The inspection took place on 8 August 2017. 3 The Droveway is a residential care home that provides care and support for up to six adults with profound and multiple learning disabilities, physical disabilities, communication and sensory impairments and complex health needs including epilepsy. At the time of the inspection there were six people living at the home. The Droveway is a residential road in Hove with local shops and a park nearby. The accommodation is arranged on one level, all on the ground floor and is fully accessible. The service had a communal lounge, dining area and an attractive and fully accessible garden.

The home 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. At the last inspection in May 2015 the service was rated good in all the domains and overall. At this inspection we found that the service continued to be good.

Staff had a clear understanding of how to assess, monitor and manage risks to keep people safe. There were enough suitable staff on duty to care for people safely. Medicines were stored and administered safely and staff understood their responsibilities with regard to safeguarding people. Relatives told us that they were confident that their relations were safe at the home. One relative said, “I visit regularly and there are always enough staff on duty.” Another relative told us, “They provide brilliant care, it is absolutely safe.”

The provider had robust recruitment systems in place and staff were supported in their roles. They received the training they needed to look after people and support their needs. One staff member said, “The training we get is very useful and relevant to the role.” Relatives told us they had confidence in the skills and knowledge of the staff. One relative said, “They are very well trained, if not they couldn’t do the job.”

Staff understood their responsibilities with regard to the Mental Capacity Act 2005 and people’s capacity to make decisions had been considered. There was clear documentation to show how decisions had been made in people’s best interests, in line with the legislation. Staff continued to seek consent from people about everyday decisions and offered them choices and options. People were supported to access the health care services they needed. When people had needed to be admitted to hospital staff members had stayed with them to support them to communicate. One staff member said, “We make sure that staff can stay with them because they are so vulnerable without people who know them well.”

People were supported to have the food and drink they needed. Risks associated with eating and drinking had been identified and assessed. Where Speech and Language Therapists had made recommendations about how to support people safely these had been incorporated into people’s care plans to guide staff. Staff monitored people’s weight and had a good understanding of people’s preferences and dislikes regarding their food and drink.

Staff had developed positive relationships with people. We observed how people were comfortable with staff and showed affection towards them. Staff spoke with warmth and admiration about the people they were caring for. One staff member said, “They have so much adversity to cope with yet they are cheerful happy people.” Relatives spoke highly of the care, one relative said, “The staff are so kind, I don’t think (person’s name) has ever been happier.” People were treated with respect and their dignity was maintained. Staff supported people to be involved in making decisions about their care and support and respected their choices.

People were leading full and busy lives. Staff supported them to access the local comm

During our inspection we met with people who use the service and who use alternative communication methods to speech. We met the registered manager, support workers, including senior support workers and agency support staff. We met with a relative of a person who uses the service.

The people that we spoke with told us they were very happy with the service and care they saw provided. One relative of a person who uses the service told us "People living here are very dependent on staff and I am very reassured by the care they give.” Another person who was visiting the service said "It’s very comfortable here. I’m impressed by the care and friendliness of the team.” We observed that people received support and care that met their individual needs from friendly, knowledgeable and professional support staff.

The provider had systems in place to gain and review consent from people who use the service. We saw that people were involved in their care and were asked for their consent. We found staff took time to ensure there was choice in the care options available.

We saw that 3 The Droveway had appropriate systems and policies in place in respect of cleanliness and infection control. The bungalow appeared clean and well maintained.

Staff received appropriate professional development and were appropriately supported.

During our inspection we found that care staff worked closely with people living in the home and despite their very limited verbal communication had developed awareness and a sound understanding of each individual's complex care and support needs. Communication and consultation with people's family members was effective and ongoing. Relatives had the opportunity to partake in individual assessment, care planning and reviewing processes.

Positive comments received from relatives indicated a high level of satisfaction with the home and the services provided:

“Fantastic. I can’t praise them (the staff) enough. My son is so calm now - and he certainly didn’t used to be - and he always seems so happy when we visit him. When he’s been home for the weekend, he’s always calm here and that means that we have proper quality time with him. It’s wonderful”.

“The carers are so good with her. They know her so well and she is obviously very happy and settled there – she laughs a lot. It’s been her home now for over twenty years. We’ve all been through a lot together but we wouldn’t want her to live anywhere else – and neither would she”.

This inspection carried out on 22 May 2015 and was unannounced. 3 The Droveway is a residential care home that provides personal care and support for up to six adults with profound and multiple learning disabilities, physical disabilities, communication and sensory impairments and complex health needs including epilepsy. At the time of our inspection the service was full.

Accommodation was provided in a residential area of Hove. The accommodation is arranged on one level, all on the ground floor and is fully accessible. The service had a communal lounge, dining area and an attractive and fully accessible garden.

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 kept safe whether they were in the service itself or out in the community. Management and staff had a positive attitude towards managing risk and keeping people safe. Potential risks of harm to the individual or others in their daily lives were assessed and identified. Management strategies provided guidance for staff on what actions to take to minimise the risk and provide appropriate and individualised support to people that enabled them to participate in activities of their choice and access the community safely.

The provider had a thorough recruitment and selection process in place to check that staff were suitable to work with people who used the service. People were supported by sufficient numbers of staff. Staffing levels were flexible and supported people to take part in social activities. One relative said, “There are always staff around when I go there. Even at weekends. People get the one to one support from staff they need.”

Staff had developed good relationships with people living at the service and respected their complex and diverse needs. They were caring and respectful and had the required knowledge and skills they needed to meet people’s needs appropriately and safely. A relative said, “My relative is the happiest he’s ever been in care. He’s clearly happy when he goes home.” Staff knew each person’s individual care and support needs well. People’s privacy and dignity was respected and they were supported to express their views and choices by whatever means they were able to. Staff clearly understood each person’s way of communicating their needs and anxieties.

Management and staff understood the requirements of the Mental Capacity Act (2005) and the Deprivation of Liberty Safeguards, which meant they were working within the law to support people who may lack capacity to make their own decisions in some areas of their care, treatment and support.

People needed specialist support with complex healthcare needs, including PEG feeding. This was used when people cannot maintain adequate nutrition with oral intake. Nutritional assessments were in place which identified what food and drink people needed to keep them well and what they liked to eat. Training in gastrostomy care and enteral feeding for those people who required that support was provided.

People received personalised care specific to their individual needs; their independence was encouraged and their leisure interests were supported. They received continuing specialist help with existing medical conditions and had prompt access to healthcare professionals when they became unwell. Each person had a health action plan which detailed how they were being supported to manage and maintain their health.

The provider had arrangements in place to routinely listen and learn from people’s experiences, and concerns. There was an emphasis on promoting good practice in the service and there was an understanding of equality and diversity and staff put these into practice. The registered manager was very knowledgeable, inspired confidence in the staff team and led by example. One relative said, “The registered manager is the most outstanding manager we’ve met.”

Quality assurance systems were robust to ensure the service delivered was high quality, safe and strove to continually improve.