This inspection took place on 24 April 2018 and was unannounced.

Priory Egerton Road is a ‘care home’. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. CQC regulates both the premises and the care provided; both were looked at during this inspection. Priory Egerton Road is registered to provide accommodation for up to 11 adults living with an acquired brain injury and provides a rehabilitation service to those living there. Nine people were living there at the time of inspection.

At our last inspection we rated the service good. At this inspection we found the evidence continued to support the rating of good and there was no evidence or information from our inspection and on-going monitoring that demonstrated serious risks or concerns. This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection.

People told us that they liked the staff that supported them, they felt listened to and felt safe and settled where they lived. Staff had an excellent understanding of people’s individual needs: they provided person centred care that placed people at the heart of the service provided. People worked with staff to develop personalised plans of the care and support they needed. Staff were kind and caring and people told us staff respected their dignity and privacy.

New staff received an appropriate induction into their role that included shadowing experienced staff and completion training. All staff undertook a programme of regular mandatory and specialist training. Staff were enabled to take further qualifications as part of their development. Staff felt supported they had opportunities to discuss their training and development needs through regular supervision and annual appraisal.

There were enough staff to safely support people to learn independent living skills and to help them to lead the life they wished. There was a positive approach to risk taking to enable people to develop their independence. Risks people might experience were assessed and measures implemented to reduce the likelihood of harm occurring to them. People were supported to have maximum choice and control of their lives and staff support them in the least restrictive way possible; the policies and systems in the service support this practice.

Medicines were managed well so that people receive them safely. Staff understood the systems in place for managing safeguarding matters and behaviours that can be challenging to others. Peoples health needs were supported and monitored to ensure they remain well and access health professionals as and when they need to. People were supported to eat healthily and were consulted about what they eat. Advice was sought when needed from health professionals regarding people’s diet and weight.

The premises were well maintained. People and staff worked together to ensure the service was clean and tidy. Regular tests and checks of fire safety equipment and annual servicing of gas and electrical installations were made. Safe systems are in place for the management of people’s medicines and administering staff were trained to do so.

People were encouraged to speak up and they had several forums where they could express their views; such as one to one meetings with their key worker, resident meetings, surveys and at their local Headway support group. People felt able to raise concerns if they had them and found staff approachable. People and relatives knew what to do if they were unhappy and were confident of taking action around this.

People were supported to develop a full and active lifestyle that included opportunities for skills development but also encouragement to pursue interests and hobbies and make use of community activities that enabled them to socialise and integrate into the community they lived in. Staff enabled and encouraged people to experience holidays

We used a number of different methods to help us understand the experiences of people using the service. Not all of the people who lived at Priory, Egerton Road were able to tell us their experiences. People that spoke with us, said, “Really great here, I’m getting ready to move on to living independently and staff support me,” and “Very nice here.” Staff told us, “The training is very good and we are well supported.”

We found by observation and looking at care plans that before people received any care or treatment they were asked for their consent and the provider acted in accordance with their wishes.

We examined three care plans and observed how staff supported people living in the home. We found that people’s care was planned and delivered in a way that protected them from unlawful discrimination.

We examined the home’s policy, practice and records in relation to medication. We found that staff were properly trained, medication was stored appropriately and administered correctly. We saw that record keeping in relation to medication was accurate and up to date.

We examined four staff files and found that the provider used effective recruitment and selection processes to ensure the care and safety of people living at the home. All staff were subject to appropriate checks before they began working at the home.

We looked at the complaints procedure and found that the service responded appropriately in line with their complaint policy and procedures.

People we spoke with said that the home offered good support and that the care staff “were great.” Two people said that they were really happy living at the home and went to college as well as “learning to be independent.” One said they were hoping to one day live independently. One person showed us their room which was personalised with photographs and personal items important to them.

We found that people were involved in decisions about their life. People were involved in the decisions about the home. Care plans and risk assessments were in place and reflected people's needs and aspirations. The home was clean and comfortable and the food provided was varied and nutritious.

We saw that quality assurance systems were in place and were audited regularly to ensure that the service was run in the best interests of the people who used the service.

Priory Egerton Road is registered to provide accommodation for up to 11 adults living with an acquired brain injury and provides a rehabilitation service to those living there. The service caters for people with low physical dependency and who need minimal support and supervision to live safely in the community. Priory Egerton Road is located in a residential area within walking distance of Bexhill town centre.

Priory Egerton Road is owned by the Priory Rehabilitation Services Limited.

At the time of this inspection 11 people were living at the service.

This inspection took place on the 3 and 7 December 2015 and was unannounced.

The service had a registered manager in place. 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 told us they felt they were safe and well cared and had their choices respected. Comments included, “Very safe” and “In a good place, because I feel safe and happy.” Staff treated people with kindness and compassion and supported them to maintain their independence. They showed respect and maintained people’s dignity. People had access to health care professionals when needed. Feedback received from people their relatives and visiting health professionals through the inspection process was positive about the care, the approach of the staff and atmosphere in the home. One health professional said, “Very knowledgeable and supportive staff.”

Staff enjoyed working in the service and were provided with a training programme which supported them to meet the needs of people. Staff felt well supported and able to raise any issue with the registered manager. People were complementary about the food and the choices available. They also told us “I cook and everyone likes it.”

People were given information on how to make a complaint and said they were comfortable to raise a concern or complaint if need be.

There was an open culture at the home and this was promoted by the staff and management arrangements. People were encouraged to share their views though ‘residents meetings’ and satisfaction surveys.

Robust systems were in place to analyse, monitor or review the quality of the service provided. Formal feedback was obtained from people and their relatives. The provider was not completing formal audits and there were no mechanisms to assess the standards of care. Staffing levels were sufficient, and additional staff were used when required to accompany staff to appointments or social events. In addition to support staff there was an occupational therapist, psychologist, and assistant psychologist that worked as part of the team.

Safe recruitment procedures were followed and appropriate pre-employment checks had been made including evidence of identity and satisfactory written references. Appropriate checks were also undertaken to ensure new staff were safe to work within the care sector.

People received care and support from dedicated staff who were appropriately trained, confident and highly motivated to meet their individual needs. They were able to access health, social and medical care, as required.

With compassion and pride, the management team and staff spoke about people, their likes, dislikes, personality and life history. It was clear staff had spent time getting to know people and delivering care in line with people’s needs. People looked at ease in the company of staff. Staff spent time chatting with people and laughter was heard throughout the inspection.

People’s needs were assessed and their care plans provided staff with clear guidance about how they wanted their individual needs met. Care plans were extremely person centred and contained appropriate risk assessments. They were regularly reviewed and amended as necessary to ensure they reflected people’s changing support needs.

There were systems in place to protect people from abuse and harm. Staff had a clear knowledge of how to protect people and understood their responsibilities for reporting any incidents, accidents or issues of concern.

People’s nutritional needs were assessed and records were accurately maintained to ensure people were protected from risks associated with eating and drinking. Where risks to people had been identified, these had been appropriately monitored and referrals made to relevant professionals, where necessary.

Medicines were managed safely in accordance with current regulations and guidance by staff who had received appropriate training to help ensure safe practice. There were systems in place to ensure that medicines had been stored, administered, audited and reviewed appropriately.

There was an open and honest culture within the home. Staff had a clear understanding of the vision and philosophy of the home. Staff spoke passionately about how Priory Egerton Road was run as a family home with family values embedded into practice.