This was an announced inspection, which took place on 10 and 17 October 2016. The service was previously inspected in March 2014 when it was found to be meeting all the regulations we reviewed at that time.

SignHealth Claridge Road provides supported living accommodation for deaf people with complex additional mental health needs. The service comprises of six self-contained flats with 24 hour staff support. There were five people using the service at the time of our visit.

There was a registered manager in place at the time of the inspection. 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 was present during our inspection.

People we spoke with told us they felt safe at the service and staff knew what action to take should they witness or suspect abuse or poor practice. Staff had a good understanding of how to keep people safe and protect their rights.

The provider carried out the required recruitment checks to ensure that staff were safe to work with vulnerable people. There were sufficient staff on duty with the right knowledge, skills and experience to meet people’s needs.

People were supported and encouraged to live as independently as possible, for example, budgeting, shopping, cooking and keeping their flats clean and tidy. Staff encouraged people to maintain a healthy diet.

The staff team were able to communicate effectively with people who used the service. The staff team comprised of both deaf and hearing staff. All staff were able to sign to British Sign Language (BSL) Level 2 as a minimum.

Staff were aware of advances in new technology that could help people who are deaf, for example, using an interpreter via a ‘face time’ facility on a smart phone or skype.

Staff received the training they needed to support people safely and effectively, which was adapted as necessary to meet staff needs. Staff received supervision and staff meetings were held, where staff were encouraged to bring forward their views, with an interpreter and minute taker present if required. Staff spoke positively about working for the service.

People were supported to access specialist health and social care services when required and had access to other health information via the organisation’s website in BSL format. There were procedures in place to ensure people received the appropriate support they needed to manage their medicines.

People spoke positively about the staff and interactions were seen to be warm and friendly. The atmosphere at the service was calm and relaxed. There was a commitment by staff to empower people to make their own decisions and choices and to know and understand their rights.

Staff supported people to develop and maintain their social contacts and interests; this helped to promote people’s well-being and reduce the sense of social isolation linked with living with deafness.

People met regularly with an advocate, who was also deaf, to share with them their views and opinions about the service and any concerns they might have.

Risk assessments and care plans were, person centred, written in plain English and had pictures to help people understand them. Information such as notices and questionnaires were written in an accessible format and used pictures to help people better understand their content. for people Records contained relevant information; all records, were stored securely and were easily accessible to staff.

A number of quality monitoring and assurance processes were in place to help ensure people were receiving a good quality of support.

We spoke with two people who used the service. They told us staff were always very helpful and supportive. One person told us: “Staff are nice, anything I need help with they will. They encouraged me to go out on my own so I did and I’ve bought some new things” and “Staff know about things and they explain stuff for me.”

We found the people living at SignHealth Claridge Road were encouraged to live as independently as possible. There were procedures in place to ensure people received appropriate support to manage their medicines. Cleaning schedules were in place and people were provided with support to maintain a clean and tidy environment.

We found the provider carried out a range of pre-employment checks in line with regulatory requirements and carried out police checks to ensure staff were safe to work with vulnerable people.

The registered manager submitted a monthly report to head office which provided information on any issues or problems in the service. This enabled the provider to monitor the quality of service provided.

The provider kept appropriate records that contained relevant information which were stored securely and could be accessed easily.

We spoke with four people who used the service and they told us they were happy with the service they had received. Comments included: “Everything has been fantastic”, “You can’t improve on perfection” and “The support they give is excellent, they respect me”.

We found the people living at SignHealth were encouraged to live as independently as possible. The provider had suitable arrangements in place for obtaining and reviewing people’s consent. Detailed care plans were in place for each person who used the service which showed people experienced effective, safe and appropriate care, treatment and support.

People were supported to ensure they had access to adequate food and drink and were encouraged to make healthy choices and eat nutritionally balanced meals.

We saw the layout and management of the premises respected people’s privacy, dignity and choice. The provider complied with legal requirements in order to keep premises safe and had arrangements in place to ensure people were protected against the risks associated with unsafe or unsuitable premises.

We found people’s needs were being met by sufficient numbers of appropriately trained staff. There were clear procedures in place for handling and responding appropriately to comments and complaints and that they were listened to and acted on effectively.

People were very positive about the care and support they received at the service. They felt involved and listened to. Staff were available and supportive. Comments included: "I get fantastic support here." "It is an excellent service. I get a lot of help and support." "I'm getting better here - I'm improving."