Multi Sensory Impairment Enabling (MSIE)

People felt safe and supported by staff. Comments included, "[The staff] are super highly skilled. They have the service user at the heart of the service. They support and advocate for them. I know when they're with them they are 100% safe."

Staff demonstrated an understanding of what might constitute abuse and knew how to report any concerns they might have.

People's individual risks were identified, and risk assessment reviews were carried out to identify ways to keep people safe.

There were safe processes in place for the management of medicines.

Effective infection control measures were in place.

Families generally confirmed that staffing arrangements met their needs. Staffing arrangements matched the support commissioned and staff skills were integral to this to suit people's needs. Health professionals and families commented the service had had issues with recruitment and retaining staff, but the provider was aware and recruitment for suitable specialist staff was ongoing within funding restrictions. At the time of the inspection, 1.7 full time staff were required to meet current overall support hours fully. Where a person's needs increased or decreased, staffing was adjusted accordingly. For example, there were examples where risk had been managed well resulting in less staff required to mitigate the risk.

There were effective staff recruitment and selection processes in place.

People received effective care and support from staff who were well trained and competent. As a specialist

service it was important that people were supported by staff with the specialist training required to meet people's individual complex needs.

Care files were personalised and detailed to reflect people's personal preferences. Their views and suggestions were taken into account to improve the service.

Health and social care professionals were regularly involved in people's care to ensure they received the care and treatment which was right for them.

Staff and management relationships with people were caring and supportive. Staff provided care that was kind and compassionate.

Staff spoke positively about communication and how the registered manager worked well with them and encouraged their professional development. The provider worked hard to instill a culture of care in which staff truly valued and promoted people's individuality, protected their rights and enabled them to develop and flourish. Staff felt respected, supported and valued by the provider which supported a positive and improvement driven culture. Some staff commented that they did not always feel the pay received recognised their specialist skills. The provider was aware of such issues which were related to funding and outside of their control.

A number of methods were used to assess the quality and safety of the service people received. The service made continuous improvements in response to their findings.