We carried out this announced inspection on 6 November 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 The Manor House 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, most 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 the last inspection on 18 November 2015 we found that the service was well managed so that people reliably received safe, effective, caring and responsive support. As a result the overall quality rating we gave the service was, ‘Good’.

At this inspection we found the service continued to be well managed so that people received all of the care they needed. Consequently, our overall quality rating for the service remained, ‘Good’.

In more detail, there were systems, processes and practices to safeguard people from situations in which they may experience abuse. Risks to people’s safety had been assessed, monitored and managed so they were supported to stay safe while their freedom was respected. In addition, medicines were managed safely. Suitable arrangements had been made to ensure that sufficient numbers of suitable staff were deployed in the service to support people to stay safe and meet their needs. Background checks had been completed before new care staff had been appointed. People were protected by the prevention and control of infection and lessons had been learnt when things had gone wrong.

Care staff had been supported to deliver care in line with current best practice guidance. People enjoyed their meals and were supported to eat and drink enough to maintain a balanced diet. In addition, people had been enabled to receive coordinated and person-centred care when they used or moved between different services. As part of this, people had been supported to live healthier lives by having suitable access to healthcare services so that they received on-going healthcare support. Furthermore, people had benefited from the accommodation being adapted, designed and decorated in a way that met their needs and expectations.

Suitable arrangements had been made to obtain consent to care and treatment in line with legislation and guidance.

People were treated with kindness, respect and compassion and they were given emotional support when needed. They were also supported to express their views and be actively involved in making decisions about their care as far as possible. This included having access to lay advocates if necessary. Confidential information was kept private.

People received personalised care that was responsive to their needs. Care staff knew how to use sign assisted language to communicate with people and they provided reassurance when people became distressed. People were supported to undertake a range of occupational and social activities. In addition, their concerns and complaints were listened and responded to in order to improve the quality of care. Furthermore, suitable provision had been made to support people at the end of their life to have a comf

This was an announced inspection carried out on 18 November 2015.

SENSE – The Manor House can provide accommodation and care for seven people who have a learning disability and who have reduced hearing and vision. There were seven people living in the service at the time of our inspection. All of the people living in the service had special communication needs and used a combination of words, signs and gestures to express themselves.

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.

Staff knew how to respond to any concerns that might arise so that people were kept safe from harm. People were helped to promote their wellbeing and steps had been taken to reduce the risk of accidents and near misses. Medicines were safely managed, there enough staff on duty and background checks had been completed before new staff were appointed.

Staff had received training and guidance and they knew how to care for people in the right way including how to respond to people who had special communication needs. People had received all of the healthcare assistance they needed.

Staff had helped people to make decisions for themselves. 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 protect people when they are not able to make decisions for themselves and it is necessary to deprive them of their liberty in order to keep them safe. In relation to this, the registered manager had worked with the relevant local authorities to ensure that people only received lawful care that respected their rights.

People were treated with kindness and compassion. 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 could become distressed. People had been consulted about the care they wanted to receive and staff supported people to express their individuality. People had been assisted to pursue their interests and hobbies and there was a system for resolving complaints.

Regular quality checks had been completed and people and their relatives had been consulted about the development of the service. Staff were supported to speak out if they had any concerns because the service was run in an open, inclusive and welcoming way. People had benefited from staff acting upon good practice guidance.

We used a number of different ways to help us understand the experiences of people who used the service. This was because some people had complex needs which meant they were not able to tell us about their experiences.

We saw people who lived in the home experienced individual care and support from staff who respected their privacy and dignity and supported people to promote their independence. Staff understood each person’s way of communicating their needs and wishes. They supported them to make choices and decisions about their lifestyles wherever they could do so.

We found people were supported to have a varied and nutritious diet which took into account personal preferences and choices.

The home was clean, tidy and well maintained and provided people with a comfortable and homely environment. Where any safety risks were identified we were told how these were being addressed. Bedrooms were individually furnished and decorated according to peoples individual preferences.

There was a thorough staff recruitment procedure in place to keep people safe. New staff followed an induction training programme so that they had the relevant skills and knowledge to confidently support people.

Records we checked were well maintained and stored safely. Care plans were detailed and person centred. They were available for staff to refer to as needed to ensure they understood the individual care each person needed.

We made two visits to the home as when we visited the home in the morning, all but one of the people who lived there were out at day care facilities. When we visited the home in the evening, all of the people were at home and we observed the dinner time period.

Two people who lived in the home were able to communicate with us and both told us they were happy living there. One person showed us their bedroom and we saw staff communicated with them well using sign language.

The atmosphere in the home was very relaxed and the people who lived there were involved in making decisions and running the home. Everyone led active lives and was involved in the local community. One person had a voluntary job at a local shop.

Everyone received person centred care and was well looked after. We spoke with three relatives of people who lived there and all said they had no concerns. One relative told us, “My daughter is very happy and safe there. The staff are absolutely wonderful.”

Another relative told us, “He is very well looked after. His clothes and personal care always look clean. They give him the same care that I give him. The staff treat him with dignity and he is definitely safe.”

One relative told us about how their son had moved into the home. They told us, "The staff provided a gradual introduction, they went at my sons pace and slowed it down when it got too much. It went really well and I know he is happy there."

In view of the communication needs of the people who use the service, we relied on observations between the staff and people who use the service, information provided by the staff and the service provider.