SENSE - 25 Horsegate

Updated 18 April 2018

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 registered persons continued to meet the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service and to provide a rating for the service under the Care Act 2014.

Due to technical problems, the registered persons were not asked to complete a Provider Information Return. This is information we require registered persons to send us at least once annually to give some key information about the service, what the service does well and improvements they plan to make. We took this into account when we inspected the service and made the judgements in this report.

Before our inspection visit we examined information we held about the service. This included notifications of incidents that the registered persons had sent us since our last inspection. These are events that happened in the service that the registered persons are required to tell us about. We also invited feedback from the commissioning bodies who contributed to purchasing some of the care provided in the service. We did this so that they could tell us their views about how well the service was meeting people’s needs and wishes.

We visited the service on 18 December 2017 and the inspection was announced. We gave the registered persons three working days’ notice. This was because the people who lived in the service had complex needs for care and benefited from knowing in advance that we would be calling to their home. The inspection team consisted of a single inspector.

During the inspection we spent time with all of the people who lived in the service. We also spoke with four care staff, the deputy manager and the registered manager. In addition, we observed care that was provided in communal areas and looked at the care records for three of the people who lived in the service. We also looked at records that related to how the service was managed including staffing, training and quality assurance.

In addition, we used the Short Observational Framework for Inspection (SOFI). SOFI is a way of observing care to help us understand the experience of people who could not speak with us.

After the inspection visit we spoke by telephone with two relatives.

Updated 18 April 2018

We inspected the service on 18 December 2017. The inspection was announced. SENSE- 25 Horsegate is a ‘care home’. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

SENSE- 25 Horsegate is registered to provide accommodation and personal care for five people who have a learning disability and/or sensory adaptive needs. There were five people living in the service at the time of our inspection visit. All of the people had special communication needs and principally expressed themselves using sign assisted language, vocal tones and gestures. The 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.

The service was run by a charitably body who 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 and the registered manager we refer to them as being, ‘the registered persons’.

At the last inspection on 11 November 2015 the service was rated, ‘Good’.

At this inspection we rated the service as, ‘Good’.

People were safeguarded from situations in which they may experience abuse including financial mistreatment. Risks to people’s safety had been assessed, monitored and managed so they were supported to stay safe while their freedom was respected. This included times when people became distressed and needed help to keep themselves and others around them safe. Most of the necessary arrangements had been made to manage medicines safely and there were enough staff on duty to provide people with the individual assistance they needed. Also, background checks had been completed before new care staff had been appointed. Furthermore, there were suitable arrangements to prevent and control infection and lessons had been learnt when things had gone wrong.

Care was delivered in a way that promoted positive outcomes for people and care staff had the knowledge and skills they needed to provide support in line with legislation and guidance. People received the individual assistance they needed to enjoy their meals and they were helped to eat and drink enough to maintain a balanced diet. In addition, suitable steps had been taken to ensure that people received coordinated and person-centred care when they used or moved between different services. People had been supported to live healthier lives by having suitable access to healthcare services so that they received on-going healthcare support. Furthermore. the accommodation was designed, adapted and decorated to meet people’s needs and expectations.

People were supported to have maximum choice and control of their lives. In addition, the registered persons had taken the necessary steps to ensure that people only received lawful care that was the least restrictive possible.

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

People received personalised care that was responsive to their needs including their need to have information presented to them in an accessible way. In addition, people had been offered opportunities to pursue their hobbies and interests. Furthermore, the registered manager recognised the importance of appropriately supporting people who chose gay, lesbian, bisexual and transgender lifestyles. There were arrangements to ensure that people’s concerns and complaints were listened and responded to in order to improve the quality of care. In addition, suitable provision had been made to support people at the end of their life to have a comfortable, dignified and pain-free death.

There was a registered manager who had promoted a positive and person centred culture in the service. In addition, there were suitable management arrangements to ensure that regulatory requirements were met. People who lived in the service and members of staff were actively engaged in developing the service. Furthermore, there were systems and procedures to enable the service to learn, improve and assure its sustainability. Also, the registered persons were actively working in partnership with other agencies to support the development of joined-up care.