Turning Point – The Sanctuary 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 Sanctuary is a supported residential unit that provides short term care and support for seven people who have mental health issues. Referrals to The Sanctuary are made through the Crisis Resolution Home Treatment Team (CRHT) for short term support from three days to two weeks to provide people with the opportunity to recover from a mental health episode with as much or little support as they need. People are able to maintain their usual daily living activities such as work or education if they choose to. The provider is an organisation called Turning Point. On the day of our visit there were six people living at the service.

At our last inspection we rated the service good. At this inspection we found the evidence continued to support the rating of good and there was no evidence or information from our inspection and ongoing monitoring that 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.

At this inspection we found the service remained Good.

People told us that they felt safe. Staff had a good understanding of their roles and responsibilities for identifying and reporting allegations of abuse and knew how to access policies and procedures regarding protecting people from abuse. Risks to people were assessed and monitored during their stay and communicated with other healthcare professionals involved in their care. Learning as a result of incidents was shared and used to inform changes to the service such as reviewing policies. Staffing levels were assessed and amended based on the needs of the people using the service and there were arrangements in place for covering if staff were unable to come to work at short notice. The building was well maintained and there were systems in place for ensuring that regular checks of the environment and equipment were carried out. Medicines were managed safely and people were supported to take their medicines.

People are supported to have maximum choice and control of their lives and staff support them in the least restrictive way possible; the policies and systems in the service support this practice.

People told us that they were able to make choices about their support and were able to maintain their independence and provided with information and guidance to access other services which were relevant to them for ongoing support.

Staff were trained in subjects relevant to the needs of the people who used the service and received regular supervision which enabled them to develop in their roles. Staff said they felt supported.

Staff spoke to people respectfully and treated them with dignity and respect. People told us that staff were available to listen 24 hours a day. People felt that their privacy was respected and staff kept information confidential. People were involved in planning their support. People’s friends and families were welcomed to visit them at the service.

People’s individuality was respected and people’s preferences were taken into account when planning their care such as religion and sexuality. There was an accessible complaints process in place which people knew how to use if they needed to however people told us that they hadn’t needed to make a complaint.

People said that the registered manager was approachable and listened to them. Staff said that the registered manager was open and they were able to raise any concerns and put forward suggestions for improvement. The vision and values of the organisation were visible within the service and staff were proud to work at the service. The provider worked with other healthcare providers to ensure that people re

There were six people living in the home at the time of our visit, two people were out at work and two people were on leave. Two people that spoke with us were very positive about the support they received and comments included. “I have been to stay here several times and it is always quite a relief. I feel that it has saved my life sometimes.”

People told us that they were consulted on all areas of their care, they said they were treated with dignity and respect and gave consent to the support they received.

Care plans were in place that were reviewed and updated daily in order to assess and monitor people’s recovery.

The home had policies and procedures in place to ensure that people received their medication safely and in accordance with prescribed guidelines.

People were supported by a well-trained and well supported staff team. Staff received regular supervision, appraisal and training relevant to their role.

There were processes in place to monitor and evaluate the quality of service being provided.

The team leader of the Crisis Resolution Home Treatment Team (CRHT) that spoke with us said. “Our relationship with The Sanctuary is very good. They are very responsive. For example last week we suggested some improvements and updates that could be made to the service and today we have a meeting with the manager and our team. We are very lucky to have this resource across East Sussex.”

During our visit we saw that people were being treated with dignity and respect and people’s independence was encouraged. People were spoken to in a respectful way. People we spoke to told us that the staff were approachable and friendly that that their privacy was respected whilst they were supported to maintain their independence. One person told us that the staff were 'brilliant' and that 'whenever you want to talk they are there'.

We saw that people experienced safe and effective care based on detailed care plans and risk assessments that met individual needs.

People using the service were protected from abuse as they were supported by a staff team who had appropriate knowledge and training on safeguarding adults. People told us if they had any concerns they would report them to the manager of senior person on duty.

Staff received ongoing training and supervision which provided them with the skills and knowledge to meet the needs of the people they were supporting.

The Provider had effective systems in place to monitor and assess the quality of the service.

We were told that independence and individuality are promoted within the Home. People living there are supported, enabled and encouraged to express their views and make or participate in making decisions relating to their care and treatment. We found that systems for consultation, interaction and communication are effective and individuals have their privacy and dignity upheld. During our visit people were observed being spoken with and supported in a sensitive, respectful and professional manner.

