We inspected Portland Road on the 24 November 2015. Portland Road is a mental health care home which can accommodate up to nine people. On the day of our inspection, eight people were living at the home. The age range of people varied from 28 – 80 years old. Predominately people required support with their mental health needs; support was also needed in relation to substance misuse, anxiety and physical health care needs.

Portland Road 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 delivery of care at Portland Road was built on the promotion of mental health recovery. Supporting people to move forward, increase independence and improve independent living skills. People told us they appreciated the level of support they received and clearly understood the ethos of the service. One person told us how the calm atmosphere where they could gradually get better and be able to move on. Another person told us, “It’s a safe and trusting place to be.”

Person centred care was central to the ethos and every day practices at the service. Staff were dedicated and compassionate about engaging with people to empower them to be involved in planning their own support. Staff used innovative and individual ways of involving people so that they felt consulted, empowered, listened to and valued. Staff worked in partnership with people to empower them to achieve their goal and support people to move on to a more independent lifestyle. Creative methods were used for people to engage in meaningful individual activities that enhanced their lives.

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 were committed to involving people with the overall running of the service, from staff induction, policies, procedures and budgets. A client representative had been nominated who was actively involved in house meetings and soon to meet the creative director of Brighton Housing Trust. External healthcare professionals spoke highly of the home. One mental health professional told us, “They work with a number of our clients who have severe and enduring mental health problems in a very caring and flexible way. There communication is very good. They work flexibly and responsively with clients and manage risks very well. The staff team appear very calm capable and co-operative and are able to manage significant levels of distress and behavioural disturbance.”

The leadership sought out creative ways to provide a personalised service and had achieved outstanding results through the promotion of co-production and client involvement. 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.

A person centred approach to safeguarding was adopted. Staff worked in partnership with people to safeguarding themselves whilst empowering people to take positive risks. Harm minimisation was utilised as an approach to managing risk. One staff member told us, “When people have abused substances, we create a safe space where they can talk to us and explore what happened.”

The home was welcoming, friendly and calm. People were relaxed, engaged with people around them or enjoying activities within the home or out in the town. People were empowered by the management team to be very much a part of the inspection. We were shown round by people and also joined people for their daily coffee morning. One person told us, “This is a very nice place to be.”

The management team were passionate and creative in their approach to ensure staff were kept up to date with training and recognised the importance of a strong skilled workforce. There were named champions in various areas such as health and safety and first aid within the service who actively motivated and supported staff to ensure people were provided with a quality service. People were also actively encouraged to become champions and one person was the ‘client’ champion for health and safety’.

Staff worked in a variety of ways to improve outcomes for individuals. Each person had an individual key-worker who they met on a weekly basis. Staff were dedicated to ensuring key-working sessions met the need of the person and promoted their wellbeing. Key-working sessions were often creative with staff engaging with people doing various activities. One person told us, “We do a variety of things during our sessions. I really enjoy them.”

There was strong emphasis on continual improvement and best practice which benefited people and staff. There were robust systems to assure quality and identify any potential improvements to the service. This meant people benefited from a constantly improving service that they were at the heart of. A robust service improvement plan was in place and part of the improvement plan involved a student social worker joining the team in January 2016 for their social work placement,

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 an excellent understanding of their needs and they felt confident in the skills of staff. The management team were always thinking one step ahead and how they could improve their practice. In line with the model of recovery, staff were completing WRAPs (Wellness Recovery Action Plan). These considered what the person would want to happen in the event of their mental health deteriorating.

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. To promote meaningful activities and reduce the risk of social isolation, staff worked in partnership with external agencies. The role of the intern and volunteer at the service also promoted social engagement.

During our inspection we spoke with four people who used the service and three members of staff including the deputy manager, a senior support worker and a project worker. We looked at surveys and records to help us understand the views of the people who used the service.

One person who used the service told us “I like living here and the food is excellent” another person we spoke with told us “I do lots of activities”.

Staff we spoke with liked working for Portland Road. One person told us “we provide a good service and a nice community spirit”. If staff needed support they felt management were approachable and helpful. Another person told us “this is a good place to work and we help and support people to move on in their lives“.

We also looked at support plans, risk assessments, staff records and policies and procedures.

We used a number of different methods to help us understand the experiences of people using the service. We observed staff interacting well and communicating effectively with people. We saw people being assisted in making choices and being included in making group decisions.

In our discussions with staff they demonstrated a thorough knowledge of the people living at the service. This was confirmed by our observations.

Care records showed that people had been supported and encouraged to make decisions about their lives. We saw that people had been involved in planning their care and support. When people’s needs changed, we found that records had been updated to reflect this. people told us that staff were helpful and supportive.

Staff spoken with demonstrated good understanding of how to safeguard from harm. Training records showed that staff received regular training to update their knowledge on abuse and safeguarding.

Training records showed that staff were suitably trained and supported in their role. This included training specific to the people living in the service. For example, counselling.

Records showed the provider regularly assessed and monitored the quality of the service. We saw that people and their representatives were asked their views about the home in annual surveys. We saw records which showed information from these surveys had been acted upon.

People living at Portland Road told us that their key workers discussed their options with them, and treated them with respect.

They feel safe, and that their needs are being met. People were generally happy with the accommodation provided.

Comments received included “it’s warm enough here. Plenty to eat, good food. I feel safe all the time. The staff are always looking in, checking on me. It’s helped me being here”.