SENSE - 428-430 Gillott Road

The accommodation for people is spread over ground and first floors of two houses. People have shared access to communal rooms and bathrooms and although they do go into the unit where they do not live this is only to engage in specific activities. At the time of the inspection the home was fully occupied by eight people who had all lived there for some time and included people living with sensory impairments and learning disabilities.

The care service had not originally been developed and designed in line with the values that underpin the Registering the Right Support and other best practice guidance. These values include choice, promotion of independence and inclusion. People with learning disabilities and autism using the service can live as ordinary a life as any citizen. However, it was clear that people were given choices and their independence and participation within the local community was being encouraged.

At our last inspection in March 2016 we rated the service good. At this inspection we found the evidence continued to support the rating of good and there was no evidence or information from our inspection and ongoing monitoring that demonstrated serious risks or concerns. This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection. At this inspection we found the service remained Good.

There was a registered manager in post who was there at the time of the inspection. 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.

People continued to receive care that protected them to keep safe and staff understood how to protect people from abuse and harm. Risks to people were assessed and detailed guidance about how to manage these was available for staff to refer to and follow. People received medicines safely as they were prescribed.

People continued to receive effective support from staff who had a sufficient level of skills and knowledge to meet their specific needs. People were supported by staff in the least restrictive way possible to have maximum choice and control of their lives in line with their abilities and known preferences. Staff involved people as much as possible to make decisions and utilised and shared information to ensure that they fully explored what the person liked to do.

People continued to be cared for by staff who displayed kindness and compassion in ways that upheld their privacy and dignity. Staff ensured that people were supported to make choices and maintain a good level of independence in line with their abilities and wishes. People’s diverse needs were well known, always recognised and support and access to activities was supported and enabled by staff.

People using the service were well known by staff and the staff team continued to work consistently to ensure that support provided respected their needs. People’s own individual communications methods were well known and consistently used by staff who were keen to advocate on behalf of people whenever they were indicating that they were unhappy, were showing dissatisfaction or demonstrating in any way that they were not at ease.

The care home continued to be well-led. The registered manager who had commenced working in the home earlier in the year was making full use of checks and monitoring arrangements to maintain and build on the quality of the service that was provided.

Further information is in the detailed findings below.

At the time of our visit the home had 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 2008 and associated Regulations about how the service is run.

Through observing care and by speaking with staff and relatives we found that people were safe. During our inspection we saw that there were enough staff to support people safely. Staff were able to tell us how they kept people safe and knew how to report any safeguarding concerns. We found that the systems for medicine management were safe.

We saw that people were supported to make choices in their care and consent was sought before staff helped people. Staff could explain how they supported people in line with the Mental Capacity Act (2005). Some people had authorisations to deprive them of their liberty. Not all staff were confident in who had these authorisations in place but could explain how to provide care in the least restrictive way.

Through our observations we saw that staff understood people's preferred method of communication and we saw and heard staff working in a kind and caring way. Staff showed skill when communicating and supporting people and we saw that staff knew people well. The service had a friendly atmosphere and people appeared comfortable and relaxed with the staff team. Relatives told us they were happy with the care their family member was receiving.

Each person had a plan of care that detailed their individual needs. Staff told us details about how people preferred to be supported and could describe how they found out people's likes and dislikes. We saw staff being responsive to people's requests for support. Care was reviewed at different times during the year to make sure people were happy with their care.

People had the opportunity to take part in activities that they enjoyed. We found that work was needed in this area to ensure people had access to meaningful activities in a more structured way. The registered manager was taking action to address this issue.

Staff told us they had received training to carry out their role effectively. We saw that there were systems in place to ensure that staff kept up to date with their knowledge. Staff told us they were supported through supervisions and felt able to suggest improvements in the running of the service.

People had been encouraged to maintain their independence. We saw that equipment had been purchased to achieve this and the environment of the home had been adapted to ensure people had freedom of movement around the home.

People's nutritional and dietary needs had been assessed and people had their preferences for food incorporated into menu plans. People were encouraged to help prepare their food and drinks wherever possible. We saw that people had access to healthcare and staff had information about how to support people in different healthcare settings.

There were systems in place to monitor the quality of the service. The registered manager and provider undertook checks to make sure the service was being delivered safely. The registered manager had ideas of how to improve the service.

Appropriate arrangements were in place to ensure that medicines prescribed were available and suitable to the individual person. People living in the home were not taking 'as required medicines' on a routine basis. If people were unable to take tablets or refused medicines appropriate arrangements were in place.

Medicines were kept safely and disposed of appropriately when not required. Records were maintained of how people were supported with medicines, when these had been administered and any monitoring checks that were needed. Medicines were appropriately stored.

People were protected against the risks associated with medicines because the provider had appropriate arrangements in place to manage medicines.

We saw that people were treated in a caring way by staff who had a good understanding of the people they were caring for. We saw that staff used different methods of communicating with people before undertaking any action with them. Amongst relative's comments were: "The staff that work at Gillott Road are phenomenal," and "All of the staff appear to be kind and have the right attitude." We checked two people's records and tracked some of their care and found that people received regular health checks and health support when needed. People were supported to be involved in activities and the number and range of these activities were increasing.

There had been a number of staff changes and action was being taken by the new management to ensure consistently good individualised care for people that live in the home. One relative told us: "The new staff not having the information worried me, I am liking the new things they are doing but I need more time to be confident about it." We spoke with staff who told us that the management of the home was better and that care for people was improving." There were enough staff on duty to provide the care that people needed. We looked at staff records and found that appropiate checks had been undertaken before staff were employed.

We looked at the management of people's medicines. We found improvements needed to be made to ensure there was always an accurate record for the amount of medicines in the home and the management of medicinal creams.