We carried out this announced inspection on 27 September 2017. We gave the service a short period of notice. This was because the people who lived there had complex needs for care and benefited from knowing in advance that we would be calling.

SENSE – 56 Monks Dyke Road is registered to provide accommodation and care for seven people who have a learning disability and/or a sensory disability. At the time of our inspection visit there were seven people living in the service. Some of the people lived with significantly reduced sight and/or hearing. In addition, all of them had special communication needs and used personal forms of sign assisted language.

The service was run by a charitable body that was the registered provider. 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. In this report when we speak about both the charitable body who ran the service and the registered manager we refer to them as being, ‘the registered persons’.

At our last inspection that we completed on 2 August 2015 we rated our domains ‘safe’, ‘effective’, ‘caring’ and ‘responsive’ as being, ‘Good’. However, our domain ’well led’ was rated as, ‘Requires improvement’. This was because the registered persons had not told us about their receipt of two deprivation of liberty authorisations. This oversight had reduced our ability to promptly check that the people who were subject to the authorisations were receiving safe and lawful care. Nevertheless, the overall rating for the service was still, ‘Good’.

At this inspection we found we rated all of our domains as, ‘Good’. In addition, the overall rating for the service was, ‘Good’.

Care staff knew how to keep people safe from the risk of abuse including financial mistreatment. People had been supported to take informed and reasonable risks. At the same time they were also being helped to avoid preventable accidents and care staff were safely managing medicines. There were enough care staff on duty and background checks had been completed before new care staff had been appointed.

Care staff had received training and guidance so that they knew how to care for people in the right way. People were supported to prepare their meals and drinks and care staff had ensured that people had enough to eat and drink. In addition, they had been helped to obtain all of the healthcare assistance they needed.

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

People were treated with kindness and compassion. Care staff respected people’s right to privacy and promoted their dignity. Arrangements had been made for people to have access to independent lay advocates if necessary and confidential information was kept private.

People and their relatives had been fully involved in making decisions about the care that was provided. People had been supported to be as independent as possible and they had been helped to pursue a wide range of hobbies and interests. There were arrangements for quickly and fairly resolving complaints.

People had been consulted about the development of their home and quality checks had been completed. Good team working was promoted and care staff had been enabled to speak out if they had any concerns.

Further information is in the detailed findings below.

This was an announced inspection carried out on 3 August 2015.

SENSE – 56 Monks Dyke Road can provide accommodation for up to seven people who have a learning disability or who live with reduced vision and hearing.

There were seven people living in the service at the time of our inspection.

There was a registered manager. 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.

The Care Quality Commission is required by law to monitor how registered persons apply the Deprivation of Liberty Safeguards under the Mental Capacity Act 2005 and to report on what we find. These safeguards are in place to protect people where they do not have capacity to make decisions and where it is necessary to deprive them of their liberty. This is usually to protect themselves. At the time of our inspection the local authority had authorised all of the people to be deprived of their liberty and so their legal rights had been protected. Staff had also followed the Mental Capacity Act 2005 Code of Practice in ensuing that whenever possible people were supported to make decisions for themselves.

Staff knew how to recognise and report any concerns so that people were kept safe from harm. People were helped to avoid having accidents and their medicines were safely managed. There were enough staff on duty and background checks had been completed before new staff were appointed.

Staff had received the training and guidance they needed to assist people in the right way including helping them to eat and drink enough. People had received all of the healthcare assistance they needed.

People were treated with kindness, compassion and respect. Staff recognised people’s right to privacy, respected confidential information and promoted people’s dignity.

People had received all of the care they needed including people who had reduced vision and hearing, had special communication needs or who were at risk of becoming distressed. People had been consulted about the care they wanted to receive and they were supported to celebrate their diversity. Staff had offered people the opportunity to pursue their interests and hobbies. There was a system for resolving complaints.

Although regular quality checks had been completed they had not identified mistakes in how we had been told about some important events that had occurred in the service. People had been consulted about the development of the service. The service was run in an open and inclusive way and people had benefited from staff receiving good practice guidance.

People’s care plans were clear, person-centred, detailed and provided up to date information on how their diverse needs should be met. This included details about their abilities, disabilities, mobility, communication methods and expression of sexuality.

People’s health care needs were documented in their records and contact with health professionals was recorded. All seven people were registered with a GP and had an allocated member of staff who coordinated their care.

We looked at menus and saw they offered a wide range of hot and cold meals. We observed meals provided for people with special dietary requirements. The manager explained maintaining nutrition was an essential part of the menu offering.

We looked around the home and observed a good overall standard of cleanliness. We saw people’s rooms were clean and communal areas were clean and tidy. The home was free from mal odour. We spoke with the registered manager and care staff, all of whom demonstrated an understanding of infection control procedures.

We looked at staff records and saw processes were in place for formal supervision. This meant each staff member had the opportunity to meet with a senior colleague every six weeks. In addition, we confirmed appraisals were undertaken annually.

We reviewed the home’s complaints records. We confirmed the home had followed its own procedure and had recorded the details of complaints as well as those of the investigation that took place and the outcome.

We saw that staff were kind and caring. People who lived at the home were given support to be as independent as possible. We saw people being guided to prepare their own food and drinks.

The staff team had worked with the people who lived at the home to create a new garden which included a summer house, greenhouse, sensory area and vegetable patch. Produce grown in the garden was used for cooking in the home.

As part of our inspection we spoke with a number of staff. They told us they liked working at the home. One member of staff said, “Our standard of care is very high.” Another commented, “We really care about the people here.”

Although people who used the service were not able to communicate verbally with us, they appeared happy and were treated as individuals. Members of staff interacted with people at every opportunity. People were allowed use of the kitchen and living rooms at any time and were always supervised.