Grindon

Grindon is a 'care home'. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

Grindon accommodates four people in one adapted building. Three people live in the main house and one person lived in an attached flat below the main house. People living at this service have autism, learning disabilities and also a hearing loss so they communicate using signing. Staff working at the service were all able to communicate using British sign language.

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." Registering the Right Support CQC policy

The service had a registered manager who was registered to manage this service and another one locally for four people. 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.

At the last inspection completed in April 2016 we rated the service as overall good with outstanding in the key area of caring. At this inspection we found caring continued to be an area which staff and the organisation excelled at. We also found the service was outstanding in the key area of well-led. This meant their overall rating had improved to outstanding.

People were being supported by staff who were highly skilled, sensitive to their needs and who worked in a truly person-centred way. Each person was afforded opportunities to continue their interests and hobbies, but also to stretch themselves and try new things. This was inspirational as sometimes people with autism struggle to try new things or go to new places. With careful planning and skilled support, people were accessing community facilities and trying activities such as surfing, holidays and shopping for their own groceries.

The management team were inclusive and forward thinking. They ensured staff understood the core values and ethos of the service which was to provide young people with a safe homely environment and enable

them to develop and enhance their skills. The service provided innovative training and support to enable them to provide the care in a way which respected people as individuals and celebrated their diversity.

Training was seen as key to ensuring staff were skilled and able to work effectively with people with complex needs. Staff had support, supervision and felt valued for their role. Staff confirmed the management approach was open and inclusive. Their ideas and suggestions were listened to and they believed good teamwork was at the heart of being successful in helping the young people who lived at the service.

The management team had developed tools and audits to help the service continually improve. This included seeking and acting on the views of people and stakeholders.

The ethos and culture of the service was to promote people's individuality and provide a safe and supportive environment from which people could develop their skills and learning. The management team and staff group understood and worked in a way which showed they truly believed in ensuring people had opportunities to grow and develop their skills and potential.

There were sufficient staff with the right skills and understanding of people's needs and wishes. This meant outcomes for people had improved. People were enjoying more activities and interactions in the local community. People said staff were kind and helpful. Our observations showed staff respected people's dignity and privacy and worked in a way which showed kindness and compassion.

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's consent to care and treatment was sought. Staff worked within the requirements of the Mental Capacity Act (2005) (MCA) and Deprivation of Liberty Safeguards (DoLS) and understood how these applied to their practice.

Care and support was person-centred and well planned. Staff had good training and support to do their job safely and effectively. Risk assessments were in place for each person. These identified the correct action to take to reduce the risk as much as possible in the least restrictive way. People received their medicines safely and time. We made one recommendation in respect of recording of medicines in line with best practice guidance.

The five questions we ask about services and what we found