This inspection took place on 3 November 2016 and was unannounced.

This is one of a number of services provided by The Royal National Institute for Deaf People (RNID), enabling flexible short and long term support for people of all ages. This includes residential care, supported housing accommodation, and community services for people who are deaf, deaf and blind, and who have a hearing loss and additional support needs.

RNID Action for Hearing Loss is registered for up to eight people. It provides care and personal support to people who have a hearing loss and who may have other additional needs such as a learning disability or where people are living with dementia. There were six people living at the service and five were present during the inspection. The service is in a large detached house, arranged over three floors accessed by a passenger lift. There was a communal dining and lounge area with an adjoining conservatory and garden for people to use. Long term care and respite care was provided.

There was a registered manager for the service. 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 safe. One person told us they felt safe because, “The staff walk around and check we are alright. There’s also a buzzer I can press.” Detailed risks assessments had been completed and been reviewed. Accidents and incidents had been recorded and appropriate action had been taken and recorded by the registered manager.

People told us staff were kind and caring. One person told us, “It’s great. It’s a happy home and we have lots of fun. It’s much better now in the last two years. It’s the new manager.” One member of staff told us, “It has a homely feel. It’s not institutionalised; everyone is free to do what they want. It’s really home.” People were cared for by staff who had been recruited through safe procedures. Staffing levels were monitored to ensure there were enough staff to meet people’s care and support needs. Recruitment checks such as a criminal records check and two written references had been received prior to new staff working in the service. Staff told us they were supported to develop their skills and knowledge by receiving training which helped them to carry out their roles and responsibilities effectively. Training records were kept up-to-date, plans were in place to promote good practice and develop the knowledge and skills of staff.

Medicines were stored correctly and there were systems to manage medicine safely. Audits and stock checks were completed to ensure people received their medicines as prescribed. People were able to self-medicate through a risk management process.

There was a maintenance programme in place which ensured repairs were carried out in a timely way. External contactors were used for service checks and repairs. Regular tests and checks were completed on essential safety equipment such as emergency lighting, the fire alarm system and fire extinguishers.

People told us they had felt involved in making decisions about their care and treatment and felt listened to. Care and support provided was personalised and based on the identified needs of each individual. People’s care and support plans and risk assessments were detailed and reviewed regularly to give clear guidance for care staff to follow. People’s healthcare needs were monitored and people had been supported to access to health care professionals when they needed to. People had been supported to join in regular activities if they wished to.

Staff told us that communication throughout the service was good and included comprehensive handovers at the beginning of each shift and regular staff meetings. They felt they knew peop

There were eight people living at the home at the time of our inspection. We spoke with three people who used the service and used a number of different methods to help us understand the views of the people who had complex needs, which meant they were not able to tell us about their experiences. We viewed care records and spoke with five members of staff. At the time of our visit the registered manager was away so our inspection was facilitated by a senior member of staff and the deputy manager.

We observed staff interacting with people in a friendly and relaxed manner. We saw that staff communicated with people using British Sign Language (BSL) and Sign Supported English (SSE) and we observed care records that included words and pictures.

We saw care records were developed in partnership with people who used the service and we saw that people were able to participate in the running of the home and decisions made. We saw that people who lived at the home were able to develop life skills and be empowered to exercise their independence where possible.

One person told us "The staff are lovely. I go to the shops to buy my papers. Staff have helped me to be more independent." Another person told us "I have choices. I'm happy here." We observed people communicating openly and saw from the way that people interacted they were happy in their environment and that staff were focused on delivering care with respect and dignity.

There were six people who used the service at the time of our visit. We spoke with two people who used the service and used a number of different methods to help us understand the views of the people who had complex needs, which meant they were not able to tell us about their experiences. We observed the care provided, looked at supporting care documentation, we spoke with the registered manager who is referred to as the manager in the report, the deputy manager and three care workers.

This told us people had been able to express their views about the care provided if they wished to, and where possible people who used the service and their representatives had been involved in making decisions about their care and treatment.

People’s care and treatment had been planned and delivered in line with their individual care plan. One person who used the service commented “The staff are wonderful, but very busy. It’s good that two staff work here that are deaf, because using sign language with them is easier.”

The service’s own care workers and regular bank staff had a good understanding of people’s care needs and had received training and support to meet people’s care needs. People knew who to talk with if they had any concerns about the care provided. One person who used the service commented, “I can talk to my link worker if I have a problem.”

The provider had systems in place to quality assure the care provided.