People told us that the staff “are very helpful here. It’s peaceful. I’ve been here since Monday, and I expect to stay until Sunday. The staff talk to you, and play cards”. Another said “The staff attitudes are very good. They’re kind.”

We asked people if they felt safe at the home. One person told us “I feel safe here, yes.” Another said “This is a safe environment”.

We were told that systems for quality assessment and improvement were in place. Information about people’s experiences had been asked for and gathered in such a way to allow for monitoring of risks and the quality of care delivery.

The inspection took place on 25 and 28 September 2015. The Sanctuary was last inspected on 29 January 2014 and no concerns were identified.

The Sanctuary is a supported residential unit that provides short term respite care and support for seven people who have mental health issues. Referrals to The Sanctuary are made through the Crisis Resolution Home Treatment Team (CRHT) for short term support from three days to three weeks. The provider is an organisation called Turning Point.

On the 25 September 2015, there were two people living in the service and on the second day, 28 September 2015, there were four people.

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.

People spoke positively of The Sanctuary and commented they felt they were safe. One said, “Totally safe, a haven to me at this time, no pressures and really lovely staff.”

Our own observations and the records we looked at reflected the positive comments people made. People had confidence in the staff to support them and we observed positive interactions throughout our inspection.

Risks to people’s mental health and well-being were well managed. The initial assessment was undertaken by The Crisis Resolution Home Treatment teams (CRHT). The assessments included health risks, behaviours that challenge and mental health challenges. The files also highlighted health risks such as alcohol withdrawal. We saw that when people arrived an assessment of people’s immediate needs was carried out in a ‘welcome interview’. This ensured that people felt comfortable and the details held by the staff were correct.

People were safe. Medicines were managed safely in accordance with current regulations and guidance. There were systems in place to ensure that medicines had been stored, administered, audited and reviewed appropriately, including the administration of controlled drugs. The organisation has medicine administration policies specific to the meet the needs of the people they support.

People were happy and relaxed with staff. They said they felt safe and there were sufficient staff to support them. One person told us, “I feel safe here. There is no pressure; the staff are there when we are ready to talk.”

When staff were recruited, their employment history was checked and references obtained. Checks were also undertaken to ensure new staff were safe to work within the care sector. Staff were knowledgeable and trained in safeguarding and what action they should take if they suspected abuse was taking place. Staff retention was good and most staff we spoke with had worked at The Sanctuary for many years.

The Care Quality Commission (CQC) monitors the operation of the Deprivation of Liberty Safeguards (DoLS) which applies to care homes. We found that the manager understood when an application should be made and how to submit one.

Where people lacked the mental capacity to make decisions the home was guided by the principles of the Mental Capacity Act 2005 (MCA) to ensure any decisions were made in the person’s best interests.

Accidents and incidents were recorded appropriately and steps taken by the home to minimise the risk of similar events happening in the future. Risks associated with the environment and equipment had been identified and managed. Emergency procedures were in place in the event of fire and people knew what to do, as did the staff.

Staff had received essential training and there were opportunities for additional training specific to the needs of the service, such as restraint. Staff had received both one to one and group supervision meetings with their manager, and formal personal development plans, such as annual appraisals were in place.

People were encouraged to eat and drink well. Staff said, “We step in to assist if they seem to be struggling to cook and we will of course make sure they eat during their stay.” People were advised on healthy eating if it was needed. Health care was accessible for people and staff supported people to make appointments as needed for medicine reviews and GP appointments during their stay.

People could choose how to spend their day and the lifestyle was flexible. One person said, “I can sit in the lounge or spend time in my room. They pop in to see if I am Ok and are just so supportive.” Another person said, “I value time just to get my thoughts together, they never push me to talk.”

People felt well looked after and supported, and were encouraged to be as independent as possible. We observed friendly and genuine relationships had developed between people and staff. One person told us, “They treat you well here.” One person told us, “Been coming here a long time, they are fantastic and always there to support me.”

People were encouraged to express their views and completed surveys, and feedback received showed people were satisfied overall, and felt staff were friendly and helpful. People also said they felt listened to and any concerns or issues they raised were addressed. One person said, “If there is anything wrong, I tell the staff.”

Staff were asked for their opinions on the service and whether they were happy in their work. Staff enjoyed their work and felt that they were a family. They felt supported within their roles, describing an ‘open door’ management approach, where management were always available to discuss suggestions and address problems or concerns.

The provider undertook quality assurance reviews to measure and monitor the standard of the service and drive improvement.