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Inspection Summary


Overall summary & rating

Outstanding

Updated 14 September 2017

The inspection was carried out on 11 August 2017 by one inspector and an expert by experience. It was an announced inspection. Forty-eight hours’ notice of the inspection was given to ensure that the people who lived in the service were available and prepared to receive unfamiliar visitors. Some people needed support to communicate. Gresham House provides support and accommodation for up to 12 adults with a learning disability. There were twelve people living there at the time of our inspection including one person who was away.

At the last inspection in July 2015 the service was rated Good. At this inspection we found the service remained: Good in regard to the questions: Is the service safe, effective, and well-led? And was: Outstanding in regard to the questions: is the service caring, and responsive?

Staff knew how to recognise signs of abuse and how to raise an alert if they had any concerns. Risk assessments were centred on the needs of the individual. Each risk assessment included clear measures to reduce identified risks and guidance for staff to follow or make sure people were protected from harm.

Accidents and incidents were recorded and monitored to identify how the risks of recurrence could be reduced. Appropriate steps had been taken to minimise risks for people while their independence was actively promoted.

There was a sufficient number of staff deployed to meet people’s needs. Thorough recruitment procedures were in place to ensure staff were of suitable character to carry out their role. Staff received essential training, additional training relevant to people’s individual needs, and regular one to one supervision sessions.

People were appropriately supported with the administration of their medicines, with attending appointments and were promptly referred to health care professionals when needed. People were supported with their nutritional needs to maintain good health.

The service was exceptional at helping people to express their views so they understood things from their point of view. They used creative ways to make sure that people had tailored and inclusive methods of communication. Clear information was provided to people about the service, in a format that was suitable for people’s needs.

Staff went ‘the extra mile’ to enhance people’s experience in the service. Staff promoted people’s independence, encouraged them to do as much as possible for themselves and make their own decisions.

People received care and support that was thoroughly personalised. Staff used innovative and individual ways of involving people so that they feel consulted, empowered, listened to and valued. The arrangements for social activities were flexible and met people’s individual needs. People’s care and support was planned proactively in partnership with them.

The registered manager was open and transparent in their approach. They placed emphasis on continuous improvement of the service. There was an effective system of monitoring checks and audits to identify any improvements that needed to be made and maintain compliance with regulations. The registered manager and deputy manager acted on the results of these checks to improve the quality of the service and support.

Further information is in the detailed findings below.

Inspection areas

Safe

Good

Updated 14 September 2017

The service remains : Good.

Staff were trained in the safeguarding of adults and were knowledgeable about the procedures to follow to keep people safe.

Staff knew about and used policies and guidance to minimise the risks associated with people�s support. Risk assessments were centred on the needs of the individuals and there were sufficient staff on duty to safely meet people�s needs.

Thorough staff recruitment procedures were followed in practice.

Medicines were administered safely.

Effective

Good

Updated 14 September 2017

The service remains: Good.

All staff had completed essential training to maintain their knowledge and skills. Additional training was provided so staff were knowledgeable about people�s individual requirements.

The provider was meeting the requirements of the Mental Capacity Act 2005.

People were referred to healthcare professionals promptly when required.

Caring

Outstanding

Updated 14 September 2017

The service was outstanding.

The service was exceptional at helping people to express their views, so staff understood people's perspectives. They used creative ways to make sure that people had tailored and inclusive methods of communication.

Clear information was provided to people about the service, in a format that was suitable for people�s needs. Staff treated people with kindness and respect.

Staff promoted people�s independence, encouraged them to do as much as possible for themselves and make their own decisions.

Responsive

Outstanding

Updated 14 September 2017

The service was outstanding.

People received care and support that was thoroughly personalised and their preferences were taken into account.

Staff used innovative and individual ways of involving people so that they feel consulted, empowered, listened to and valued.

The arrangements for social activities were flexible and met people�s individual needs. People�s care and support was planned proactively in partnership with them.

Staff responded promptly to changes in people�s medical, social and psychological needs.

Well-led

Good

Updated 14 September 2017

The service remains: Good.

There was an open and positive culture which focussed on people. The registered manager sought people and staff�s feedback and welcomed their suggestions for improvement. Staff had confidence in the manager�s leadership and in the management team.

There was a robust system of quality assurance in place that included the regular auditing of all aspects of the service, to identify where improvements could be made.