Background to this inspection
Updated
1 May 2018
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 13 February 2018. It was unannounced.
This was a comprehensive inspection, which took place because we carry out comprehensive inspections of services rated Good at least once every two years. The inspection was carried out by one inspector.
Before the inspection, we asked the provider to complete 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 looked at previous inspection reports and notifications about important events that had taken place in the service, which the provider is required to tell us by law. We used all this information to plan our inspection.
Some people were unable to tell us about their experiences, so we observed care and support in communal areas. We telephoned one relative to ask for feedback about the service which is provided for their loved ones. We spoke with seven staff, which included support workers, team leaders, the registered manager, the visiting service quality compliance manager and the business development manager.
We requested information by email from local authority care managers and commissioners who were health and social care professionals involved in the service and an advocate involved with the service. We also contacted Healthwatch to obtain feedback about their experience of the service. There is a local Healthwatch in every area of England. They are independent organisations who listen to people’s views and share them with those with the power to make local services better.
We looked at the provider’s records. These included two people’s care records, which included care plans, health records, risk assessments daily care records and medicines records for all five people living at the service. We looked at three staff files, a sample of audits, satisfaction surveys, staff rotas, and policies and procedures.
We asked the registered manager to send additional information after the inspection visit, including audits and reports. The information we requested was sent to us in a timely manner.
Updated
1 May 2018
The inspection took place on 13 February 2018. The inspection was unannounced.
At our previous inspection on 06 January 2016, we found a breach of Regulation 12 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. The provider had failed to properly manage medicines. We asked the provider to take action and meet the regulation.
The provider sent us an action plan on 15 March 2016. The action plan detailed that they had already made changes and were meeting the regulation.
Kent Autistic Trust – 9 Perry’s Close 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. The service accommodates six people with an autistic spectrum condition in one purpose built building. There were five people living at the service when we inspected.
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.
The management of the service was overseen by a board of trustees for The Kent Autistic Trust. Trustees and the chief executive officer for the trust visited the service regularly.
There was a registered manager in place. 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.
Medicines practice at the service had improved. People received their medicines when they should and medicines were handled safely.
The service provided good quality person centred care and support to people enabling them to live as fulfilled and meaningful lives as possible.
Staff and people received additional support and guidance from the provider’s positive behaviour support team which also consisted of a speech and language therapist and occupational therapist. Strategies were in place to manage any incidents of heightened anxiety and behaviours that others may find challenging.
People and their relatives had opportunities to give feedback about the service in a variety of ways. People were enabled to feedback about their service through weekly house meetings and their annual review meetings. Relatives were positive about the service received.
The provider had sustained good practice, development and improvement at the service. The provider had achieved accreditation and continued to work in partnership with organisations to develop best practice within the service.
The provider had a strong set of values that were embedded into each staff member’s practice and the way the service was managed. Staff were committed and proud of the service. The provider and registered manager used effective systems to continually monitor and improve the quality of the service.
Staff knew how to protect people from the risk of abuse or harm. Staff followed appropriate guidance to minimise identified risks to people's health, safety and welfare.
People had been supported within the service in a person centred manner to understand death and dying to support them to understand about the sad loss of a friend and housemate. People were supported to celebrate the person’s life and to remember the person.
The registered manager understood their responsibility to comply with the requirements of the Mental Capacity Act 2005 (MCA) and Deprivation of Liberty Safeguards (DoLS). 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 support this practice.
People were supported to eat and drink enough to meet their needs. People were enabled to make themselves drinks and snacks when they wanted them. People received the support they needed to stay healthy and to access healthcare services.
Staff respected people’s privacy and dignity. Interactions between staff and people were caring and kind. Staff were patient, compassionate and they demonstrated affection and warmth in their discussions with people.
Care plans detailed people’s preferred routines, their wishes and preferences. They detailed what people were able to do for themselves and what support was required from staff to aid their independence wherever possible. People were supported to achieve their goals and aspirations. People were involved in review meetings.
The provider operated safe and robust recruitment and selection procedures to make sure staff were suitable and safe to work with people. There were suitable numbers of staff to safely meet people’s needs. Staff received regular training and supervision to help them to meet people's needs effectively.
Further information is in the detailed findings below.