This inspection took place on 4 September 2018 and was unannounced. This is the first inspection of this service since the provider changed from RNIB Charity to Royal National Institute of Blind People (RNIB) in 2017.

RNIB-Tate House 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. RNIB-Tate House accommodates up to 39 older people and people living with a sensory impairment in one adapted building.

There was a registered manager in place. 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.

When we visited enough staff were deployed to meet people’s needs safely. Some concerns were raised with us that staffing pressures could lead to care becoming more task focused on occasion than people would wish. We have made a recommendation regarding how staffing is calculated so dependency factors and changing care needs are acted upon in a timely way.

People told us they felt safe and they knew who to speak with if they had any worries or concerns. Staff had completed safeguarding training. They said they would raise any issues of concern with a manager and were confident managers would take appropriate action.

Detailed risk assessments were in place. Staff knew how to support people safely without placing undue restrictions on them.

Medicines were stored safely and people told us they received their medicines as prescribed. We have made a recommendation regarding how medicines are ordered to reduce the potential for error.

The provider had a robust recruitment policy and procedures in place. Staff received training and support to fulfil their roles effectively.

People had assessments of their needs before they moved into the service. Care plans were comprehensive and guided staff on how to support people in a way that met their care preferences.

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

The environment was suitably adapted to meet the needs of people living with a sight or a physical impairment and this helped to maintain and enhance people’s independence. Equipment was kept in a good state of repair. The premises were clean and tidy and staff had access to personal protective equipment to reduce the risk of the spread of infection.

People’s health and nutritional needs were met. People who used the service and relatives were extremely positive about staff approach and attitude and people told us staff respected their privacy and dignity.

People could follow their own individual pastimes and pursuits or they could choose to participate in a range of activities, which the activities organiser and volunteers organised. There were good links with the community. For example, the service hosted a Quaker meeting, which the public could attend.

There was a complaints procedure and people felt able to raise concerns and complaints.

Care staff described managers as supportive and they commented on a good team ethic. The provider had obtained external advice regarding their quality and monitoring systems and they acted upon any advice provided to them. Audits and checks were undertaken and these were used to drive improvements in quality and safety.