The inspection took place on 14 August 2017 and was announced.

Sense – 18 Watergate is a care home which provides personal care for up to five people who experience a range of learning disabilities, physical disabilities and sensory impairments. The accommodation includes private ensuite bedrooms and shared communal areas. There were five people living at the home when we inspected.

At the last inspection, the service was rated Good.

At this inspection we found the service remained Good.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice. Where necessary people had been referred for a Deprivation of Liberty Safeguards assessment and staff supported people to make choices about their care.

Staff received appropriate training and support to ensure that the care provided was safe and met people’s needs. This allowed staff to ensure that medicines were managed safely and that risks to people were identified and care was planned to keep minimise risks. Staff had received training in how to keep people safe from abuse and knew how to raise concerns. Thorough recruitment checks ensured that staff were safe to work at the home with vulnerable people.

Care plans fully reflected people’s needs and supported staff to provide personalised care. People were able to make choices about their meals and helped staff to prepare their meals. Where needed food was modified to appropriate textures for people to eat safely and the equipment provided at meal times supported people’s independence. Activities offered supported people to engage with their local community and enabled them to live a busy life.

There were effective audits in place to monitor the quality of care that people received. Systems supported people using the service and their families to raise any concerns they had about the care provided. The registered manager kept up to date with changes in best practice.

The inspection took place on 11 June 2015 and was unannounced.

Sense – 18 Water Gate is a home for people with sensory impairment and learning disabilities or autism or other physical disabilities. The home is registered to provide care for a maximum of five people. Accommodation is provided in single bedrooms each of which has an en-suite bathroom.

There was a registered manager in place at the time of our visit. 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.

There were enough staff available to care for people safely and the registered manager took into account people’s needs when setting staff levels. There were appropriate recruitment and selection processes in place to ensure staff were suitable to employ. Staff received training in subjects needed to keep people safe. Staff were supported with regular supervisions and appraisals and training needs identified by staff to enhance their communication with people living at the home were supported by the registered manager.

Care plans recorded the risks to people’s health and safety while living in the home and action had been taken to minimise the risks people were exposed to without restricting their activities of daily living. Accidents and incidents were monitored and where trends in incidents were identified the registered provider and staff took action to reduce the incidents. People’s ability to eat and drink safely had been assessed and individual guidelines were in place to keep people safe when eating.

Systems were in place to obtain, store, administer and dispose of medicine safely. Medication administration charts had been accurately and where medicine had been prescribed as to be taken was required it was clearly recorded why it had been administered.

The Care Quality Commission is required by law to monitor how a provider applies the Mental Capacity Act 2005 (MCA) and Deprivation of Liberty Safeguards (DoLS) and to report on what we find. DoLS are in place to protect people where they do not have capacity to make decisions and where it is considered necessary to restrict their freedom in some way. People had been assessed to see if they were at risk of having their liberty deprived and appropriate applications had been submitted to the local authority. Records showed when decisions had been made in a person’s best interest, family and health and social care professionals had been included in the decision making process.

There was a calm relaxed atmosphere in the home and people were comfortable approaching staff for assistance. Relatives were consistently positive about the caring attitude of the staff. Staff knew about people’s individual likes and dislike and how they preferred to received their care. People were supported to maintain family relationships and to make their family feel welcome in the home.

Staff had a positive attitude about people’s abilities and supported them with daily living skills, activities and holidays to reach their full potential and lead a fulfilling life. People were supported to be part of their care reviews and help to set their goals in the coming year.

The people living at the home were at the heart of the service and the provider’s values supported staff to ensure people received a personalised service. The registered manager was innovative in developing the service to meet people’s needs with the resources allocated to them.

There were appropriate systems in place to monitor the quality of service provided and where issues were found action was taken to resolve the issue.

On the day we visited all of the people who lived at the home were present. However we were unable to gain people's views because of the different ways people communicated. We therefore spent time observing care, speaking to staff and reviewing records to see what it was like to live at the home.

Care was planned and delivered in a way that was intended to ensure people’s safety and welfare. Records showed the risk to people’s safety and well-being were assessed and reviewed on a regular basis.

People were provided with a choice of suitable and nutritious food and drink. We saw there was a four week menu plan. This reflected the different cultures of people living in the home.

We looked around the home and could see all areas were clean and tidy.

The manager ensured there were enough staff with the right mix of skills to support people’s needs.

There were systems in place to identify risks and manager risks to people.

Sense – 18 Watergate Quadring provides care for five deafblind people. On the day we visited four of the people who lived at the home were present. However they were unable to communicate with us so we spent time observing their care, speaking to staff and reviewing their records to see what it was like to live at the home.

We saw there was a good relationship between the people living at the home and the care workers. For example, we saw one person give a care worker a big hug when they helped them change their shoes for slippers.

We saw people were involved in their care and encouraged to be as independent as possible. For example, one care worker told us how people are encouraged to be independent with their laundry.

In this report the name of a registered manager appears who was not in post and not managing the regulatory activities at this location at the time of the inspection. Their name appears because they were still a Registered Manager on our register at the time.

The four people living in the home each attended the local Sense education centre each week day. In the evenings and weekends they were able to make choices about how to spend their time. We saw that one person was very keen to help with preparing for a meal.

The people we saw indicated that they felt safe and secure at their home and they appreciated the consistency in the staff group. We observed that all interactions and contacts between the staff and people living there were positive and respectful.