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Inspection carried out on 26 November 2019

During a routine inspection

About the service

Baronsmede is a care home that provides accommodation and personal care support for up to nine adults with learning disabilities. The service specialises in the care of people who have a learning disability and complex needs including communication, physical health and challenging behaviour. At the time of our inspection eight people were living at the service.

Baronsmede is a detached house located within Crowborough village. The service operates over two floors and had been fully adapted to meet the needs of people who lived there. People had their own bedrooms and bathrooms and shared the communal areas and garden.

The service had been open for over 30 years and therefore had not been developed and designed in line with the principles and values that underpin Registering the Right Support and other best practice guidance. The outcomes for people using the service reflected the principles and values of Registering the Right Support and other best practice guidance. The principles reflect the need for people with learning disabilities and/or autism to live meaningful lives that include control, choice, inclusion and independence. People using the service received planned and co-ordinated person-centred support that is appropriate and inclusive for them.

People’s support focused on them having as many opportunities as possible to gain new skills and become independent. The provider supported people to develop skills that enabled them to have a more independent life style. Some people had successfully moved into their own accommodation, and the provider was in the process of changing the environment into a smaller residential service with separate supported living accommodation for five people.

The service was a large domestic style property. It was registered for the support of up to nine people. Eight people were using the service. This is larger than current best practice guidance. However, the size of the service did not have a negative impact on people. There was a large communal lounge, dining room and conservatory and people had their own personalised rooms. There was also a separate lounge with a kitchenette and dining area which people used to enhance their own independence. This facility enabled people to prepare their own meals and snacks and spend with friends. There was a self-contained flat upstairs that enabled people to prepare for their journey into independent living. An extension had also been built to provide a bespoke environment for one person. The building design fitted into the residential area and there were deliberately no identifying signs or anything else outside to indicate it was a care home. Staff were also discouraged from wearing anything that suggested they were care staff when coming and going with people.

People’s experience of using this service

We received overwhelmingly positive feedback about the leadership of the service. There was a visible person-centred culture which was truly imbedded within the ethos of the service. The registered manager and staff team were highly motivated and proud of the service they delivered to people. There was a strong commitment to ensure the service was inclusive and people had the opportunity to develop new skills and community connections.

People received personalised care that was exceptionally responsive to their needs. There was a strong sense of leadership in the service that was open and inclusive. The provider focused on achieving exceptional outcomes for people and their staff.

There were high levels of satisfaction amongst people and relatives who used the service. Everyone we spoke with said they would recommend the service to others. Comments from relatives included “I am so lucky to have found Baronsmede, it is brilliant” and “I can’t speak highly enough of it, everything they do is just wonderful” There were consistently high levels of engagement with people using the service, families and other professionals

Inspection carried out on 9 March 2017

During a routine inspection

This inspection took place on 9 March 2017 and was unannounced.

Baronsmede is registered to provide personal care for up to nine people with a learning disability. The service also provides supported living services to people on an adjacent property. The provider offered day services where people could attend. At the time of our inspection, eight people were using the service.

The service had 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 protected from harm because staff had had been trained to recognise abuse and knew what action to take to keep people safe. Appropriate recruitment procedures ensured staff were suitable to provide people’s support. People’s needs were met by a sufficient number of skilled staff. People received support to take their medicines from competent staff. Medicines were safely and securely stored at the service.

People received care from staff with the relevant knowledge to meet their individual needs. Staff received ongoing training, supervision and support to enable them to be effective in their role. People received enough to eat and drink and enjoyed the choice of meals provided at the service. Staff supported people to access healthcare services and to have their health needs met.

Staff sought people's consent before they supported them and respected their choices. People’s support was provided in line with the requirements of the Mental Capacity Act 2005. Staff upheld people’s dignity and privacy when they supported them. Staff were kind and caring and promoted people’s independence. People’s communication needs were understood which enabled staff to deliver appropriate care to them.

People received care responsive to their individual needs, wishes, preferences and routines. People were involved in decisions about their care. Staff were familiar with people and had developed good relationships with them. People and their relatives knew how to make a complaint about their care and were confident about doing so.

People’s views were sought and acted on to improve the quality of care provided. An open and inclusive culture encouraged staff to provide personalised care to people. The registered manager was approachable and visible at the service. Staff felt valued at the service and were clear about their roles and responsibilities. The quality of care was assessed and monitored and improvements were made when needed.