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Inspection carried out on 4 March 2020

During a routine inspection

About the service

Sherbourne Grange is a residential care home providing accommodation and personal care to 14 people who have a learning disability, autistic spectrum disorder or physical disabilities at the time of the inspection.

The home is two large specifically adapted buildings merged into one bigger than most domestic style properties. It was registered for the support of up to 16 people. This is larger than current best practice guidance. However, the size of the service having a negative impact on people was mitigated by the building design fitting into the residential area and the other large domestic homes of a similar size. There were deliberately no identifying signs, intercom, industrial bins or anything else outside to indicate it was a care home.

The service applied the principles and values of Registering the Right Support (RRS) 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 and what we found

The provider had safeguarding systems and processes in place to keep people safe. Staff knew the risks to people and followed the assessments to ensure they met people’s needs. The number of experienced and knowledgeable staff was sufficient to meet people's needs. Staff followed the infection control procedures the provider had in place. Incidents and accidents were monitored, and lessons were learned when things went wrong.

People’s needs and choices were assessed, and care was reviewed regularly. Care plans identified the involvement of people in the care they received. The consistent staff team received regular refresher training. People were supported to eat healthily and maintain fluids. People were supported to access healthcare services and activities to promote their wellbeing. People were also supported to access healthcare services as they needed.

Care was person-centred with people's privacy, dignity and equality maintained. People were involved in their care and supported to express their views. The staff made every effort to get to know people and understand what was important to them.

Care was personalised, and people were supported to effectively communicate their needs and preferences. The provider had a complaints procedure in place to manage and respond to any complaints they may receive. People were supported to maintain relationships with their families and to engage in activities that interested them.

Quality assurance systems were robust with spot and competency checks completed regularly. The registered manager understood their legal responsibilities in regard to safeguarding and notifications. The provider worked with other professionals such as district nurses and GP's to ensure care needs were met.

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.

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 12 September 2017).

Why we inspected

This was a planned inspection based on the previous rating.

Follow up

We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.

Inspection carried out on 26 July 2017

During a routine inspection

This inspection took place on 26 July 2017 and was unannounced. We last inspected this service on 31 July 2015 when we found that a good service was being provided. At this inspection we found that the service continued to provide a good service.

Sherbourne Grange provides accommodation and care to up to 16 people who have a learning disability, autistic spectrum disorder or physical disabilities. At the time of our inspection there were 14 people living at the home.

There was a registered manager in post. 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 were supported by a staff team that understood how to protect them from risks including abuse, accident and injury. People received a safe and effective service because there were sufficient numbers of appropriately recruited, trained and supported staff that had the skills and knowledge they needed to support people.

People were supported to maintain good health because they had regular access to healthcare professionals and received their medicines as prescribed.

People were supported to have choice and control of their lives, where possible, by staff that knew them well. Staff were kind and caring towards them and promoted and protected their dignity. People were supported to maintain their independence where possible.

People received care and support that met their needs and preferences in a personalised way. People were supported to maintain links with people who were important to them and to do things they were interested in.

Feedback about the service was sought from people, relatives and professionals that visited the home through meetings, comments, complaints and questionnaires. Audits were carried out to identify areas for improvement and actions were taken where needed.

Inspection carried out on 31 July 2015

During a routine inspection

This inspection took place on 31 July 2015 and was unannounced. Sherbourne Grange was last inspected on 3 July 2013 and was meeting all the regulations checked.

Sherbourne Grange provides accommodation and care to up to 16 people who have a learning disabilities, autistic spectrum disorder or physical disabilities. At the time of our inspection there were 16 people living in the home.

The home is required to have a registered manager in post. 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. There was a registered manager who had been in post for several years and knew the people living there well.

Staff knew how to reduce the risks of harm from abuse and unsafe practices. Risks were managed and people and staff knew what the risks were and how they were to be managed. Staff knew what actions to take in emergency situations to ensure people were protected.

Staffing levels met the needs of people and were adjusted according to what was happening on each day. Systems were in place to ensure that staff cared for different people on a weekly basis so that they were aware of each person’s needs and how they wanted to be cared for.

The appropriate checks were undertaken when new staff were recruited to ensure that they were suitable to work with the people that lived in the home. Staff were supported to meet people’s needs through training, care planning and supervision. There was a stable staff team that provided continuity of care.

People were supported to have their medicines safely. Health care professionals were involved to ensure that they received the medical care they needed. Staff followed the advice of health care professionals where this had been given.

Staff were caring and ensured that people were treated with dignity and respect ensuring their privacy was maintained. People were supported to remain as independent as possible and were involved in carrying out some tasks of daily living. People were supported to maintain and develop relationships with people important to them. People’s family members were often also supported to receive practical and emotional support.

Staff ensured that people received food and drink that met personal preferences, cultural and medical needs and kept them as healthy as possible.

People were supported to take part in leisure activities on an individual and group basis that included holidays. People were supported to maintain and develop links with family members.

The provider had quality assurance systems in place to monitor the care and support people received.

Inspection carried out on 4 July 2013

During a routine inspection

There were 14 people living at the home at the time of our inspection. We spoke with 3 people, three staff and the manager. We walked around the home and observed how people were being supported.

All of the people spoken with told us they liked living at the home. One person said "it is nice here, there is a relaxed atmosphere, and it is normal, I feel comfortable here". Another person told us, "I love it here, we choose how we spend our day, and the staff support us when we need them to."

People told us that staff respected their privacy and dignity and that they were given choices about their care. This meant people were involved in their care.

Staff spoken to were able to tell us about people's needs and records seen confirmed the that staff were knowledgeable about the people they cared for. We saw positive interactions between staff and people that lived at the home. This meant staff had the information to support people and meet their needs.

People told us they felt safe living at the home. We found that staff were clear about the action to take should they become aware of an allegation of abuse in the home.

Staff spoken with told us they felt supported by the manager, and have regular training opportunities.

There were systems in place to monitor how the home was run, to ensure people received a quality service.

Inspection carried out on 3 April 2012

During a routine inspection

We asked people whether they liked living at Sherbourne Grange. We received a range of positive responses. One person told us they felt settled and well-looked after in their home. They said that they were fully involved in making decisions about their life. One person used a picture book to indicate that they felt happy. One person gave us a �thumbs up� signal.

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