SENSE Andlaw House

Updated 16 January 2019

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

This comprehensive inspection took place on 3 and 4 December 2018 and was unannounced. It was carried out by one adult social care inspector and a specialist advisor with expertise in learning disability. We commissioned a British Sign Language (BSL) interpreter to facilitate communication with people living at the service. In the event this was not appropriate because people had their individual and unique communication methods. They were, with their consent, supported during the inspection by the member of staff best able to facilitate communication.

Before the inspection, the provider completed a Provider Information Return (PIR). This is a form that asks the provider to give some key information about the service, what the service does well and improvements they plan to make. We looked at the information in the PIR and looked at other information we held about the service before the inspection visit.

We looked at a range of records related to the running of the service. These included staff rotas, supervision and training records, medicine records and quality monitoring audits. We looked at the care provided to people; observing how they were supported, looking at five care records and speaking with two people to help us understand their experiences. We received feedback from four relatives. We spoke with eleven staff including care staff, the operations manager, registered manager and deputy manager.

Updated 16 January 2019

Andlaw House is a residential care home for people who are deafblind living in Exeter. The home comprises two flats with separate staff teams. At the time of the inspection there were four people living in each flat. People who live there may also have additional complex and diverse needs, a learning disability, and/or a physical disability. The provider is Sense, a national charity organisation for people who are deafblind. Sense use the term 'deafblind' to cover a wide range of people, some of whom may or may not be totally deaf and blind.

At our last inspection we rated the service good. At this inspection we found the evidence continued to support the rating of good and there was no evidence or information from our inspection and ongoing monitoring that demonstrated serious risks or concerns. This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection.

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Why the service is rated Good with an outstanding rating in caring.

The service provided exceptional ways to enable people to communicate effectively to ensure they were involved in decisions. There was an extremely positive approach to human rights to ensure equality and diversity was embedded into practice. 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.

People were at the heart of the service and supported to make decisions about every aspect of their care and support. Staff were creative and innovative in helping people to express their views and participate fully in the world around them. We observed that staff were kind and patient and treated people with dignity and respect. The service was proactive in ensuring people would be treated and cared for equally regardless of their sexual orientation, culture or religion. People were able to maintain ongoing relationships with their families, who were made to feel welcome and kept fully informed about the wellbeing of their family member.

People remained safe at the service. There were adequate numbers of suitable staff to meet their needs and support them to live their lives as they wished. Risk assessments were carried out to enable people to retain their independence and receive care with minimum risk to themselves or others. People continued to be protected by staff who understood what to do if they suspected anyone was at risk of harm or abuse. People received their medicines safely.

People continued to receive effective care because staff had the skills and knowledge required to support them. Good communication in line with people’s assessed needs was key to the support people received at Andlaw House, and the service was compliant with the Accessible Information Standards. People’s healthcare was monitored by the staff and people had access to a range of healthcare professionals according to their individual requirements .

The service remained responsive to people’s individual needs. Care plans were comprehensive, person centred and easy to follow. This meant they provided clear guidance for staff, enabling them to meet people’s needs according to their preferences. People could choose to participate in a range of activities. There was a clear complaints process in place. People’s end of life wishes had not been documented, but action was being taken to ensure this sensitive issue was discussed with people and their relatives at their annual review.

The service was well led. There had been significant changes at the service since the last inspection. 80 per cent of the staff team had left and the provider and registered manager had been working closely with local authority quality assurance and improvement team to address the issues that had undermined the quality and safety of the service. There had been a change in the culture of the service, which had improved communication, openness and honesty and created a more flexible staff team. Staff, people and relatives were extremely positive about the service and the way it was now managed. The provider had effective quality assurance systems in place which enabled them to monitor progress and ensure the continued quality and safety of the service.

Further information is in the detailed findings below.