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Inspection Summary


Overall summary & rating

Outstanding

Updated 5 July 2017

We inspected Sackville Gardens on the 25 November 2015. Sackville Gardens is a mental health care home which can accommodate up to five people. On the day of our inspection, five people were living at the home. The age range of people varied from 20 – 60 years old. People required support with their mental health needs, this included supporting people with eating disorders and anxiety. Support was also needed in relation to diabetes and physical health care needs.

Sackville Gardens belongs to the provider Brighton Housing Trust and falls under the ‘Archway Project’. The ‘Archway Project’ is part of the accommodation strategy for Brighton and Hove City Council for people with mental health needs. It helps bridge the gap between hospital and community and forms part of the pathway to help people move towards more independent living. The provider operates two registered care homes and three supported living units.

The service had a registered manager. A registered manager is a person who has registered with the Care Quality Commission to manage the home. 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 home is run.

The ethos of person centred care was at the forefront of Sackville Gardens, innovative ways of involving people were used so that people felt consulted, empowered, listened to and valued. Staff demonstrated flexibility and found creative ways to enable people to live as full a life as possible.

The provider, management team and staff were dedicated and committed to placing people first and ensuring they had the best quality of life possible. Staff engaged with people to promote meaningful activities and reduce any risk of social isolation. Engagement with the local community was encouraged by the provider and staff were actively involved in building further links with the community and encouraging people to engage with other services outside of the service.

The delivery of care at Sackville Gardens was built on the promotion of mental health recovery. Supporting people to move forward, increase independence and improve independent living skills. People spoke highly of living at Sackville Gardens and clearly recognised and understood the ethos of the service. One person told us, “They are supporting me so I can move on.” Another person told us, “I never would have thought I would have a period this long of being well and not hurting myself. That’s because I feel safe here and comfortable.”

The management team demonstrated how they had sustained some outstanding practices, development and improvement at the service. The leadership sought out creative ways to provide a personalised service and had achieved positive results through involving people. Client steering groups and focus groups had been organised. These provided a forum for people to be actively involved in the design and running of the service. The service was part of Psychologically Informed Environment (PIE) pilot and recognised the impact of the environment on people. The positive impact of this approach meant the some people had started to engage more with staff and their own recovery. Client steering groups and focus groups had been organised. These provided a forum for people to be actively involved in the design and running of the service.

The registered manager and staff team demonstrated passion and commitment to providing the best possible mental health care and promoting opportunities for people so they could live as full a life as possible. There was an established management team that was transparent in their approach and strove to achieve excellence.

Co-production (developing the service in an equal and reciprocal relationship between staff and people) was at the heart of the service. The provider, management team and staff involved people with the overall running of the service, from staff induction, policies, procedures and budgets. People spoke highly of continually being involved and felt their voice was heard.

Staff were highly motivated and achieved positive results through working closely with other agencies. One professional told us, “They are very good at liaising with me at an early stage if they feel a client’s mental health is deteriorating which means we can then look at interventions. This often prevents a hospital admission or a severe deterioration in their mental health.” Staff commented that one of the key strengths of the service was their relationships with other professionals. One staff member told us how the psychiatrist visited the home on a weekly basis and promoted a less formal environment than people going to see them.

The recovery model was fully utilised and people were supported to achieve their individual goals. Staff also recognised when people’s mental health may be deteriorating and the signs and triggers to look for. People confirmed that staff had a good understanding of their needs and they felt confident in the skills of staff. One person told us, “They know the signs to look for when I’m unwell.”

There was a clear focus on making safeguarding personal which meant putting the person at centre of any safeguarding concerns. Risk assessments provided clear guidance to staff and harm minimisation was utilised to also keep people safe. People commented they were involved in designing their risk assessments. There were enough suitable staff to meet people’s needs and promote people’s safety and wellbeing. There were systems in place to protect people from the risks associated from medicines and staff were vigilant in monitoring and using these.

There was a strong emphasis on communication. Staff were creative in how they could support people and various forms of communication had been established. One person told us, “I write a note to staff or use my communication card to inform staff when I’m in a bad way.”

Mealtimes were seen as sociable events. People cooked for one another and staff also joined people for the evening meal. Innovative methods and positive staff relationships were used to encourage those who were reluctant or had difficulty in eating and drinking.

Inspection areas

Safe

Good

Updated 5 July 2017

Sackville Gardens was safe. Staff worked collaboratively to manage risk and people keep safe. There was a clear focus on making safeguarding personal and taking a personalised approach to safeguarding which meant putting the person at centre of any safeguarding concerns.

Risk assessments provided clear guidance to staff and harm minimisation was utilised to also keep people safe. Medicines were stored safely and people were empowered to manage their own medicine regime.

Staffing levels were sufficient and enabled staff to have time to support people on a one to one basis and also provide support in times of crisis. Recruitment practices were safe and staff of the right calibre and experience was employed.

Effective

Outstanding

Updated 5 July 2017

Sackville Gardens was effective.

Creativity was used in the environment being designed to take account of the psychological and emotional needs of the people with much positive impact on people’s wellbeing and engagement.

Staff were exceptionally dedicated and highly skilled which ensured people received a high level of care that promoted both their physical and mental health needs.

Mealtimes were encouraged to be a social event and utilised as a forum to help people develop independence with their cooking skills.

Caring

Good

Updated 5 July 2017

Sackville Gardens was caring. The provider, management team and staff were committed to a strong person centred culture and client involvement. People were actively encouraged to express their views and opinions.

People had positive relationships with staff that were based on respect. People were treated with dignity and their confidentiality was respected. Staff spoke with kindness and compassion for the people they supported.

Staff had spent considerable time forming friendships with people and building trust.

Responsive

Outstanding

Updated 5 July 2017

Sackville Gardens was responsive. The service strove to be known as outstanding and innovative in providing person centred care based on best practice.

Staff demonstrated flexibility and found creative ways to enable people to live as full a life as possible. Person centred care was at the forefront of the delivery of care innovative ways of involving people were used so that people felt consulted, empowered, listened to and valued.

Staff were dedicated and compassionate about evolving the ethos of person centred care and activity engaged with people to empower them to achieve their goal and support people to move on.

People were actively involved in deciding upon activities and involved in management of the activity budget. Staff recognised the importance for meaningful activities and reducing the risk of any social isolation

Well-led

Good

Updated 5 July 2017

Sackville Gardens was well led. There was an extremely positive and inclusive culture and people were very much at the heart of the service.

A committed and stable staff team were dedicated and compassionate about improving outcomes for people. There was a firm focus on client involvement and person centred care.

There was a strong emphasis on continual improvement and best practice which benefited people and staff. There were robust systems to ensure quality and identify any potential improvements to the service.