RNID – Action on Hearing Loss Brondesbury Road is a service for six people who are deaf, have hearing loss or tinnitus. Some people are deaf/blind and some people display behaviours that may challenge. The service is spacious and provides accommodation on the first and second floor. RNID Action for Hearing Loss Brondesbury Road is located close to Queens Park and Kilburn High Street; both areas provide good transport links and shopping facilities.

The service had a registered manager in place. A registered manager is a person who has registered with the Care Quality Commission (CQC) 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 January 2016 the service was rated Good.

At this inspection we found the service remained Good.

There was a system to ensure that people were safe and protected from abuse. Staff knew how to recognise abuse and how to report allegations and incidents of abuse. Recruitment of staff was safe and robust. We saw that pre-employment checks had been completed before staff could commence work. There were sufficient numbers of staff to support people to stay safe. Risks to people’s safety and welfare had been assessed and action taken to minimise the risk. Accident and incident information was analysed to identify trends and where changes were required to prevent future reoccurrences. Regular safety checks were carried out to ensure the premises and equipment were safe for people. We also saw there were systems in place to protect people and staff from infection. There were suitable arrangements for the recording, administration and disposal of medicines.

People were supported to have maximum choice and control of their lives. People confirmed they were involved in planning their care. We saw that their care was person centred. Their care records showed relevant health and social care professionals were involved in their care. The service was working within the principles of the Mental Capacity Act 2005 (MCA) We saw that people's mental capacity to make decisions about their care had been considered as part of the initial care assessment. Their human rights were protected because the requirements of Deprivation of Liberty (DoLS) were being followed, which meant they were not deprived of their liberty. There were arrangements to ensure that people’s nutritional needs were met. We also saw that people’s dietary requirements, likes and dislikes were assessed and known to staff. Staff had been trained to meet people's care and support needs.

People were treated with kindness, respect and compassion by staff. Staff were consistently described as kind and caring. Staff understood the need to protect and respect people's human rights. We saw they had received training in equality and diversity. People’s spiritual or cultural wishes were respected. People told us and we saw that care staff promoted their independence. People were supported to maintain friendships and important relationships, which minimised risk of isolation.

People received person centred care. Their communication needs were met in relation to the Accessible Information Standard (AIS). The service had made reasonable adjustments to make sure that communication was made as easy as possible for people using the service. People’s support plans reflected their social needs. They were supported to take part in meaningful activities that were socially and culturally relevant and appropriate to them. People knew how to complain. They told us they could discuss any concerns they had with the registered manager and were confident any issues raised would be dealt with.

The service was well managed and well-led. There were effective quality assurance systems to monitor the quality of service being delivered. The service regu

This unannounced inspection took place on 14 & 15 January 2016. The service met all of the regulations we inspected against at our last inspection in October 2013.

RNID Action for Hearing Loss Brondesbury Road (RNID AfHL Brondesbury Road) is a service for six people who are hearing impaired, some people have additional sensory impairments and may also display behaviours which challenges the service. The service is spacious and provides accommodation on the first and second floor. RNID Action for Hearing Loss Brondesbury Road is located closely to Queens Park and Kilburn High Street; both areas provide good transport links and shopping facilities.

The service had a registered manager in place. A registered manager is a person who has registered with the Care Quality Commission (CQC) 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.

There was a strong emphasis on continually striving to improve by finding innovative and creative ways to empower people and seek their view. In addition, a wide range of different quality assurance systems were used to ensure the quality of service was continuously monitored and also to make sure that improvements were implemented.

The service developed and created an inclusive communication environment for people who used the service, staff and visitors.

We found that RNID AfHL Brondesbury Road provided a highly personalised, person-centred service for people with hearing impairments and people who have additional loss of their vision. People were in control of their support and participated in decision-making for the service and organisation as a whole. People were encouraged and enabled to learn new skills and become more independent. People were provided with support that was outcome-focussed and there were systems to document this.

People consented to their support and staff and the registered manager of the service worked in partnerships with people and their relatives to support people in taking positive risks and make independent well informed decisions. Feedback about the service was encouraged and there were a range of mechanisms to support this.

Staff were aware of the requirements of their role and were vetted appropriately before starting work. Staff supported people safely and knew what to do to protect people from the risk of abuse.

Recruitment procedures ensured staff had the appropriate values when they were employed. We saw that staff gained skills and qualifications shortly after they started work. Ongoing training was provided and staff were encouraged to pass on their expertise to their colleagues in various aspects of service delivery through workshops and team meetings.

People received their medicines in a safe manner and staff recorded and completed Medicine Administration Record (MAR) charts correctly.

People had access to healthcare services and received on-going healthcare support. Referrals were made to other professionals if the need arose. People met with their GP, psychiatrist, audiologist, optometrist and their behaviour was regularly reviewed with the involvement of the person’s psychiatrist.

Risk assessments and care plans for people using the service were effective, individual and there was a strong focus on how to meet people’s communication needs as well as any other needs. People were encouraged and supported in gaining greater independence by working together with social workers, British Sign Language (BSL) interpreters and relatives to achieve the best possible outcome.

People had the opportunity to comment on the service at regular meetings and were clear how and whom they would raise concerns with.

Quality assurance systems were in place to assess and monitor the service people received. The service worked well in partnership with other or

We used a number of different methods to help us understand the experiences of people using the service, because the people using the service had complex needs, which meant they were unable to tell us their experiences. People looked content and well supported. Staff we spoke with were knowledgeable regarding their roles and responsibilities and the needs of people who used the service.

Staff demonstrated they understood aspects of the safeguarding process relevant to them. They understood that they needed people’s consent before providing care and support.

People’s records were accurate and fit for purpose. Staff demonstrated a clear understanding of protecting people’s confidentiality and had completed relevant training in data protection.

We used a number of different methods to help us understand the experiences of people using the service, because the people using the service had complex needs, which meant they were unable to tell us their experiences. We spoke with relatives of two people who commended the service for its respect of people’s privacy and dignity and were appreciative of their level of involvement in their relatives’ care. One of the relatives told us “they communicate with us very well and always keep us informed of what is happening,” and another said, “we are invited to annual reviews.”

Relatives were content with the care and support that people received, which they regarded as effective and safe. One relative told us “they organise things well and we have not been given any indication that our relative is not supported well.”

Staff demonstrated they understood aspects of safeguarding process relevant to them. They told us they were well supported by the management and were aware of their limitations but confident to approach managers when they needed to.

Relatives were content with the treatment and support that the service provided, which they attributed to staff’s competency and awareness of people’s needs. One relative told us, “l can only speak highly of staff” and another said “the manager is competent and proactive.”

The provider had systems to monitor the quality of the service, some of which we saw had been utilised to produce service improvement plans.

We observed that staff interacted with people who used the service in a caring and sensitive way. People appeared relaxed in the presence of staff and were treated with respect by them. Feedback from people who used the service included: ‘I like going on holiday with my key worker’ and ‘I like my key worker, staff and my room’. People were given choices in relation to their daily routine and the kind of activities they participated in. People and staff communicated effectively using sign language.