This inspection was unannounced and took place on the 11 and 12 May 2017. Sansa House is a residential home which provides accommodation and personal care for up to five people who are supported with complex needs, including learning disabilities and autism. At the time of our inspection four people were living at Sansa House and one was visiting relatives.

The home is a detached house within a residential area close to Basingstoke town centre. Each person has their individual living space within the home, including en-suite bathrooms, with a communal lounge area and kitchen. People’s rooms had been decorated and furnished to meet their individual needs.

The primary aim at Sansa House is to support people to increase their independence and maximise their potential. Staff promoted people’s independence and provided emotional and psychological support for people to take part in activities outside and to plan and complete tasks around their home.

The service had a registered manager in place. A registered manager is a person who has registered with the Care Quality Commission (CQC) 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. Since our last inspection the registered manager had also become the registered manager at another service within the provider’s care group. A deputy manager and a positive support coordinator managed the home in their absence, supported by two team leaders.

People felt safe living at Sansa House and trusted the staff who really cared for them. People were protected from the risks of potential abuse by staff who knew what actions to take if they felt people were at risk.

Risk assessments were created to protect people from harm whilst promoting their independence. Staff supported people in their everyday lives in accordance with their risk management plans, which minimised the risk of harm to them and kept them safe.

There were plans to protect people in the event of an emergency and the provider’s business plans ensured continuity of care to reduce the disruption to people and staff.

Accidents and incidents were recorded, reported and analysed by the registered manager to identify any themes or trends. The registered manager ensured all incidents were reflected upon during shift handovers and staff meetings to ensure necessary learning was shared as soon as possible.

Staff underwent robust pre-selection checks to assure the provider they were suitable to support people with autism or a learning disability. Daily staffing needs were analysed by the registered manager. This ensured there were always sufficient numbers of staff with the necessary experience and skills to support people safely.

People’s medicines were administered safely by staff who had completed safe management of medicines training and had their competency to do so assessed.

Staff had completed an effective induction course based on nationally recognised standards and spent time working with experienced staff. This ensured staff had the appropriate knowledge and skills to support people effectively.

The registered manager had innovative and creative ways of training and developing their staff that made sure they put their learning into practice to deliver good care to meet people’s individual needs. Staff received effective supervision, appraisal, and support to carry out their roles and responsibilities.

People were supported by staff who understood and effectively applied the principles of the Mental Capacity Act, 2005 and the Deprivation of Liberty Safeguards. Staff confidently applied the MCA to make sure that people were involved in decisions about their care so that their human and legal rights were protected.

There was a strong emphasis on the importance of eating and drinking well. Staff devised methods to encourage t

This announced inspection of Sansa House took place on 29 October 2014. The home provides accommodation and personal care for up to five people. The home is a detached house within a residential area and has been furnished to meet individual needs. People who use the service have complex needs including autism.

The primary aim at Sansa House is to support people to increase their independence and maximise their potential. Support workers promote people’s independence and provide emotional and psychological support for people to take part in activities outside and to plan and complete tasks around their home.

The home had a registered manager in place. A registered manager is a person who has registered with the Care Quality Commission (CQC) 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.

Staff at Sansa House worked with people to identify their individual needs and what they wanted to achieve in the future. Staff showed flexibility and creativity in supporting people to become more independent. This often focused on helping people to manage anxiety and frustrations and created a caring family environment.

People told us they trusted staff and valued the support they received. They were supported to be active and achieve their ambitions. Staff supported people to make choices and respected their right to make decisions. This included taking on new challenges with informed risk assessments.

People had comprehensive risk assessments. Where risks to people had been identified there were plans in place to manage them effectively. Staff understood the risks to people and followed guidance to safely manage these risks.

Staff were aware of changes in people’s needs and reported any concerns to healthcare services promptly. Support workers sought guidance from health and social care professionals which was then implemented and recorded.

Everyone at Sansa House told us they trusted the staff who made them feel safe. Staff had completed safeguarding training and had access to guidance. They were able to recognise if people were at risk and knew what action they should take. People also had access to guidance about safeguarding in a format that met their needs, to help them identify abuse and respond appropriately if it occurred.

The registered manager completed a daily staffing needs analysis to ensure there were always sufficient staff with the necessary experience and skills to support people safely. Whenever possible the registered manager and staff worked together with people to identify in advance when their needs and dependency were likely to increase.

Robust recruitment procedures ensured people were supported by staff with the appropriate experience, skills and character. Staff were encouraged to undertake additional relevant qualifications to enable them to provide people’s care effectively and were supported with their career development.

Medicines were administered safely in a way people preferred, by trained staff who had their competency assessed by the registered manager. Staff complied with the provider’s medicine’s procedures whilst supporting people in the community.

Staff had completed training on the Mental Capacity Act (MCA) 2005 and understood their responsibilities. Where people lacked the capacity to consent to their care, legal requirements had been followed by staff when decisions were made on their behalf. The provider utilised advocacy services for people where required.

The CQC monitors the operation of the Deprivation of Liberty Safeguards (DoLS) which applies to care homes. The registered manager had completed the required training and was aware of relevant case law. We found the provider to be meeting the requirements of the DoLS.

People’s needs in relation to nutrition and hydration were documented in their care plans. We observed people received appropriate support to ensure they received sufficient to eat and drink. Meals, drinks and snacks provided to people reflected their dietary needs and preferences.

There was a friendly and relaxed atmosphere within the home, where people were encouraged to express their feelings, whilst respecting others. People told us that when they had a problem or were worried they felt happy to talk with any of the staff. Whenever people had raised concerns or issues prompt action had been taken by the provider to address them. Feedback was sought and obtained in various ways ranging from provider surveys, house meetings, resident’s meetings and support worker meetings.

All accidents and incidents were investigated thoroughly by the registered manager and specialist support workers. Actions identified from complaints or the analysis of incidents and trends were implemented promptly by the registered manager to ensure the delivery of a high quality service and maintain the safety and welfare of people. The registered manager effectively operated a series of audits to assess and monitor the quality of the service.

Staff had received training in the values of the provider as part of their induction. For example, one support worker told us, “All the people we support are encouraged to express themselves and their needs in a safe and supportive environment and we treat everyone as individuals, with dignity and respect.” Throughout our inspection staff continually demonstrated these values in the course of their work with people.

The provider placed a strong emphasis on striving to improve. The registered manager had developed an open and positive culture where people and support workers were encouraged to raise concerns, which were always acted upon. Leadership from the registered manager and the two specialist support workers was highly visible and inspired staff.

People were treated with respect. Their independence within decision making was promoted by staff within the guidance of individual risk assessments.

People told us they were happy living in the home and felt safe, cared for and listened to by staff. One person said “I love all the people” and “I go out bowling and shopping with staff”. Another person said in reference to staff, “Yeh, they’re alright”.

We saw positive interactions between staff and people who used the services, with particular reference to people who had limited verbal communication skills.

People’s care plans detailed how they wanted their needs to be met and supported the choices they had made. People’s health and social care needs were reviewed and met to promote their wellbeing.

Staff had received the training and support they needed to support the people who used the services. These included professional qualifications.

People had opportunities to contribute their views about the quality of the service and knew who to contact should they have a concern or complaint about the services provided. The home had processes in place to promote the safety of the home and to monitor and improve outcomes for people who used the services.