SENSE - 163 Newington Road

About the service

SENSE - 163 Newington Road is a residential care home providing personal care to four people the time of the inspection. The service can support up to four people.

People’s experience of using this service and what we found

People told us they were happy living at the service. When we asked people if they liked living there one person signed ‘happy’ and another person beamed a big smile in response. Relatives were also happy with the service. One relative said, “[My relative has] really bloomed there. [They are] happy there and can express [themselves]. [They] like the atmosphere.

Right Support:

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.

People were supported to make day to day choices and set goals and aspirations. When decisions needed to be made on people’s behalf staff followed appropriate processes to ensure decisions made were in the person best interest.

Right Care:

Staff understood how to protect people from poor care and abuse. Staff had training on how to recognise and report abuse and they knew how to apply it. People’s care, treatment and support plans reflected their range of needs and staff knew people’s needs well.

The service had enough appropriately skilled staff to meet people’s needs and keep them safe. Safe recruitment processes were followed. People received their medicines as prescribed and medicines were managed safely. The service was clean, and people were protected from the risk of infection.

Right Culture:

Staff were motivated and felt well supported. There was a positive culture at the service and people benefited from being supported by happy staff which was reflected in the atmosphere at the service. Staff turnover was very low, which supported people to receive consistent care from staff who knew them well. People and those important to them were involved in planning their care.

When incidents occurred, these were reported, and action was taken to reduce the risk of incidents re-occurring. Regular audits were undertaken to ensure the quality of the service was maintained. The service worked well in partnership with other health and social care providers such as occupational therapists to ensure people were well supported and safe.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection

The last rating for this service was good (published 18 June 2019).

Why we inspected

The inspection was prompted in part due to concerns received about staffing and staff not recording incidents. A decision was made for us to inspect and examine those risks. As a result, we undertook a focused inspection to review the key questions of safe and well-led only. We found no evidence during this inspection that people were at risk of harm from this concern. Please see the safe and well-led sections of this full report.

For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating. The overall rating for the service has remained good as a result of our findings on this inspection.

We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for SENSE - 163 Newington Road on our website at www.cqc.org.uk.

Follow up

We will continue to monitor information we receive about the service, which will help inform when we next inspect.

163 Newington Road is a residential care home that was providing personal care to four people with sensory impairments at the time of the inspection. The premises had been built to accommodate wheelchair users, so it was on one level, with one wide corridor leading to different areas of the building. There was a small wrap-around garden that people spent time in warmer months and areas within the building for people to relax and/or socialise within.

The service applied the principles and values of Registering the Right Support and other best practice guidance. These ensure that people who use the service can live as full a life as possible and achieve the best possible outcomes that include control, choice and independence.

People’s experience of using this service:

The outcomes for people using the service reflected the principles and values of Registering the Right Support in the following ways; there were no signs outside the property to identify it as a care home. People were encouraged to be a part of the local community; attending clubs, pubs, local shops, cafes, swimming pools and gyms.

We found the service met the characteristics of outstanding in the responsive domain and the characteristics of good in all other domains and is rated Good overall.

¿ People had become more independent since joining the service.

¿ People’s communication was developed, so that they could express their views and receive the support they desired. Relatives and professionals praised the difference the staff team had made to people's communication abilities, for example they were teaching one person to use British sign language (BSL) as well as deafblind manual.

¿ To achieve truly person-centred and responsive care and support, the service adjusted to new people and the changing needs of those already there. This involved training staff in different forms of communication such as Braille, deafblind manual and adjusting as people's communication abilities reduced. It also involved learning to support people with conditions and needs such as; diabetes, epilepsy, PEG feeding and those requiring massage and different forms of physiotherapy and end of life care. Relatives praised how well the service changed and adapted with people’s changing needs.

¿ In addition, staff adjusted the environment to enable people to have a positive life living at the service. People chose how they wanted their rooms and the premises to be decorated. Lessons were learnt when things went wrong, and adjustments were made to the premises to avoid similar incidents. For example, rails and sensory strips were introduced to a corridor where people had once collided, and staff were supporting people to use one side or the corridor for one direction and a sensory strip for the other.

¿ People's wishes at the end of their lives were respected and staff went above and beyond to support them and their families at such a difficult time. For people who wished to stay at the service, specialist equipment was introduced to enable people to stay at the service for as long as possible and these preferences were met by the service. Relatives praised the staff for 'going the extra mile' to respect their loved one's preferences at the end of their lives.

¿ People were supported at health appointments across the country and staff stayed at people’s bedside when in hospital to provide comfort and support when people were anxious.

¿ Professionals were involved in people’s care and support to achieve the best outcomes for people. Staff worked closely with dieticians, speech and language, physiotherapists and other health professionals to support people to achieve goals, such as losing weight or regain strength and mobility to promote independence and wellbeing.

