SignHealth Bowfell Road

Signhealth Bowfell Road is a residential care home providing personal care for up to six deaf people with mental health needs. Each person has their own self-contained flat and there is a communal lounge, garden, a staff office and sleep-in room.

Not everyone who used the service received personal care. CQC only inspects where people receive personal care. This is help with tasks related to personal hygiene and eating. Where they do we also consider any wider social care provided.

People’s experience of using this service and what we found

The service provided highly person-centred care and support. People were fully engaged in planning and agreeing their support and activities. Risks were assessed and well managed.

The service promoted people’s involvement in their care and support through visual communication methods and innovative role playing to help people to make choices and decisions.

Visual care plans were developed with people choosing the pictures or photographs to be used.

An independent advocate visited the service at least every three months to discuss any issues and support people to express their views.

Care staff were positive role models for people. All staff were fluent in British Sign Language (BSL). BSL interpreters were booked so people and staff could be fully engaged in any appointments.

The service applied the principles and values of Registering the Right Support and other best practice guidance. These ensure that people who use the service can live as full a life as possible and achieve the best possible outcomes that include control, choice and independence.

The outcomes for people using the service reflected the principles and values of Registering the Right Support by promoting choice and control, independence and inclusion. People's support focused on them having as many opportunities as possible for them to gain new skills and become more independent.

The home was fully adapted, with visual fire alarms and door bells. Visual information was used throughout the service to provide people with information.

People and relatives were very positive about the staff team at Signhealth. People were relaxed and comfortable with staff. The staff knew people and their support needs exceptionally well. People were supported to participate in a wide range of activities and to increase their independence at home and in their wider community.

People’s health and nutrition needs were being met by the service. People received their medicines as prescribed.

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

The staff team said they enjoyed working at Signhealth, were well supported by the management team. They were very positive about the training and presenting what they had learnt to the rest of the staff team so that everyone benefitted from the courses they had completed.

The management team had a robust quality assurance system to monitor and improve the service. There was an open culture, with involvement from people and staff in the running of the service.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection

The last rating for this service was good (published 30 December 2016).

Why we inspected

This was a planned inspection based on the previous rating.

Follow up

We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.

SignHealth Bowfell Road is a residential care home based in Urmston, Salford. The service provides 24 hour support within an independent living environment for up to six deaf people with mental health needs. Each person lives in their own self-contained flat with a kitchen and a bathroom. There is a shared lounge, communal entrance and hallways, and a staff office. There is also a large outdoor space with car parking, seating areas, vegetable and flower gardens.

There was a registered manager at the service. 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 and associated Regulations about how the service is run.

People, their relatives and healthcare professionals were very positive and highly complementary about the quality of care and support provided to people at the service. People using the service told us they felt very safe living at the home. One person told us, “I get great support from staff, they are great at knowing me and how to motivate me. I'm very happy living here."

People at the service, relatives, staff and professionals spoke highly of the registered manager and the senior team who they said demonstrated a strong leadership and provided a ‘hands on’ approach to the care people received. They told us the provider and staff went above and beyond to ensure they received a person centred service.

The registered manager involved people, relatives and healthcare professionals to ensure people received the support they required and to make decisions that were in their best interests. Healthcare professionals told us, “We at the unit cannot praise the team at SignHealth Bowfell Road enough, they are an amazing team, they have a holistic approach to the care they provide both physically, psychologically and socially."

There was a strong emphasis on person centred care. Risk assessments and care plans were very person centred and written in plain English which made it easier for people to understand them and what their purpose was so that people could be fully engaged in progress towards agreed goals.

People were encouraged to become more independent in their daily living skills. People were particularly well supported to be part of the local community and to access educational and vocational opportunities.

Staff were very clear on the values of the organisation and service. They spoke of their “Mission” to get people properly integrated into the community. Promoting equality was a major thrust of the service.

Positive risk taking was driven throughout the organisation, balancing the potential benefits and risks of taking particular actions over others, in order to support people to live fulfilling lives. Staff understood how to manage risks to people's health and supported them to develop and reach their full potential. Staff had clear guidance on the positive management of behaviours that may challenge the service and others which protected people's dignity and rights.

