Peace Manor Residential Care Ltd - Pembroke Road Unit - Erith

People were generally supported to maintain their independence and develop daily living skills. However, this was not always consistently promoted. One person told us they enjoyed cooking but was not currently supported to do this independently. Staff told us they considered there to be risks associated with the person using cooking equipment; however, there was no documented risk assessment to demonstrate how these risks had been assessed or how the person could be supported to take positive risks safely. Whilst people were encouraged to undertake other aspects of independent living, such as cleaning their rooms and completing laundry tasks, the lack of an individual assessment meant opportunities to further promote this person's independence had been missed.

People generally experienced choice and control over their daily lives, but opportunities to maximise this were not always considered. Snacks, fruit and other food items were stored in locked cupboards, meaning people needed to ask staff to access them. During our assessment, we observed staff responding promptly to requests for food and drinks and people told us they received these when they asked. However, the arrangements in place reduced people's ability to access food independently and did not fully promote choice and control. Leaders had not explored alternative approaches that could balance individual risks whilst enabling others to access food more freely.

We found the service was working within the principles of the Mental Capacity Act 2005 (MCA). Deprivation of Liberty Safeguards (DoLS) authorisations were appropriately applied for, monitored and reviewed. People were free to leave the service and access their local community as they wished.

People were protected from abuse and avoidable harm. Staff had received safeguarding training, understood their responsibilities and knew how to recognise and report concerns. Incidents were recorded, reviewed and monitored, and learning was shared with staff to reduce the risk of similar events occurring. Staff described opportunities to reflect on incidents through debrief discussions and learning reviews.

The provider maintained effective systems to manage health and safety, infection prevention and control, fire safety and medicines. The service was clean and well maintained. Medicines were managed safely, with appropriate arrangements for ordering, storage, administration and disposal. Staff responsible for administering medicines were trained and assessed as competent. We found medicine stocks matched records and there were clear protocols for medicines prescribed on an 'as required' basis.

There were enough suitably recruited staff available to meet people's needs safely. Planned staffing levels were maintained and reflected the staffing arrangements we observed during our visit. Staff told us there were sufficient numbers of staff to support people safely and flexibly, including when attending activities and appointments.

Staff received induction, supervision, annual performance reviews and training relevant to the needs of people using the service. This included specialist training in mental health and bipolar disorder. Staff told us they felt supported in their roles and could request additional learning and development opportunities when required.

People's needs were assessed before they moved into the service. Assessments considered a wide range of factors, including physical and mental health needs, communication preferences, cultural requirements, sexuality and support needs. The provider also considered people's compatibility with others living at the service before new admissions were agreed.

Risks associated with people's health, wellbeing and community access were assessed and regularly reviewed. Care records identified known triggers, signs of deterioration and actions staff should take to support people safely. The service worked with relevant health and social care professionals to support positive outcomes for people, and records showed people's progress was reviewed regularly.

Staff treated people with kindness, dignity and respect. We observed warm, caring and positive interactions throughout the assessment. People appeared relaxed and comfortable in the presence of staff, and staff sought consent before providing support or entering private areas.

People were supported to take part in activities they enjoyed and maintain links with their local communities. Individual activity plans reflected people's interests and goals. Staff encouraged people to participate in daily living activities and develop practical skills that promoted independence.

People told us they felt listened to and had opportunities to influence how the service was run. Regular residents' meetings enabled people to discuss menus, activities and other aspects of the service. We observed the registered manager responding positively to concerns raised by people and taking action to resolve issues.

Leaders and staff understood people's individual needs and worked collaboratively with partner agencies to support their health and wellbeing. Staff told us they felt able to raise concerns and were confident they would be listened to. The provider continued to review and develop its quality assurance systems and was introducing new approaches to strengthen care planning and record keeping.