¿ People decided how they wanted to be supported, through person-centred reviews which they planned and organised with the support of staff. Relatives and people’s representatives were invited, and they discussed goals and ideas and celebrated achievements.

¿ People were supported to make new friends and to maintain existing relationships.

¿ People were supported to learn and try new things, as well as developing their current interests and hobbies. For example, people were knitting, making jewellery, going to the gym, swimming and making art works for competitions.

More information is in the full report

Rating at last inspection:

At the previous inspection we rated the service as good (published 17 February 2017)

Why we inspected:

This was a planned inspection based on previous rating.

Follow up:

We will continue to monitor the service and assess the information we receive.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

SENSE - 163 Newington Road is a care home for adults who have sensory impairment and learning disabilities. The service is run by the national charity Sense, and can provide care and support for up to four people.

The service is situated in a residential area of Ramsgate. There were four people living at the service at the time of the inspection. Most people had lived at the service for a long time and some people had very complex physical needs. The accommodation was on one level. There was a communal lounge, conservatory, dining room/kitchen area and a small garden. Hallways were wide and accessible so people in wheel chairs could move around the service. Each person had their own bedroom which contained their personal belongings and possessions that were important to them. The service had its own vehicle to access facilities in the local area and to access a variety of activities.

Rating at last inspection

At the last inspection, the service was rated good and requires improvement in the ‘safe’ domain.

Why we inspected

We carried out an unannounced comprehensive inspection of this service on 3 August 2016. A breach of legal requirements was found. After the comprehensive inspection, the provider wrote to us to say what they would do to meet legal requirements in relation to the breach of Regulation 12 of the Health and Social Care Act Regulated Activities Regulations 2014, Safe care and treatment. We undertook this focused inspection 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 SENSE - 163 Newington Road on our website at www.cqc.org.uk

At this inspection we found the service remained good and is now rated good in the 'safe' domain.

Why the service is rated Good

The service had improved since the last inspection. Medicines were now stored safely and at the correct temperature. Staff were not decanting medicines from their original packaging. There were clear guidelines in place when people needed medicines on an as and when basis.

Staff knew how to recognise and respond to abuse. There had been no safeguarding incidents since our last inspection.

Risks relating to people’s health and mobility had been assessed and minimised where possible. Regular health and safety checks were undertaken to ensure the environment was safe and equipment worked as required. Regular fire drills were completed.

There was enough staff to keep people safe. Staff were checked before they started working with people to ensure they were of good character and had the necessary skills and experience to support people effectively.

Sense- 163 Newington Road is a care home for adults who have sensory impairment and learning disabilities. The service is run by the national charity Sense, and can provide care and support for up to four people. The service is situated in a residential area of Ramsgate. There were four people living at the service at the time of the inspection. Most people had lived at the service for a long time and some people had very complex physical needs. The accommodation was on one level. There was a communal lounge, conservatory, dining room/kitchen area and a small garden. Hallways were wide and accessible so people in wheel chairs could move around the service. Each person had their own bedroom which contained their own personal belongings and possessions that were important to them. The service had its own vehicle to access facilities in the local area and to access a variety of activities.

There was a registered manager working at the service and they were supported by a deputy 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. The registered manager, deputy manager and staff supported us throughout the inspection.

The registered manager had been in charge at the service since it had opened 11 years ago. They knew people and staff well. The registered manager was passionate about giving people the care and support they needed in the way that suited them best. They were committed to improving people’s lives. The registered manager was supported by a dedicated, stable staff team who had also worked at the service for many years.

People's medicines were not always handled and managed as safely as they could be. Temperatures where medicines were stored were not checked. When people needed medicines on an ‘as and when’ basis the guidance was not in place to make sure these were given consistently. Some medicines were decanted from their original packaging into containers. This increased the risk of mistakes being made. This was a breach of the regulations.

Risks to people’s safety were assessed but the guidance on how to keep some risks to a minimum had not been recorded. Some assessments identified people’s specific needs, and showed how risks could be minimised but other risk assessments did not contain all the information to make sure staff had all the guidance and checks needed to mitigate risks. Staff knew people well and had given the appropriate care and support. This is an area for improvement.

The registered manager and staff team carried out regular environmental and health and safety checks to ensure that the environment was safe and that equipment was in good working order. Audits and monitoring systems ensured that any shortfalls or areas for improvement were identified and addressed promptly. There were systems in place to review accidents and incidents and make any relevant improvements as a result. Emergency plans were in place so if an emergency happened, like a fire, the staff knew what to do. Fire safety checks were carried out regularly throughout the building and there were regular fire drills so people knew how to leave the building safely.

