhappy with the service. There were systems in place to monitor and assess the quality of service provided. The service worked in partnership with external organisations to develop and improve the service.

Where required people were supported with their end of life wishes. People's funeral wishes were recorded in the care records. There was no one receiving end of life care at the time of our visit but the registered manager told us they would work closely with relatives and other professionals to ensure people received appropriate care and support.

The registered manager complied with the requirements of their registration. They submitted notifications of events and displayed the rating of their last CQC inspection as required.

The five questions we ask about services and what we found