About the service:

89 Hastings Avenue is a small residential care home for people with a range of sensory, physical and learning needs. The service was providing personal care and support to four people at the time of the inspection. The home 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. These values were seen in practice at the home. For example, staff did not wear uniforms and people lived their lives in the ways they wanted.

What life is like for people using the service:

¿ Since the last inspection in July 2016, the home has made several improvements and now meets the characteristics of outstanding in all areas and overall.

¿ By talking to people, observing interactions and looking through pictures, it was clear that people were living happy and fulfilling lives at the service. They had great relationships with staff who knew them intently and had a genuine passion for providing people with the best opportunities in life.

¿ Relatives commented; "They deserve an outstanding rating, as a parent as a professional. It is an amazing, amazing place," "They really are outstanding in my eyes. They are brilliant. [Our loved one] is definitely in the best place."

¿ Staff shared a common vision for the service and for the people it supported; to enable them to live as independently as possible. We saw that staff were dedicated to improving people's communication, mobility and confidence and the care and support that was provided to people were guided by peoples' own aims and goals.

¿ People were challenged and encouraged to achieve their goals and there had been remarkably positive and consistent outcomes for people. One person had lost significant amounts of weight through healthy eating and exercise and was enjoying a range of activities they could not enjoy before; including swimming and a range of sports at a local sports club. Another had been supported to significantly develop their communication by increasing their signing skills and vocabulary. They were now able to communicate their choices and decisions using their own and recognised British language signs. One person who at one point was a wheelchair user, decided they want to go on the bus more and to become more mobile. Staff worked with the person and we saw that they regularly travelled on public transport to go to the gym. The person showed us their exercises that they did each day with staff and physiotherapists told us how impressed they were with the person's progress.

¿ Staff worked closely with people, health professionals and families to reduce the use of 'mood stabilising' psychotropic medicines and had introduced innovative methods tailored to people to reduce their anxiety. Staff and relatives told us that the new method had been working well and the person was now on half the dosage, with a continued reduction planned.

¿ People had developed friendships with one another and with people they had met at different clubs and groups locally. Relatives told us that their loved ones used to feel isolated, but now they had lots of friends and determined what they wanted to do each day and with whom.

¿ People chose who they wanted to support them, by taking part in interviewing new members of staff and staff used a matching tool, that matched potential new staff with people by shared interests and personalities.

More information is in Detailed Findings below.

Rating at last inspection:

Good overall and in all domains except caring, which was rated as outstanding (report published 28 July 2016).

Why we inspected:

This was a planned inspection based on the rating at the last inspection. We found improvements had been made since our last inspection and the service has met the characteristic

This inspection took place on 24 June 2016 and was unannounced.

Sense- 89 Hastings Avenue is a care home for adults who have sensory impairment and learning disabilities. The service is run by the national charity Sense, and can provide care and support for up to four people. The service is situated in a residential area of Margate. There were four people living at the service at the time of the inspection.

There was a registered manager working at the service and they were supported by a deputy 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. The registered manager, deputy manager and staff supported us throughout the inspection.

The registered manager had been in charge at the service for a long time. They knew people and staff well and had good oversight of everything that happened at the service. The registered manager led by example. They encouraged and supported the staff team to look at different ways of improving the lives of people and improving the service. They promoted the ethos of the service which was to give personalised care and support to people and support them to achieve their full potential to be as independent as possible. The dedication and attitude of the registered manager and staff was described by others as ‘over and beyond the call of duty’. People received care that was personal to them.

Staff understood people’s specific needs well and had good relationships with them. People were settled, happy and contented. Visiting professionals and relatives told us they only had positive experiences and praise for the service. Throughout the inspection people were treated with dignity and kindness. People’s privacy was respected and they were able to make choices about their day to day lives.

Risks to people’s safety were assessed and managed appropriately. Assessments identified people’s specific needs, and showed how risks could be minimised. People were supported to take risks and not be restricted by them. The registered manager carried out regular environmental and health and safety checks to ensure that the environment was safe and that equipment was in good working order. There were systems in place to review any accidents and incidents and make any relevant improvements as a result.

The provider had taken steps to make sure that people were safeguarded from abuse and protected from the risk of harm. Staff had been trained in safeguarding adults and knew what action to take in the event of any suspicion of abuse. Visiting professionals and relatives told us that people were cared for in a way that ensured their safety and promoted their independence.

Emergency plans were in place so if an emergency happened, like a fire, the staff knew what to do. Safety checks were carried out regularly throughout the building and there were regular fire drills so people knew how to leave the building safely.

People and their relatives felt comfortable about complaining. When they did raise concerns they were taken seriously and their concerns were looked into and action was taken to resolve them.

Before people decided to move into the service their support needs were assessed by the registered manager to make sure the service would be able to offer them the care that they needed. People indicated that they were satisfied and happy with the care and support they received. People received care that was personal to them. People, and those close to them, were involved in planning and reviewing their care and support. There was a close relationship and good communication with people's relatives. Relatives felt their views were listened to and acted on.

Staff understood people’s specific needs well and had good relations

We visited when three of the four people living at the home were in, all of whom spoke with us about life at the home. We spoke with the manager and several staff.

People told us they were happy at Hastings Avenue. All people spoke to us using British Sign Language, and staff were competent in conversational signing. One person said that they decided to live here because staff were good at signing.

We saw that people were involved in planning all of their care and support. We saw that records were in text and pictures were used where this was helpful. Care and support plans were reviewed regularly and risk management aimed to increase people’s involvement in day-to-day activities.

We saw the building and grounds were safe and maintained to a high standard. A programme of refurbishment was in place. People showed us their new paints and told us that they made decisions and choices about the building. Systems were in place to check that health and safety risks were minimised.

The home was warm, clean and homely. People were safe and comfortable and could get around the house easily. People had the right support to manage their medicines and records were very well kept. There was a good range of nutritious food available.

People who use the service were unable to speak to us about their experience of the service due to their communication difficulties. One person who used the service was able to give a "thumbs" up sign to indicate they were happy. We observed the interaction between people who used the service and staff. We also spoke with the registered manager and staff.

We observed care being given to people who used the service and looked at people's care plans. We found people were respected and involved in their care and safeguarded against abuse. We observed and saw evidence that people's care and welfare were maintained and the people were treated with respect. We found that there was a good system in place to monitor the quality of the service.

People were supported to express their views and make important decisions because the staff supported them with their communication and spent time with them. There were clear recruitment process in place and staff said they received the training they needed and were well supported when starting work in the service.