SENSE - 6 Lilac Grove

Sense - 6 Lilac Grove is registered to provide accommodation and personal care for up to four people who are visually, hearing and sensory impaired. At the time of our inspection there were three people living in the home. Three of the bedrooms are located on the ground floor with a communal lounge, dining room and kitchen. The fourth bedroom is located on the first floor.

The care 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.

At our last inspection in April 2016 we rated the service good. At this inspection we found the evidence continued to support the rating of good. 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.

A registered manager was employed by the service and was present during our inspection. 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 were supported by staff who were kind and caring and who showed a genuine interest in people’s well-being. People looked relaxed in the presence of staff and did not hesitate to seek assistance and support when required.

The service was responsive to people’s needs and people were able to make daily choices about their daily routines and the support they received. People had access to a range of organised and informal activities. Care plans were person centred and contained detailed information of people’s likes, dislikes and preferences.

People were supported to have maximum choice and control of their lives, and staff supported them in the least restrictive way possible. We saw staff seeking consent before providing assistance or support to people. There was a range of ways used to support people to communicate their wants and wishes. For those people who were unable to verbally ask for help, staff anticipated their needs. We observed this was done by staff interpreting the sounds they made, their expressions and body language.

People had access to food and drink throughout the day and were supported to eat their preferred food choices. Where people chose not to eat the menu options available alternatives were offered.

People continued to be protected from the risk of harm or abuse and received a safe service. People’s medicines were managed safely, and they received them in the way they preferred. There were sufficient staff to keep people safe and to meet their care and support needs.

People received care from staff who knew them well and had the skills and knowledge to meet their individual needs. Staff monitored people’s health and well-being and made sure they had access to the appropriate healthcare professionals according to their individual needs.

The registered manager had systems in place to monitor the quality of the service provided. The service worked in conjunction with other health professionals to support people to access additional support and services where needed.

Further information is in the detailed findings below.

We carried out this inspection on the 07 April 2016. This was an announced inspection which meant the provider knew the day before we would be visiting. This was because this is a small service where people go out on activities during the day. We wanted to ensure people using the service would be at home during some of our inspection. We wanted to make sure the manager would be available to support our inspection, or someone who could act on their behalf. The inspection was carried out by one inspector. As some people were unable to verbally tell us about their experiences of the service, we telephoned and spoke with relatives after our inspection. During our last inspection in December 2013 we found the provider satisfied the legal requirements in the areas we looked at.

The service had a registered manager in place. 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. 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. We found the service to be well led.

Staff knew people’s individual communication skills, abilities and preferences. There was a range of ways used to support people to communicate their wants and wishes. People were supported to follow their interests and take part in social activities. People were encouraged and supported to develop and maintain relationships with people that mattered to them and avoid social isolation.

Care plans were personalised and each file contained information about the person’s likes, dislikes and preferences. Peoples’ needs were reviewed regularly and as required. Handover between staff at the start of each shift ensured important information was shared and acted upon where necessary.

People were protected against the risk of potential harm and abuse. Staff had the knowledge and confidence to identify safeguarding concerns and acted on these to keep people safe.

People were supported by sufficient staff with the right skills and knowledge to meet their needs. Safe recruitment practices were followed before new staff were employed to work with people. People’s needs were met by staff who had access to the training they needed. We reviewed training records for staff, which confirmed they had received training on a range of subjects.

There were safe medicine administration systems in place and people received their medicines, as prescribed. Records confirmed people had access to health care professionals as required such as a GP, dentist and an optician.

People’s dietary needs and preferences were clearly recorded in their care plans. One person told us they liked the food and were able to make choices about what they had to eat.

The registered manager and staff acted in accordance with the requirements of the Mental Capacity Act 2005. Where people did not have the capacity to make decisions themselves, mental capacity assessments were in place and records showed that decisions had been made in line with best interests. Where required, Deprivation of Liberty Safeguarding applications had been submitted by the registered manager.

The registered manager investigated complaints and concerns. People and their relatives were able to share their views on the service and knew how they could make a complaint. The provider had quality monitoring systems in place. Accidents and incidents were investigated and discussed with staff to minimise the risks or reoccurrence.

There were four people living at the service at the time of our visit. We met three people and four staff, viewed care records and carefully observed staff interactions with people.

Throughout the visit, we saw that people were being treated with dignity and respect and that people were being encouraged to be as independent as possible. People we spoke to told us that the staff were friendly and always helpful. One person told us "I like living at Lilac Grove'.

We saw that people experienced safe and effective care based on care plans, and risk assessments that met their needs. Staff told us "the care plans are very detailed, with all the information anyone would want in them".

Staff we met were confident to raise any concerns that may arise and people told us they felt safe. Staff received regular, relevant training and supervision that gave them the skills to support people appropriately.

A complaints procedure was available to anyone to use. There were no complaints in the complaint log. One staff said "nothing to complain about here, to be honest".

The manager had a quality system in place, to obtain feedback to improve the service.

One person told us "it's nice here.' Some of the people who used the service were deaf blind and had limited communication. A staff member told us 'we use observations about their likes and dislikes. They have as much choice as every one else.'

People told us they liked living at the home. All the people we spoke with told us they were happy with their decision to live at the home.

A staff member told us "we are all like a community here. Some staff have worked here many years."

Discussions with the staff members on duty and our observations of three people's care files confirmed that many activities took place in the home. These included arts and crafts, watching videos and games. There were also many activities in the community. These included trips to the cinema, swimming and walking in the countryside.

We saw the service had a detailed complaints procedure that was known to people who used the service and staff members. There was a complaints file but there were no complaints in the file. A staff member told us 'we haven't had any formal complaints but if we did then we would follow our procedure.'