43 Sedlescombe Road South is a care home providing social and residential care for up to six people with learning disabilities. On the day of our inspection there were four people living in the service. People had varied needs related to their learning disabilities. Some had more specialist needs associated with Autism and with behaviours that challenged. People who lived at the service were adults below the age of thirty-five. People had different communication needs. Some people had limited verbal communication, and other people used gestures and body language to make their needs known. The provider owned four other care homes locally.

People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. The Care Quality Commission (CQC) regulates both the premises and the care provided, and both were looked at during this inspection.

The care service has 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.

This comprehensive inspection took place on 16 and 17 January 2018 and was announced. It was the first inspection since the service was registered. The service 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. The registered manager was also the manager of four other homes locally.

There were exemplary systems to assess and plan new admissions to the service. Transition plans included advice and guidance from people’s relatives and specialist professionals. These were based on people’s individual needs. Social stories were used to ensure people were as far as possible involved every step of the way and the systems ensured staff worked consistently and effectively to achieve maximum success. (Social stories are short descriptions of a particular situation, event or activity, which include specific information about what to expect in that situation and why). All of the people living at the service had very complex needs and required differing levels of support. Relatives spoke very positively of the service. One relative told us staff had a, “Can do attitude and carry things through. They have a plan for (relative) that I believe will happen. He now has a future.” A health professional told us, “The assessment, transition and discharge process was robust and the manager and staff worked well with the person his family and other professionals to ensure all went smoothly. Good communication and support planning with person centred training and crisis planning in place through transition.”

Most people were not able to tell us verbally if they had any concerns about the service. The registered manager had recently introduced a new system to assess and analyse incidents to determine if they had occurred as a result of a person’s frustration or were an indicator they were unhappy at that time about the way they were supported. The results had been extremely beneficial and were to be used as a way of enhancing the training provided to staff. Whilst the service already looked at why incidents occurred and how to minimise a reoccurrence, the new system gave greater clarity on people’s expectations and the consistency in approach they needed to make them feel safe.

There were commendable systems to ensure people were supported to attend health care appointments. Due to one person’s complex needs it had been a long time since they had attended a GP appointment. The service worked with the surgery to arrange an a