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Inspection carried out on 7 November 2017

During a routine inspection

SignHealth Longley Road is a residential care home based in Tooting, south west London. It provides support within an independent living environment for up to six deaf people with mental health needs. The service is situated over three floors and people have their own private areas with a kitchen, bathroom and lounge area in addition to a bedroom.

At the last inspection, the service was rated Good. At this inspection the service remained Good.

People’s safety was at the heart of the service. People continued to remain safe as the service developed robust risk management plans that identified known risks and gave staff clear guidance about how to mitigate those risks. Risk management plans were reviewed regularly to reflect people’s changing needs. Staff had sufficient knowledge of managing behaviours others may find challenging, in order to keep people safe.

The service had an embedded culture that protected them from the risk of harm and abuse. Staff continued to received safeguarding training and were able to demonstrate significant understanding of what action they would take, should they suspect abuse had taken place. Staff were aware of the providers ‘whistleblowing’ policy.

Incidents and accidents were regularly reviewed to ensure lessons were learnt and the risk of repeat incidents were minimised.

The service ensured specialist equipment was used to keep people and staff safe. Specialist equipment was specific to the people using the service. Adaptions to the environment were undertaken and regularly reviewed to ensure they functioned as intended.

People continued to be supported by sufficient numbers of qualified and suitable staff to effectively and safely meet their individual needs. The service had exceeded the expectations of providing staff that could identify with people’s communication needs and the impact their conditions had on them.

People’s medicines were managed in line with good practice. Staff’s knowledge of medicines management was robust and records confirmed people received their medicines as prescribed. People were encouraged to self-administer their own medicines with support from staff to encourage further independence.

Staff had sufficient understanding of the importance of following good practice in line with infection control management. Records indicated the service monitored and implemented systems in order to reduce the risk of infection.

The embedded culture of the service ensured people continued to be supported to have maximum choice and control of their lives and to be supported in the least restrictive way possible; the policies and systems in the service supported this practice. Staff had a comprehensive understanding of the Mental Capacity Act 2005 and Deprivation of Liberty Safeguards.

People received effective care and support from staff that had undergone regular training both mandatory and person specific. Staff could request additional training should they deem it necessary.

Staff continued to receive regular supervisions and annual appraisals to ensure they reflected on their working practices. Records of staff supervisions were personalised and gave staff clear guidance on how to enhance their skills and the delivery of care.

People were encouraged to maintain healthy lives and have access to sufficient food and drink that met their dietary needs and preferences. People continued to receive support and guidance on how to make healthy choices and had access to healthcare professionals to monitor their health and wellbeing.

The service had an embedded culture of supporting people in a person centred way that was tailored to their individual needs and preferences. People were supported to make decisions about the care they received. The service had robust systems in place that encouraged and empowered people’s differences and treated people equally. Staff treated people with the upmost compassion, respect and maintained their privacy and dignity.

People and

Inspection carried out on 21 Oct 2014

During a routine inspection

This inspection took place on 21 October 2014 and was unannounced. The service met the regulations we inspected at their last inspection which took place on 23 September 2013.

SignHealth Longley Road provides 24 hour support within an independent living environment for up to six deaf people with mental health needs. Each person lives in their own self-contained flat with a kitchenette and a bathroom and there is a shared lounge.

There was a registered manager at the service. 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 using the service told us they felt safe living at the home. They were given information about reporting concerns in a visual format and were encouraged to raise any issues through key worker meetings, group meetings or by speaking with an advocate.

Staff members felt valued and an important part of the team. They received training that was relevant to them and excellent support through regular supervision and a yearly appraisal.  Staff meetings were held monthly in which staff were encouraged to express their views. The registered manager was supported by a team leader, a co-ordinator and support workers. There were clearly defined roles and responsibilities for each staff member which gave care workers a sense of being valued and an important part of the team.

Risk assessments and care plans were person centred and written in plain English which made it easier for people to understand them and what their purpose was. Other information such as notices and questionnaires were written in an accessible format and used pictures to support people’s understanding.

People’s healthcare needs were managed well by the provider. People received regular health check-ups and met with the community psychiatrist on a regular basis which meant their mental health needs were monitored. Multi-disciplinary reviews also took place which helped to get a fuller picture of people’s needs so they could be supported better. People received their medicines safely and those who were able to, were encouraged to take their medicines independently.

Staff had received training in the Mental Capacity Act (MCA) 2005 and Deprivation of Liberty Safeguards (DoLS). We saw evidence that the provider sought guidance and made appropriate referrals to assess people’s capacity to make decisions in respect of specific situations. People were offered advocacy support. An independent mental capacity advocate (IMCA) visited the service every month and spoke to people individually.

People were encouraged to become more independent in their daily living skills. People were assigned a key worker who supported people in this regard. People’s care records had stated aims which they worked towards. We saw evidence that people had become more independent and confident during their time at SignHealth Longley Road.

The service was part of a number of external organisations which helped to share best practice and common issues that may be affecting people who were using the service.

Questionnaires to get feedback about the quality of service were sent to people using the service, relatives and healthcare professionals. The feedback from these surveys was very positive. Quality assurance audits were carried out regularly which covered a number of areas including health and safety and records, and manager comments. Actions resulting from audits were followed up.

Inspection carried out on 23 September 2013

During a routine inspection

Due to the complex needs of people using the service, we were unable to speak with them during the inspection. However, care plans and other records showed that people's care was planned and described in a person-centred manner. Staff gave us examples where they had held best interest meetings for people using the service.

There was a key worker system in place, where one member of staff took a lead role in the care planning for individual people. We saw evidence that where people using the service had difficulty in understand how to manage their money or use public transport, staff helped to support them to become more confident in these aspects.

Each person had their own self-contained flat with a kitchen and bathroom. We were shown one flat which was clean, pleasantly decorated and well furnished.

We looked at four staff files during the inspection. We saw that had attended a number of training courses to enable them to become more qualified to carry out their roles. These included safeguarding of vulnerable adults, mental health awareness, first aid, moving and handling and medication.

Inspection carried out on 7 June 2012

During a routine inspection

People told us that they enjoyed living in the home and felt they were very well supported by staff. We spoke to four out of the six people who lived in Longley Road and most of them had a strong desire to live in their own accommodation in the future. They told us that they received positive support to achieve their independence in preparation for living on their own.

The service was based in a three floor house divided into 6 self contained flats. Each flat had an open plan living area, and kitchen, sleeping and bathroom facilities. There was a communal lounge and kitchen on the ground floor. All members of staff were trained to communicate in sign language.

Reports under our old system of regulation (including those from before CQC was created)