The inspection took place on 3 December 2018 and was unannounced.

SENSE 2 and 10 Grove Road is a ‘care home’. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection. The service accommodates eight people who are living with a learning disability or autism spectrum disorder. At the time of our inspection there were seven people living at the service, with an additional person using the service as respite. One of the people currently living at the service is in the early stages of moving to a service that can meet their future needs.

The care service has been developed and designed in line with the values that underpin the Registering the Right Support and other best practice guidance. These values include choice, promotion of independence and inclusion. People with learning disabilities and autism using the service can live as ordinary a life as any citizen.

At our last inspection on 30 March 2016 we rated the service ‘good.’ At this inspection we found the evidence continued to support the rating of ‘good’ overall. There was no evidence or information from our inspection and ongoing monitoring which 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 continued to receive a safe service. Medicine administration records were completed by staff when they had administered the medicines safely. Where medicines were given in variable doses the guidance for staff was not always clear. Medicines records were not always written using good practice guidance. Risks associated with people’s needs had been assessed and measures were in place to reduce risks. There were sufficient staff to meet people’s needs and safe recruitment procedures for staff were in place. Accidents and incidents were monitored to identify any trends and measures were put in place to reduce the likelihood of these happening again.

The service continued to be effective. Staff received training and support they required including specialist training to meet people’s individual needs. People were supported with their nutritional needs. The staff worked well with external health care professionals, people were supported with their needs and accessed health services when required. 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. The principles of the Mental Capacity Act (MCA) were followed.

People received care from staff who were kind, compassionate and treated them with dignity. Staff had developed positive relationships with the people they supported, they understood people’s needs, preferences, and what was important to them. Staff knew how to support people based on their likes and preferences. People’s independence was promoted.

People continued to receive a responsive service. People’s needs were assessed and their support was planned with them and or their relative where required. Staff knew and understood people’s needs well. People received opportunities to pursue their interests and hobbies, and social activities were offered. There was a complaints procedure available if this was needed.

The service remained well-led. The monitoring of service provision was effective because shortfalls had been identified and resolved. There was an open and transparent and person-centred culture with adequate leadership. People were asked to share their feedback about the service.

Further information is in the detailed findings below.

This unannounced inspection took place on the 30 March 2016. The service was last inspected in April 2014 and was meeting all the regulations. SENSE 2 and 10 Grove Road provides accommodation for a maximum of eight adults with sensory impairments and learning disabilities. The service is comprised of two separate houses with three people living in each home. There were six people living at the home at the time of the inspection.

At the time of our visit the home had a registered manager who was present throughout the inspection. 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.

Our observations of care delivered and our conversations with relatives and staff led us to conclude that people were safe living at the home. We saw there were sufficient staff available to meet people’s individual needs and staff we spoke with knew how to safeguard people from harm. Whilst most medicines were given safely we found that improvements were needed in the administering and storage of some medicines.

People had been supported in line with the Mental Capacity Act (2005). Choices were offered to people in all aspects of their care using their preferred method of communication. Whilst restrictions had been placed on some aspects of people’s care the provider had ensured that care was delivered in the least restrictive way.

Staff had received training about people’s individual conditions and there were systems in place to ensure staff updated their knowledge. Staff felt supported in their role and told us they were involved in developing the service through their suggestions for improvement.

People received personalised care which was documented in a plan of care. Staff could describe people’s likes and dislikes and their preferences for care. We observed staff responding to people’s requests for support. Reviews of care were carried out at regular intervals to ensure that care provided was still meeting people’s needs.

We saw that staff were skilled in interpreting people’s communication needs and supported people in a calm unhurried manner. People appeared relaxed in the presence of staff and we saw that staff knew people well. Relatives were complimentary about the staff and were happy with the care provided.

People had the opportunity for new life experiences through daily activities and planned holidays. These had been organised through knowledge of the person’s preferences and communication aids had been developed to support people in making these decisions.

The service had promoted people’s independence by ensuring the home environment had been tailored to meet individual need. We saw that independence was encouraged in most aspects of people’s care including in the preparation of meals.

People had their healthcare needs monitored and had regular access to healthcare professionals. People were supported to receive a healthy diet and people’s preferred meals had been incorporated into menu planning.

Staff and relatives were happy with how the service was managed. There were systems in place to monitor the quality and safety of the service which in the most part were effective. There were plans in place to develop the service which were centred on the people living at the home.

At our last inspection In October 2013 we found that improvements were needed to the storage of medicines. In addition the home's audit undertaken the day before our visit had shown that other improvements were needed. At this visit we looked at all of the medicine stocks for each of the people who lived at 2 and at 10 Grove Road and checked the storage and administration records. We spoke with the manager and with one of the deputy managers about the medication administration. People who lived in the home had sensory impairments and learning disabilities and were not able to tell us about their medicines.

Appropriate arrangements were in place to ensure that medicines prescribed were available and suitable to the individual person. People living in the home were not taking medicines 'as required medicines' on a routine basis. Medicines were kept safely and disposed of appropriately when not required. Records were maintained of how people were supported with medicines, when these had been administered and any monitoring checks that were needed. Medicines were appropriately stored. People were protected against the risks associated with medicines because the provider had appropriate arrangements in place to manage medicines.

When we visited this service on 26 November 2012 we looked at the care provided in 2 Grove Road.

We spoke with three relatives who were happy with the care at 2 Grove Road. We saw that people were assisted, talked with and supported in a kind and caring way. People had opportunities to experience a range of activities and this had improved people's wellbeing. Although people living in the home had a range of disabilities the care staff and management were keen to support people to be as independent as possible.

People had contact with health professionals when needed. Arrangements were made for people to receive support for both out-patient and in-patient appointments. Care staff were knowledgeable about the people they cared for and received appropriate training.

We visited this home unannounced. We spent most of our time in 10 Grove Road although over the course of the inspection we saw all six of the people that lived in both houses that make up this registered home. The people in this home were unable to verbally communicate with us. We observed that people living in each house appeared well cared for and staff used different methods to effectively communicate with them. Relatives of three people we spoke with were happy with the care their relative received and stated they were involved in person centred planning meetings. These meetings discussed all aspects of their relative’s care including if their relative happy or unhappy.

Staff showed knowledge about people’s preferences and the risk management plans in place. There were sufficient staff on duty to ensure that people had access to activities and could work with people individually at times. Staff had appropriate training to meet the needs of people they were caring for. We saw that people received appropriate care and treatment.

People were not protected against all of the risks associated with medicines because the appropriate checks in place to identify errors had not identified all of the concerns.

We had received no information about complaints about the home in the last year. We had been appropriately informed of any concerns. Relatives of three people told us that if they had any concerns these were dealt with appropriately. This meant that systems the provider had in place for management of complaints or concerns was effective and ensured that a response was given.

Risks to people’s health and wellbeing were identified and audited with plans made to minimise risks to people using the service.