This unannounced inspection took place on the 16 June 2017. SENSE-115 Gough Road provides accommodation and support to five people who have sensory impairments. We last inspected this service in October 2014 and found the service to be ‘Good’ in all areas. At this inspection we judged that the service provided remained ‘Good.’

People received support to remain safe whilst ensuring the risks associated with their care were well managed. Staff had knowledge of how to recognise safeguarding concerns. The staff were aware of the appropriate action they should take should concerns arise. There were sufficient, appropriately recruited, staff available to support people.

People received safe support with their medicines from staff who had received training to provide this support. Medicines were stored safely and systems were in place to ensure medicines had been administered as prescribed.

People were supported to have maximum choice and control of their lives and staff supported people in the least restrictive way possible. The policies and systems in the service supported this practice.

People were supported by staff who had received training to provide them with the skills they needed for their role. People received food and drinks they enjoyed and were supported to have their individual healthcare needs met.

People were supported by staff who knew them well. Relatives confirmed that they were happy with the care their relative was receiving. We observed many caring and relaxed interactions between staff and people

Care plans had been developed which stated how people preferred to be supported. We saw that these were reviewed with people and staff that knew the person well to ensure the care received continued to meet people’s needs.

People had a full and active life which was enhanced by people’s opportunity for regular activities that were based on people’s interests. There were systems in place for complaints or concerns to be raised and relatives told us they felt comfortable in raising concerns should they need to.

There were systems in place to monitor the quality and safety of the service provided. Relatives were happy with how the home was managed and staff felt supported in their roles.

Further information is in the detailed findings below.

The inspection took place on 3 October 2014 this was unannounced. At our last inspection in December 2013 we found that all the regulations we looked at were met.

The home provides accommodation and care in a spacious house which had been adapted to meet the specific needs of five people with learning disabilities and also living with one or more sensory impairments. People were unable to communicate with us verbally but expressed their feelings through non-verbal communication.

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.

Relatives,health care staff and social care professionals who supported people at the home told us that they thought the home was safe. Our observations showed that staff were aware of, and acted to minimise, any identified risks to people without restricting their independence. We saw there were systems and processes in place to protect people from the risk of harm and staff took individual responsibility for the safety and well-being of people in their care.

Staff told us they had received appropriate training and were knowledgeable about the needs of people who lived in the home. Our observations showed they anticipated people’s needs as they knew them well. Staff had received training about the needs of deaf blind people and used the knowledge to communicate and support people to make choices in their day-to-day their life. There were enough staff to meet people’s needs and support them to follow interests and pursuits they enjoyed.

People had their health care needs met and their medicine administered appropriately. Action was taken to familiarise people with routine medical interventions such as taking of blood before this was needed. This demonstrated the manager was proactive in helping people to access health care assessments so that their health was maintained

People had a choice of food and drink that reflected their individual needs. Staff supported appropriately where health professionals had made recommendations about a person’s food and drink needs. In addition the manager had recently looked to involve a person in hosting a dinner party. This included inviting and greeting their guests and shopping and preparing the food they liked. This allowed the person to experience a social occasion involving food.

The provider had invested in employing specialist staff to assess some of the needs of people such as with eating and drinking or the way people showed their feelings. The specialist staff had produced guides for care staff so that they had the information they needed to meet the complex needs of people living in the home.

Relatives we spoke with told us that the care people received was excellent .They said staff were caring, interested and were committed to ensure that people had a good quality of life in the home. We saw that people were treated with dignity and respect and that people were able to have private time safely as any potential risks had been identified and minimised. Staff used differing forms of communication with people such as objects or hand under hand signs to tell them what was going to happen next in their day. We also saw that staff observed people for non-verbal communication so that they could meet their needs.

Management systems were well established to monitor and learn from incidents and concerns. The manager and provider undertook checks and had systems in place to maintain the quality of the service the home was providing. The manager had innovative ideas about how the home could continue to improve and had put some of these into action. The provider supported the ideas of staff and managers where these were of benefit to people of the home. Where these had proven to be successful they were shared with all of the provider’s homes. This meant both the manager and the provider were striving for continued improvement in this home.

People living in the home were unable to tell us about the care they received. We observed how people were cared for to understand people's experience of care. One of the ways we did this was by undertaking a short observational framework for inspection (SOFI). We also walked around the home and spoke with four care staff, the registered manager and two health / social care professionals.

Care staff supported people in a sensitive way to ensure that risks to them were minimised and to communicate what was going to happen. For example we saw that people were helped to have their nutritional needs met as described in their eating and drinking guidelines and this lessened the risk of people choking. People were supported to experience a range of activities and to undertake some day to day tasks. People appeared well cared for, having their personal care needs met in an environment that supported them.

Systems were in place to ensure that risks to people's safety and well-being had been identified and risks minimised. Amongst the comments we had from social and health care professionals were: "The staff try and promote independence and skills. It is a very positive home" and "There is a stable staff group of exceptional quality." Care staff were appropriately recruited, checked, trained and supported.

We were not able to communicate with the people who live at the home so we observed how people were cared for to understand people's experience of care. One of the ways we did this was by undertaking a short observational framework for inspection (SOFI) We also walked around the home and spoke with two care staff on duty, the registered manager and two relatives.

Care staff supported people in a sensitive way using differing methods of communication to ensure that people understood what was going to happen. People were supported to experience a range of activities and to undertake some day to day tasks. People appeared well cared for having their personal care needs met in a spacious environment that supported them.

Two people told us they were contacted should care staff be concerned about their relative. They told us their relatives were well cared for and care staff were very good. Systems were in place to ensure that risks to people's safety and well being had been identified and risks minimised. Permanent care staff were generally appropriately trained and supported. However, the responsibility for bank staff needed to more explicit to ensure that they received training and supervision.