SENSE - 1 Ashley Green is registered to provide care and accommodation for up to five people who require nursing or personal care. The service specialises in providing care and support to people over the age of 18 with Learning disabilities or autistic spectrum disorder, physical disability and sensory impairment. The home is situated in a cul-de-sac and has an outdoor sensory garden area that included a sensory building, adapted to provide stimulation to people in the winter time when the weather was unsuitable to use the garden area. Off street parking was available with good access to the home.

The home was previously inspected on 16 March 2015 and was rated as Good in all domains except Safe which required improvement. This inspection took place on 24 May 2017 and was unannounced. The inspection was completed by one adult social care inspector and an expert-by-experience. At the time of our inspection five people lived at the home.

During our previous inspection in March 2015, we found that systems and processes in place to ensure people’s medicines were managed and administered safely were not always effective and audits failed to highlight any areas that required improvement. During this inspection in May 2017 we found the registered provider had implemented improvements, which meant people received their medicines safely and these were managed according to the latest best practice guidance. Effective internal and external medicine audits had been completed that maintained the level of medicines management.

During our previous inspection in March 2015 we saw good evidence that risk was well managed. However, where records were required to evaluate any support provided for its effectiveness in providing people with improvements to their health, these records were not always robustly completed. During this inspection in May 2017, we found care plans included detailed risk assessments. Where people were at risk with their health for example, from malnutrition, detailed records included charts that recorded people’s weight and these were reviewed to ensure they were effective and recorded the person’s progress.

At the time of our inspection 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.

Procedures were in place which helped to ensure people were supported by care workers who understood the importance of protecting them from avoidable harm and abuse. Care workers had received training on how to identify abuse and report any concerns to the appropriate authorities.

There were sufficient care workers with appropriate skills and knowledge to meet people's individual needs and the registered provider had a robust recruitment process that ensured only care workers deemed suitable to work with vulnerable people had been employed.

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

Care workers clearly understood and had developed a variety of resources that helped people to communicate their preferences and choices and we saw these were upheld and responded to throughout our inspection.

People and their relatives or advocates had involvement in their care planning. Records included how consent to care and support had been agreed and who was involved. This information was reviewed annually or as people’s needs changed.

People were provided with a wholesome and nutritionally balanced diet which was of their choosing and care workers were proactive in supporting people to assist them with preparation and choosing their drinks and foods.

People were s

We used a number of different methods to help us understand the experiences of people who used the service. This was because the people using the service had complex needs which meant they were not able to tell us their experiences in a meaningful way. We observed staff interaction with the people who used the service and we looked at care records.

People’s needs were assessed and care and treatment was planned and delivered in line with their individual care plan. We observed staff carrying out care tasks and we saw that they were doing so in accordance with each person's care plan.

We saw that staff treated people with dignity and kindness. We observed that a friendly and positive approach was used, to ensure that the wishes and needs of people using the service were respected.

We found medication was administered safely to people. People were given appropriate support, to ensure they had taken their medication as prescribed.

We found people were cared for, and supported by, sufficient, suitably qualified, skilled and experienced staff. Staff demonstrated different methods of communicating with people to ensure their wishes and beliefs were respected.

Relatives were aware of how to raise concerns or complaints. The provider had a complaints policy in place which was available throughout the service. Advocacy services were available if needed to support people with complex needs.

We used a number of different methods to help us understand the experiences of people using the service, because the people using the service had complex needs which meant they were not able to tell us their experiences. We observed staff interaction with the people who used the service and we looked at care plans.

We were unable to talk to the staff who worked at the home because they had taken the people who used the service out to activities in the community.

The manager told us that they felt ‘working with people who are deafblind was rewarding.’ They told us that they felt that ‘care is good.’

We saw that staff had received training in safeguarding and from the safeguarding questionnaires in the staff files we looked at, they were able to identify the signs of abuse.

The people who lived in the home were kept safe because the provider had taken steps to maintain the building and we saw that regular health and safety checks had been carried out.

We saw that the care plans were detailed and tailored to meet the needs of the individual.

We saw the interaction between staff and the people who used the service, we felt it was warm and respectful.

In view of the communication needs of the people who use the service, we relied on observations between the staff and people who use the service to assess service users’ views about the service. We observed staff offering people choices about how and where they wanted to spend their time, and what food and drinks they wanted.

We spoke with staff during our visit. Staff were very positive about working in the home and praised the teamwork and supportive atmosphere

This inspection took place on 16 and 23 March 2015 and was announced. At the last inspection in August 2013 we found the provider was meeting the regulations we looked at.

SENSE- 1 Ashley Road provides care and support to adults aged 18 and over who have a sensory and hearing impairment and have an additional learning and/or physical disability. The home is situated within a residential area of Leeds. It can accommodate up to five adults. The service had a registered manager. 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.

People were safe. The provider had systems in place to protect people from the risk of harm. Staff understood how to keep people safe and knew the people they were supporting very well. Overall, people were protected against the risks associated with medicines because the provider had appropriate arrangements in place to manage medicines. Some minor medication issues were identified during the inspection; the provider agreed to introduce more regular medication audits to ensure these were picked up through their own systems.

There were enough staff to keep people safe. Staff were skilled and experienced to meet people’s needs because they received appropriate training and support. The service met the requirements of the Deprivation of Liberty safeguards.

People were well cared for. People received appropriate support to make sure their nutritional and health needs were appropriately met. People’s needs were assessed and care and support was planned and delivered in line with their individual care needs. The team were introducing a new care planning format to ensure care was set out in a way that clearly described what staff needed to do.

The service was person centred, and had good management and leadership. People got opportunity to comment on the quality of service and influence service delivery. Effective systems were in place that ensured people received safe quality care.