This unannounced inspection took place on the 20 June 2017. SENSE- 58 Featherstone Road provides accommodation and support to four people who have sensory impairments. We last inspected this service in August 2014 and found the service to be ‘Good’ in all areas. At this inspection we judged that the service provided remained ‘Good.’

People were supported to receive safe care by staff who were aware of and minimised the risks associated with their care. Staff were aware of the signs of abuse and appropriate action they should take to safeguard the people living at the home. Robust recruitment processes were used to ensure staff were safe to support people.

People received their medicines safely. Staff had received training to provide this support safely. There were systems in place to check that medicines had been given 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 to access a range of healthcare professionals as needed to promote their health. People were supported by an established staff team who had developed the skills and knowledge to meet people’s individual needs. People were assisted to have food and drinks they enjoyed.

People received support from staff who understood and knew them well. Staff enjoyed supporting the people living at the home.

Care had been planned around people’s needs and wishes. Reviews of care took place to ensure people continued to be supported in the way they preferred.

People were supported to pursue activities that were of interest to them. There was an open culture where relatives felt able to raise any concerns they may have. Systems were in place for complaints and concerns to be raised.

Feedback consistently said the home was well-led. Staff felt supported both by the registered manager and their colleagues. Systems were in place to monitor the quality and safety of the service and the registered manager demonstrated a strong commitment to ensure the home continued to develop.

Further information is in the detailed findings below.

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008 and to pilot a new inspection process being introduced by CQC which looks at the overall quality of the service.

58 Featherstone Road is an adapted domestic property. It provides accommodation and care for up to four people who have a learning disability and who are living with one or more sensory impairments. 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 and has the legal responsibility for meeting the requirements of the law; as does the provider.

We found that people were safe. Our observations, feedback from staff, relatives and health professionals who visited the home confirmed this. Staff we spoke with were knowledgeable about abuse. Staff  told us they would not tolerate abuse or poor practice and were aware of their responsibilities to report this in the event of it happening. Staff were aware of people’s individual risk assessments and were working in innovative ways to promote people’s freedom and reduce the restrictions which people’s disabilities could place on them. Staff and relatives told us there were enough staff on duty to enable people to be supported to live the lifestyle of their choice.

We observed staff working skilfully to meet the specific and complex needs of the people they were supporting. Many staff had gained experience over time and all staff had been trained in providing care safely and how to meet the specific needs of the people they supported.

People were encouraged to help choose, purchase and prepare their own food. We observed that people were offered meals of their individual choice and preference. Staff supported people sensitively during meal times and gave the support people needed to eat safely in accordance with their risk assessments and eating and drinking guidelines.

People had been supported to stay healthy. We found that people had attended a wide range of routine and specialist healthcare appointments and staff had worked innovatively to support people with their health, to ensure their disability didn’t exclude them from attending healthcare appointments.           

Staff we spoke with demonstrated compassion for the people they were supporting. Many of the staff had built up relationships with people and their families over many years. Relatives we spoke with confirmed staff were always kind, attentive and caring. The manager was able to demonstrate how they matched staff with people to ensure the best possible relationships were formed.  

People had been encouraged to be as involved in their own lives as far as possible. We saw staff use communication aids and signs to enable people to make choices and to know what was going to happen during the day. Staff we spoke with were able to describe how each person communicated and we found this was supported with written records.  

The manager and the provider both demonstrated a strong focus on the people living in the home. We observed that the manager had a very detailed and active knowledge about each person and we observed that they were involved in the day-to-day running of the home.   

We visited 58 Featherstone Road unannounced. During our inspection we observed and listened to how the four people who lived there were cared for. We spoke with the manager and four staff and later spoke with two relatives of the people who lived in the home. All of the people who lived in the home had hearing and sight impairments and were unable to communicate verbally with us.

Care staff supported people in a sensitive way using differing methods of communication to ensure that people understood what was going to happen. Some people living in the home had improved in their ability to use these communication tools and this had helped to broaden their experiences. People appeared well cared for, having their personal care needs met in an environment that supported them.

Relatives we spoke with comments included: "I am very pleased with the care. They always let us know about any changes in my relative's health or staff changes," and "(My relative) receives excellent care. Everything the staff do is person centred. They use a total communication system with my relative to assist them....they are constantly trying to improve."

People were protected against the risks associated with medicines because the provider had appropriate arrangements in place to manage medicines.

Staff were well trained and supported to prove safe and effective care and systems were in place to ensure that risks to people's safety and well-being had been identified and risks minimised.

People who lived at the home were not able to tell us their views due to their learning disability and communication needs. We observed interactions between people and care workers to help us understand their experiences of living at the home. We saw that care workers were kind, respectful and unhurried.

We spoke with three relatives of people who lived at the home. They told us they were pleased with the care provided at the home. Relatives told us ‘’Wonderful. I could not wish for a better home’’ and ‘’Obvious to me X is very happy there.’’

People had an active lifestyle. Each person had a schedule of activities personal to them. People were involved in activities during our visit. Some people went out to a pub, another person relaxed in their bedroom in a massage chair.

Care workers spoken with were aware of people’s needs. For example, where people needed a soft diet and what this consisted of. We found that at the evening meal people had foods of a consistency in line with their care plan.

When we arrived at the home on 23 November 2012 all of the people that lived in the home had gone to Weston Super Mare for the day. We looked at records and spoke with the acting manager. We returned on 3 December 2012 to observe care and speak with staff. We subsequently spoke with three relatives and a friend of people that lived in the home.

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 an environment that supported them. We spoke with a friend of and three relatives of people that lived in the home. They told us care staff contacted them if they had concerns about the heath of their relative. They told us the home was: "Smashing," "Absolutely excellent," and "My relative is very well cared for and very happy."

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 recruited, trained and supported.