Russell Hill

This inspection took place on 7 February 2018. At the last inspection in June 2015 the service was rated 'good' overall and 'outstanding' in our key question "is the service responsive?" At this inspection we found the service remained 'good' overall and remained 'outstanding' in our key question "is the service responsive?"

Since our last inspection, people continued to receive highly personalised care and support, tailored to meet their individual needs, which was leading to demonstrable positive outcomes and enhancements to their quality of life. People remained actively involved in planning and making decisions about their care and support needs. Staff displayed excellent understanding and awareness of people's needs and how these should be met in line with people's specific preferences and choices. Staff understood the importance of respecting people's rights and how to promote equality and inclusion within the service so that people did not experience discriminatory behaviours and practices when being supported with their needs. Relatives said the care and support provided to their family members was helping them achieve a good quality of life.

People were safe living at Independence Homes Limited - 33 Russell Hill. Staff protected people from the risk of abuse and used the provider's safeguarding policy and procedure for reporting any concerns they had about people to the appropriate person and authority. Risks to people's health, safety and wellbeing were assessed and reviewed and staff followed current guidance on how these should be minimised to keep people safe from injury or harm.

The provider ensured risks posed to people by the premises were appropriately managed. The provider

maintained a servicing programme of the premises and the equipment used by staff to ensure those areas of the service covered by these checks did not pose unnecessary risks to people. The premises was kept clean and clear of slip and trip hazards so people could move freely and safely around. Staff followed good practice to ensure risks to people were minimised from poor hygiene and cleanliness when providing personal care, cleaning the premises and when preparing and storing food. Medicines were stored safely and securely and people received them as prescribed.

There were enough staff to keep people safe. The provider maintained recruitment checks to assure themselves of staff's suitability and fitness to support people. Staff had regular and relevant training to keep their knowledge and skills up to date with best practice. Staff were happy in their work, motivated and supported by the provider to meet the values and vision of the service which were focussed on people experiencing good quality care and support.

Staff used information and guidance, based on best practice and current standards to plan and deliver care that would support people to experience good outcomes in relation to their healthcare needs. People's care and support needs were discussed and reviewed with them regularly to ensure the support provided continued to meet these. People were encouraged to keep healthy and well, to eat and drink enough to meet their needs and helped to access healthcare services when needed. The provider's bespoke epilepsy alarm system ensured people received timely support from staff when required.

People were encouraged to do as much as they could to retain their independence and control over their lives. The design and layout of the premises provided people with flexibility in terms of how they wished to spend their time when at home. People were supported to participate in a wide range of personalised and group activities and events to meet their social and physical needs and to build and maintain friendships and relationships with others. They also had access to education opportunities to develop skills and promote their independence.

Staff were warm and welcoming towards people's relatives and friends. They were kind and caring and treated people with dignity and respect. Staff ensured people's privacy was maintained when being supported with their care needs.

People were asked for their consent before care was provided and prompted to make choices. Staff were aware of their responsibilities in relation to the Mental Capacity Act 2005 (MCA) and supported people in the least restrictive way possible. The policies and systems in the service supported this practice.

People, relatives and staff were asked for their views about how the quality of care and support could be improved. Senior staff demonstrated good leadership and were approachable and supportive. Senior staff monitored the quality of care and support provided. They undertook surveys and regular audits of the service and took appropriate action if any shortfalls or issues were identified through these. If people were unhappy and wished to make a complaint, the provider had arrangements in place to deal with their concerns appropriately.

The provider supported the service to continuously improve and worked in partnership with others to develop and improve the delivery of care to people. The provider was assisting in trials of new technology to improve outcomes for people living with epilepsy. Senior staff worked collaboratively with local authorities funding people's care to support to make appropriate decisions about the on-going and future care and support needs of people. The provider was also currently working with a local authority to deliver advanced safeguarding training to managers to further develop their learning about how to deal with concerns effectively and to use learning from these to reduce risks to people's safety.

The service had a registered manager in post who was aware of their registration responsibilities particularly with regards to submission of statutory notifications about key events that occurred at the service.

Further information is in the detailed findings below.

The five questions we ask about services and what we found