An outstanding characteristic for the service was the time spent developing ways to accommodate the changing needs of the people who used the service, using innovative and flexible ways to support people to move forward. Staff supported people to identify and manage their changing needs in a flexible way to ensure they made progress towards their recovery, and to manage their sometimes very complex physical health needs.

People’s healthcare needs were particularly well managed by this service. Staff worked as part of multi-disciplinary teams to support people with a range of very complex healthcare needs. Healthcare professional described the support offered to people as being 'outstanding' stating, “SignHealth are instrumental in providing a quality of life to people that leads to an amazing levels of independence and this contributes to really positive outcomes to wellbeing.”

The provider used a robust recruitment procedure which ensured people received support from staff vetted as suitable to work with vulnerable people. As part of the recruitment process the provider used value based recruitment techniques, a clearly defined culture statement and staff competency assessments. People were involved and contributed to the recruitment process of potential staff. All staff used British Sign Language (BSL) and deaf staff were recruited as much as possible to act as positive role models. Staff were very skilled at communications skills, including BSL, to maximise engagement with people.

Staff had detailed knowledge of people's needs and had the skills to provide their care effectively. The registered manager and senior team carried out regular supervision sessions and appraisals.

Staff members said they felt valued and an important part of the team. They received training that was relevant to them and excellent support through regular supervisions and a yearly appraisal. Staff felt well supported and understood their roles and responsibilities to ensure they delivered people's support in an effective manner. There were clearly defined roles and responsibilities for each staff member. Staff turnover was low and people had keyworkers who knew them very well. This meant people were supported by a stable, highly skilled and competent staff team who were meeting the needs of people who could have complex and challenging healthcare needs.

People were at the heart of the service, which was organised to suit their individual needs and aspirations. They were given information about reporting concerns in a number of ways including in a visual format and were encouraged to raise any issues through key worker meetings, group meetings or by speaking with an advocate.

The registered manager effectively used the audit systems to continually monitor and drive up the quality of the service offered to people.

The service was well led and run by the registered manager, supported by a strong staff team who were clear and passionate about promoting deaf people to participate and engage fully in society.

We found people living at SignHealth were happy and felt well supported by staff. Some of the comments from people who used the service included; 'I've lived here for two years and I am happy. I'm a lot calmer here and the staff are good. I'm supported with cooking, hovering and domestic tasks. I like to go out when I can and go into town. I have no complaints'. Another person told us; 'I'm really happy. I have routine and I'm able to follow it whilst living here. I have worked in the past and I'm currently on a course at Salford College. The staff are nice they treat me well'.

We found the building was clean, tidy and odour free. People who used the service were responsible for cleaning their own bedrooms and this was checked by staff.

We looked at the recruitment procedures to ensure staff were recruited safely. We found CRB's had been sought as well as references from previous employers.

During our inspection we found there were appropriate quality monitoring systems in place. This was done with the use of annual surveys, staff and tenant meetings and regular auditing which captured areas of strength and improvement.

The people using this service told us they preferred to be known as tenants for the purpose of this report. We spoke to four tenants during our visit. They told us that they were happy living at SignHealth Bowfell Road and were satisfied with the service they received. One of the tenants told us, 'I don't want to move anywhere. I want to stay here till I die.'

The tenants said that staff respected their rights to privacy, dignity and independence and they were supported to lead the lifestyle of their choice. They told us that they felt safe and that they got on well with the staff who provided their support. In conversation with four tenants they said, 'Staff good. If I am not happy, I ask them for help, like if I am not happy with someone or get on my nerve', 'I felt more comfortable, safe and independent', 'There one staff who is my favourite, any problem I go to her' and 'I know what I am doing with my medication, have own chart and staff help me, I am happy'.

We found that the provider had good systems in place for safeguarding people from harm and for reviewing and improving the quality of the service. The staff team had received training that was appropriate to their roles.