Archived: Pepenbury

Updated 16 December 2016

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 inspection took place on 28 and 29 September 2016 and was unannounced. The inspection team consisted of three inspectors, one specialist advisor and one expert by experience. The advisor was specialised in learning disabilities and behaviours that challenge. An expert by experience is a person who has personal experience of using, or caring for someone who uses this type of service.

Prior to this inspection we reviewed all the information we held about the service, including data about safeguarding and statutory notifications. Statutory notifications are information about important events which the provider is required to send us by law. Before the inspection, the provider had 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 took the PIR in consideration.

As some people who live at Pepenbury were not consistently able to tell us about their experiences, we observed the care and support being provided for them. We talked with relatives and other people involved with people's care provision during and following the inspection. As part of the inspection we visited seven of the eight houses and spoke with the registered manager, one senior manager, four care co-ordinators, one community nurse, ten care staff, 12 people and seven people's relatives. We looked at a range of records about people's care and how the service was managed. We looked at 13 people's care plans, medication administration records, risk assessments, accident and incident records, complaints records, health and safety checks, fire safety documentation and quality audits that had been completed.

We last inspected Pepenbury in March 2014 when no concerns were found.

Updated 16 December 2016

We inspected Pepenbury on 28 and 29 September 2016. The inspection was unannounced. Pepenbury is a residential care service which offers accommodation and support for up to 56 adults with a learning disability and other associated needs, such as physical disability. At the time of the inspection there were 56 adults living at the service in 8 residential houses on the Pepenbury site. People were grouped in the homes with people of a similar level of ability or diagnosis. Some people had profound learning disabilities and physical disabilities, some people had autism spectrum disorder, other people had behaviours that challenge and some people had moderate learning disabilities. Some people were able to communicate verbally and other people had severe communication difficulties. The site is on the outskirts of Tunbridge Wells and people are accommodated in eight detached houses.

At the time of our inspection there was a registered manager at the home. 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.

Risks to people's safety had been assessed and actions taken to protect people from the risk of harm. The provider had systems in place to protect people against abuse and harm. The provider had effective policies and procedures that gave staff guidance on how to report abuse.

The registered manager had robust systems in place to record and investigate any concerns. Staff were trained to identify the different types of abuse and knew who to report to if they had any concerns.

Some premises had been adapted to meet people’s needs but some environments, such as bathrooms were in need of refurbishment. We have made a recommendation about this in our report.

Medicines were managed safely and people had access to their medicines when they needed them.

Staff were well trained with the right skills and knowledge to provide people with the care and assistance they needed. Staff met together regularly and felt supported by the management team. Staff were able to meet their line manager on a one to one basis regularly. There were sufficient staff to provide care to people throughout the day and night. When staff were recruited they were subject to checks to ensure they were safe to work in the care sector.

Where people did not have the mental capacity to understand or consent to a decision, the provider had followed the requirements of the Mental Capacity Act (2005). An appropriate assessment of people's ability to make their own decisions had been completed. Where people's liberty may be restricted to keep them safe, the provider had followed the requirements of the Deprivation of Liberty Safeguards (DoLS) to ensure each person's rights were protected.

People had enough to eat and drink, and received support from staff where a need had been identified. People's special dietary needs were clearly documented and trained staff ensured these needs were met.

The staff were kind and caring and treated people with dignity and respect. Good interactions were seen throughout the day of our inspection, such as staff talking with people as equals. Staff knew the people they cared for well and treated them with kindness, compassion, dignity and respect.

People could have visitors from family and friends whenever they wanted. People and [most of?] their relatives spoke positively about the care and support they received from staff members.

People received a person centred service that enabled them to live active and meaningful lives in the way they wanted. People had freedom of choice at the service. People could decorate their rooms to their own tastes and choose if they wished to participate in any activity. Staff respected people's decisions.

People felt well cared for and were supported with a variety of activities. People had individualised activities planners that reflected their choices and interests.

Support plans ensured people received the support they needed in the way they wanted. People’s health needs were well managed by staff so that they received the treatment and medicines they needed to ensure they remained healthy. Staff responded effectively to people's individual needs.

Staff interacted with people very positively and people responded well to staff.

The culture of the service was open and person focused. The registered manager provided clear leadership to the staff team and maintained an active presence in the home.

Audits to monitor the quality of service were effective and embedded. They identified actions to improve the service which were followed up and carried out.