Archived: SENSE - 92 Black Prince Avenue

SENSE 92 Black Prince Avenue is registered to provide accommodation and personal care for two people who have a learning disability and/or sensory adaptive needs. There were two people living in the service at the time of our inspection visit. Both of the people had special communication needs and 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 23 April 2015 the service was rated, ‘Good’.

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

There were systems, processes and practices to safeguard people 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 occasions when people became distressed and needed support in order to keep themselves and others around them safe. In addition, medicines were managed safely. Suitable arrangements had been made to ensure that sufficient numbers of suitable staff were deployed in the service and background checks had been completed before new care staff had been appointed. Furthermore, there were robust arrangements to prevent and control infection and lessons had been learnt when things had gone wrong.

Although people were supported to have maximum choice and control of their lives, the registered persons had not taken all of the steps necessary to fully support care staff to only provide lawful care that helped people in the least restrictive ways possible. However and in practice, care staff did deliver care in line with current guidance.

Although people had benefited from most parts of the accommodation being well maintained suitable provision had not been made to ensure that all areas were comfortably warm. 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.

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.

The registered persons had not taken all of the steps necessary to ensure that the service consistently met all regulatory requirements. Although a number of quality checks had been completed they had not always resulted in shortfalls in the service being quickly put right. However and in practice, the registered manager promoted a positive culture in the service that focused upon achieving good outcomes for people. Care staff had been helped to understand their responsibilities to develop good team work and to speak out if they had any concerns. In addition, people and their relatives had been consulted about making improvements in the service. In addition, a number of measures were in place to promote the financial sustainability of the service. Furthermore, the registered persons were actively working in partnership with other agencies to support the development of joined-up care.

We saw that staff had consulted with people who used the service (and their representatives) about what assistance was to be provided.

People showed us that they received all of the support they needed. Records confirmed that assistance had been provided in a safe, reliable and responsive way.

We found that the provider had measures in place to help safeguard people from abuse.

We saw that people were being supported in a safe and comfortable setting.

Documents and records showed that quality checks were being completed to ensure that people were reliably provided with the facilities and services they needed.

We made two visits to the service, on the first visit we met the two people who lived at the home and observed how they were cared for. The visit was short as the people were going out shopping with staff. We visited the home again and met with the regional and acting manager.

The people who lived at the home were unable to communicate with us verbally however they were happy to show us around their home. We saw they lived active lives with the support from staff. Both people looked well cared for, well groomed and wore clothing of their own choice. Both people had busy social lives, they attended day care facilities during the week and went out in the evenings and at weekends.

We spoke with a relative who told us, "It's the best place he has ever lived at. The staff call me every week. I go to regular meetings and am involved with helping to make decisions. I have no concerns at all."

We identified some concerns during the first visit to the home. We found concerns with how the staff managed people's behaviours and identified that staff supported people to go on a shopping trip without safe levels of staffing which had been recommended in the person's behaviour management plan. We also found some concerns within the environment. Details of concerns found are included in the main body of this report.