43 Sedlescombe Road South

Updated 29 March 2022

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.

As part of CQC’s response to the COVID-19 pandemic we are looking at how services manage infection control and visiting arrangements. This was a targeted inspection looking at the infection prevention and control measures the provider had in place. We also asked the provider about any staffing pressures the service was experiencing and whether this was having an impact on the service.

This inspection took place on 25 February 2022 and was announced. We gave the service one day’s notice of the inspection.

Updated 29 March 2022

43 Sedlescombe Road South is a care home providing social and residential care for up to six people with learning disabilities. On the day of our inspection there were four people living in the service. People had varied needs related to their learning disabilities. Some had more specialist needs associated with Autism and with behaviours that challenged. People who lived at the service were adults below the age of thirty-five. People had different communication needs. Some people had limited verbal communication, and other people used gestures and body language to make their needs known. The provider owned four other care homes locally.

People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. The Care Quality Commission (CQC) regulates both the premises and the care provided, and both were looked at during this inspection.

The care service 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.

This comprehensive inspection took place on 16 and 17 January 2018 and was announced. It was the first inspection since the service was registered. 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. The registered manager was also the manager of four other homes locally.

There were exemplary systems to assess and plan new admissions to the service. Transition plans included advice and guidance from people’s relatives and specialist professionals. These were based on people’s individual needs. Social stories were used to ensure people were as far as possible involved every step of the way and the systems ensured staff worked consistently and effectively to achieve maximum success. (Social stories are short descriptions of a particular situation, event or activity, which include specific information about what to expect in that situation and why). All of the people living at the service had very complex needs and required differing levels of support. Relatives spoke very positively of the service. One relative told us staff had a, “Can do attitude and carry things through. They have a plan for (relative) that I believe will happen. He now has a future.” A health professional told us, “The assessment, transition and discharge process was robust and the manager and staff worked well with the person his family and other professionals to ensure all went smoothly. Good communication and support planning with person centred training and crisis planning in place through transition.”

Most people were not able to tell us verbally if they had any concerns about the service. The registered manager had recently introduced a new system to assess and analyse incidents to determine if they had occurred as a result of a person’s frustration or were an indicator they were unhappy at that time about the way they were supported. The results had been extremely beneficial and were to be used as a way of enhancing the training provided to staff. Whilst the service already looked at why incidents occurred and how to minimise a reoccurrence, the new system gave greater clarity on people’s expectations and the consistency in approach they needed to make them feel safe.

There were commendable systems to ensure people were supported to attend health care appointments. Due to one person’s complex needs it had been a long time since they had attended a GP appointment. The service worked with the surgery to arrange an appointment at the quietest time of day. A staff member checked with reception when the GP was ready and the person was taken straight to the GP without having the stress of spending time in the waiting room. What could have been a very anxious time for the person, was handled well to reduce the risk of an incident. This meant that the next time an appointment was needed, the person would be more likely to respond positively.

People were encouraged to make decisions and choices. They 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. Best interest meetings, with a multidisciplinary approach, were held when necessary to ensure people’s needs were met.

People’s needs were effectively met because staff had the specialist training and skills they needed to meet people’s complex needs. Staff attended regular supervision meetings and received an annual appraisal of their performance. Staff supported people in the least restrictive way possible.

People were observed to be relaxed and content in their surroundings and there was warm and friendly atmosphere. People were supported to take part in a variety of activities to meet their individual needs and wishes. There were enough staff who had been appropriately recruited, to meet people’s individual needs.

There was excellent leadership with very good lines of communication between the staff team and the registered manager. Staff felt supported and spoke positively of the registered manager. There were robust systems for reviewing the quality of the care and support provided and the owners were involved regularly to check on the running of the service. The registered manager had very strong links with local organisations to gain advice and support that would benefit the organisation and to provide support for other services for people with learning disabilities.

Further information is in the detailed findings below.