The inspection took place on 13 and 14 November 2017. The first day of the inspection was unannounced, however the second day of the inspection was announced and the management team, staff and people knew to expect us.

Blind Veterans UK is a charity that was founded in 1915 to support men and women who have served in the armed forces or who have completed National service. It provides practical and emotional support to enable people who have impaired vision or who have lost their sight in battle or through accident, illness or older age, to lead enriched and fulfilling lives. The provider is forward-thinking and their aims and vision are that no person who has served on behalf of the Country should face blindness alone. There are two centres that provide residential and respite care, as well as day facilities and holidays. Blind Veterans UK – Brighton 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. The home accommodates 77 people across three different floors, each of which have separate adapted facilities. One of the floors specialises in providing nursing care. On the days of our inspection there were 36 people at the home who were in receipt of the regulated activity of personal care. All people had a sensory loss. In addition, some people had other conditions such as physical disabilities, diabetes, multiple sclerosis and Parkinson’s disease.

There was a large management structure within the home. The management team had recently been restructured to aid efficiency and consisted of a centre manager, a care manager, facilities manager, operations manager, rehabilitation services manager and a residential manager. This management team ensured that the service that was delivered met people's needs. The home did not have a registered manager. A registered manager is a ‘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 home is run. The previous registered manager had left three months prior to the inspection. The provider had been proactive in the recruitment of a new manager and one had been recruited and was in the process of applying to become registered manager.

People were asked their consent before being supported. Staff had an understanding of the legislation and guidance that related to assessing people's capacity and making decisions in people's best interests. However, this had not always been implemented in practice. There was a lack of documentation to demonstrate that people, who had conditions that might affect their capacity, had their capacity assessed and that relevant people had been involved in the decision making process. At the end of the inspection, when our findings were fed back to the management team, they took immediate action to ensure that the relevant assessments and documentation were in place. However, this needs to be further embedded in practice.

Without exception, people, a relative and healthcare professionals told us that staff were consistently kind, caring and compassionate and our observations confirmed this. Comments from people were overwhelmingly positive. They included, “I’ve never felt so well looked after, everyone is so kind and helpful. Nothing is ever any trouble”, “Oh nothing is too much trouble for them, they like to know you’re happy and comfortable”, “You only have to hear the tone of their voice and you can tell they really care about you” and “The care is exemplary, you really feel it here”. Further comments included, “It’s a magnificent place”, “The care, efficiency and service is really out of this world” and “This is the best place in the country”. A visiting health care professional echoed these positive comments, they told us, “In my experience t

The inspection took place on 6 October 2015.

Blind Veterans is a care home with nursing for up to 77 people that require support and personal care. People at the home have sensory impairments and some people have additional physical disabilities. Some people may be living with conditions associated with advancing age, including dementia. At the time of our inspection 42 people were living at the home, 40 of whom were aged over 65 years. The home, which also provides respite and short breaks for people, is located in Ovingdean and is one of three centres run by the charity Blind Veterans UK.

There was a registered manager in post. A registered manager is a person who has registered with the Care Quality Commission to manage the home. 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 home and commented they felt safe. One person said, “I feel absolutely safe. There is always a carer around.” People had confidence in the staff to support them and we observed positive interactions throughout our inspection. Staff were knowledgeable and trained in safeguarding and what action they should take if they suspected abuse was taking place.

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.

The registered manager was up-to-date with changes to the law regarding the Deprivation of Liberty Safeguards (DoLS) and they were making sure that people’s legal rights were being protected.

People enjoyed the full range of facilities that the home offered such lounges, dining areas, IT training rooms, library, gym, pool, chapel, arts area and workshop. It benefitted from a magnificent position overlooking the South Downs to the North and English Channel to the South. The environment was designed to meet the needs of visually impaired people and those with frailties associated with ageing. There was signage to help people find their way around the building and it included colour and lighting which may add to orientation for people with sensory and cognitive impairment.

The home provided an impressive range of social activities. A health care professional told us about a, “Brilliant activities coordinator who has been instrumental, together with the manager, in setting up individual activity profiles” for people.

People were listened to and as a result received care that was suited to their preferences and needs. People were encouraged to express their views. People also said they felt listened to and any concerns or issues they raised were addressed. One person said, “They [the staff] understand my care needs and choices unbelievably well. They help me to be as independent as possible.”

We observed friendly relationships between people and staff. People were glowing in their descriptions of the care they received; they were very complimentary about the friendliness and professionalism of the staff. Comments included, “They are second to none” and “I cannot speak too highly of the staff” and another said, “The quality of the care and nursing is beyond description”. People told us the staff supported them to maintain their independence as it was important to them.

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

People were supported to eat and drink well. There was a varied daily choice of meals. People were able to give feedback and have choice in what they ate and drank and special dietary requirements were met. A healthcare specialist told us, “The residents at Blind Veterans are well supported and cared for. From a dietetic point of view, there seems to be a lot of variety in the menu. With the staff that I have spoken to, they know the residents well and their likes and dislikes which is very helpful for my dietetic assessments.”

People felt their physical health needs were looked after and this encouraged them to be as independent as possible. Health care was accessible for people and the home worked closely with GP’s and therapists to maintain people’s health and welfare.

Staff were asked for their opinions on the home. Staff enjoyed their work. They felt supported within their roles and described a caring management approach. They described how management were always available to discuss suggestions and address problems or concerns. A nurse told us that “The management are supportive. I can go to the manager or the Practice Development Nurse and there is an open culture”.

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

During our visit we spoke with seven people who used the service and two relatives. We spoke with eight staff members, these were the head of care, a residential care manager, two registered nurses, three care workers, and the activities co-ordinator.

We also took information from other sources to help us understand the views of people who use the service, which included a members and relatives satisfaction survey and members meeting minutes. The people we spoke with told us they were happy with the care they received and with the staff team. Other comments from the people who used the service included, “I have nothing but praise for the staff” and “I was amazed how friendly everyone is here”. The staff we spoke with knew the people living at Blind Veterans and had a good understanding of their support needs. One staff member told us, “I love this job, we get the best training, the best equipment, we all work as a team and the care we deliver is excellent”. Other comments from staff included, “We really do deliver good quality care” and “We respect the member’s privacy and dignity and keep people involved in their care”. A person who used the service told us "I couldn't have done without them [Blind Veterans UK], they've been brilliant to me".

We found that people were supported to give valid consent to care and treatment and understood how to change their decisions.

People experienced care that was effective, safe and appropriate that meet their needs and protected their rights.

People were protected from the risk of a health care associated infection.

The people who used the service had their medicines at the times they needed them and in a safe way.

The staff employed by the service had the appropriate checks carried out before starting their employment. This included health and welfare needs, Disclosure and Barring Service (DBS) checks and the appropriate skills to and qualifications to perform their jobs.

We found that people’s complaints and comments were listened to and acted upon effectively.

During our visit we spoke with five people who used the service and a volunteer whose partner used the service. We spoke with nine staff members, these were the manager, deputy manager, the ward manager, three care workers and three staff who worked in Human Resources (HR).

We also took information from other sources to help us understand the views of people who use the service, which included a satisfaction survey and meeting minutes.

The people we spoke with told us they were happy with the care they received and with the staff team.

Staff we spoke with knew the people living at the home well and had a good understanding of their support needs.

One person who used the service told us “I couldn’t have done without them [Blind Veterans UK], they’ve been brilliant to me”. Another person who used the service we spoke with told us “It’s the best nursing home in the country, I am looked after very well indeed”.

One member of staff we spoke with told us “It’s really good here. Everybody will tell you the same”.