Before people decided to move into the service their support needs were assessed by the registered manager to make sure the service would be able to offer them the care that they needed. People received care that was personal to them. People indicated and said they were satisfied and happy with the care and support they received. Staff understood people’s specific needs well and mutual good relationships had developed. People were settled, happy and contented. Staff were caring and respected people's privacy and dignity. There were positive and caring interactions between the staff and people. People were comfortable and at ease with the staff. When people could not communicate verbally staff anticipated or interpreted what they wanted and responded quickly. Throughout the inspection people were treated kindness and respect. People were able to make choices about their day to day lives. Everyone had an allocated key worker. Key workers were members of staff who took a key role in co-ordinating a person’s care and support and promoted continuity of support between the staff team. Care and support was planned around people’s individual preferences and needs.

People were involved in activities which they enjoyed and were able to tell us about what they did. Planned activities took place regularly and there was guidance for staff on how best to encourage and support people to develop their interests, skills and hobbies. Staff supported people to achieve their personal goals.

Staff were familiar with people’s life stories and were very knowledgeable about people’s likes, dislikes, preferences and care needs. They approached people in a calm, friendly manner which people responded to positively. This continuity of support had resulted in the building of people’s confidence to enable them to make more choices and decisions themselves and become more independent.

The registered manager and staff were effective in monitoring people’s health needs and seeking professional advice when it was required. Staff followed the advice that they were given.

The provider had taken steps to make sure that people were safeguarded from abuse and protected from the risk of harm. Staff had been trained in safeguarding adults and were confident that the registered manager would take action in the event of any suspicion of abuse. Some staff where unsure of the agencies they could report abuse to outside the organisation. Relatives told us that people were cared for in a way that ensured their safety and promoted their independence.

Relatives felt their views were listened to and acted on. People and their relatives felt comfortable about complaining. If they raised a concern they would be taken seriously and felt confident that their concerns would be looked into and action taken to resolve them. There was a close relationship and good communication with people's relatives.

People were supported to have a nutritious diet. Care and consideration was taken by staff to make sure that people had enough time to enjoy their meals. Meal times were managed effectively to make sure that people received the support and attention they needed.

The registered manager and staff understood how the Mental Capacity Act (MCA) 2005 was applied to ensure decisions made for people without capacity were only made in their best interests. CQC monitors the operation of the Deprivation of Liberty Safeguards (DoLS) which applies to care services. These safeguards protect the rights of people using services by ensuring that if there are any restrictions to their freedom and liberty, these have been agreed by the local authority as being required to protect the person from harm. DoLs applications had been made to the relevant supervisory body in line with guidance.

The management team made sure the staff were supported and guided to provide care and support to people enabling them to live fulfilled and meaningful lives. New staff received a comprehensive induction, which included shadowing more senior staff. Staff had regular training and additional specialist training to make sure that they had the right knowledge and skills to meet people’s needs effectively. Some people used British Sign Language (BSL) to communicate and staff had received training so they could communicate effectively with people.

Staff said they could go to the registered manager at any time and they would be listened to. Staff fully understood their roles and responsibilities as well as the values of the service and the organisation. All staff worked hard and were dedicated to provide the best level of care possible to people.

A system to recruit new staff was in place. This was to make sure that the staff employed to support people were fit to do so. There were sufficient numbers of staff on duty throughout the day and night to make sure people were safe and receive the care and support that they needed. There were enough staff to take people out and to do the things they wanted to.

The registered manager had sought informal feedback from people, relatives and other stakeholders about the service. Not all the feedback had been analysed to drive improvements to the quality and safety of the service. This is an area for improvement. Relatives had recently been asked to complete a questionnaire so feedback could be analysed to improve the service. Staff surveys had been undertaken across the company and improvements had been made as a result of these.

Staff told us that the service was well led and that the management team were supportive. The registered manager was aware of and had been submitting notifications to CQC in an appropriate and timely manner in line with CQC guidelines.

One person we spoke to said 'I like it here, I like to have music on. My favourite is singing with (the therapist) and massage'. Another person gave us the thumbs up and smiled when asked if life was good here. We observed staff have warm and friendly contact with people throughout our visit.

We saw that people were supported by staff who knew them well. The support described in the plan was being delivered by staff. We saw staff take as much time as was needed to help a person communicate effectively. We saw that signing was being practiced using everyday pictures, such as food items and meals.

We saw that there was plenty of food, much we were told was home cooked. We saw records around food for one person, but records were not kept for other people. The manager said they will change and improve this right away.

The home was warm, clean and homely. People looked safe and comfortable and could get around the house easily. People had the right support to manage their medicines and records were very well kept.

We reviewed all three care plans at the home, and found that they contained individualised guidelines for daily personal care needs for each person, as well as use of specific equipment for staff. The care plans also contained risk assessments and consents for each person. we spoke with two staff members and the manager, and they were all knowledgeable about their roles and the support needs of each of the people at the home. This meant that the staff and manager were able to provide safe and appropriate care and support for each person.