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Inspection carried out on 7 June 2017

During a routine inspection

Care service description.

Chilmington House is a care home providing accommodation and personal care support for up to seven people who have a learning disability and sometimes additional physical disabilities. The service is provided in a single story building to promote accessibility.

Rating at last inspection.

At the last inspection, the service was rated Good.

Rating at this inspection.

At this inspection we found the service remained Good.

Why the service is rated good.

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 rights and freedom were protected by staff who also advocated strongly with external services to ensure people’s needs were met.

People were kept safe by a staff team who understood how to do this and had attended relevant training. Health and safety and risk assessment systems also helped ensure people and staff were as safe as possible.

Staff were caring, involved people and their representatives in decision making and listened to their wishes. Relationships between people and staff were relaxed, positive and respectful. People’s dignity and privacy were promoted by the staff.

The service responded positively and in a timely way where people’s needs changed. People had access to a range of appropriate activities and events to reflect their culture, gender and interests.

The views of people and their representatives were listened to and the service took action to address any points raised.

The service was well led by a consistent management team who had effective system to monitor its day-to-day operation and the approach of staff.

Further information is in the detailed findings below

Inspection carried out on 14 April 2015

During a routine inspection

The inspection took place on 14 April 2015 and was unannounced. The service provides personal care support for up to seven people with a learning disability or who had needs within the autistic spectrum. Some people may have additional physical disabilities or sensory impairment. Care was being provided to six people at the time of the inspection.

The service was required to have a registered manager and one was 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.

The service met people’s needs effectively and staff knew the people and how they communicated their wishes and emotions very well. We saw that people had positive relationships with staff and trusted them. People’s expressions and some verbal feedback indicated that people felt safe and well cared for.

Staff were kind and patient and involved people in day-to-day decisions about their care as much as possible. People were encouraged and given time to make choices for themselves and staff checked with them before providing care support.

People’s rights were safeguarded and each had the support of either family or local authority advocates. Feedback about the service from external professionals was very positive and no concerns had arisen regarding the care provided since the last inspection.

People had very good access to the local community and a wide range of activities supported by staff. The service had two adapted vehicles to ensure everyone could access the community.

People’s moves into the service from elsewhere were managed very well at the right pace for the person’s needs. Staff were well trained, effectively supported and were enthusiastic and motivated in their work.

People’s health and dietary needs were met by staff and people could choose what they wanted to eat. The service managed people’s medicines effectively on their behalf and in people’s best interests.

The provider had a clear set of values and ethos for the service which staff understood and followed. The service was well managed and monitored by the management team and the provider.

Inspection carried out on 8 April 2014

During a routine inspection

We considered all the evidence we had gathered under the outcomes we inspected. We used the information to answer the five questions we always ask;

Is the service caring?

Is the service responsive?

Is the service safe?

Is the service effective?

Is the service well led?

This is a summary of what we found-

Is the service safe?

We found that people were cared for in an environment that was safe, clean, well maintained and adapted to meet their needs. Regular servicing and maintenance was carried out and we saw records which confirmed that.

Where people�s health had changed, the home had sought the advice of external healthcare specialists appropriately to maintain their wellbeing and safety. We saw that the staff were aware of the needs of the individuals they were supporting.

CQC monitors the operation of the Deprivation of Liberty Safeguards (DoLS) which applies to care homes. We found that the home liaised effectively with the local authority DoLS team and had made applications as appropriate.

Is the service effective?

We saw that people�s needs were met by a knowledgeable staff team who were well trained and supported. People�s needs had been effectively met and any changes were referred to management and acted upon. We saw that the people supported enjoyed positive relationships with the staff. The family members we spoke with told us the home met people�s needs effectively and provided them with a fulfilling lifestyle. Relatives also praised the home's management of health needs and said they were kept informed and consulted appropriately. One relative said: �X is extremely lucky to be there.� and another told us: �X has improved so much since being there.�

Is the service caring?

We saw staff working in a caring and inclusive way while supporting people. They enabled people to make decisions and choices and understood their non-verbal communication. One of the relatives told us the staff were: �brilliant at reading X�s body language.� We saw that staff gave people the time they needed to make these choices and to do things such as eating their meal in an unhurried way. The relatives we spoke with told us the staff were very caring. Two gave the example of staff remaining with people when in hospital to ensure their needs continued to be met. One relative said: �X adores the staff and now smiles much more than in the past.�

Is the service responsive?

We saw that people�s care plans and other documents recorded people�s needs and any changes in these over time. We saw that the home responded promptly to any changes and sought appropriate advice or healthcare support.

Care was provided based on people�s known and indicated wishes and preferences. People had access to meaningful activities and the community. In one situation, where a person�s access to an activity had been curtailed due to an incident, an alternative location was found to ensure this activity could continue. One of the relatives we spoke with told us that staff brought the person they supported to their home to visit them. The three relatives we spoke with all said their views had been sought through regular surveys, during care reviews and at other times where issues had arisen.

Is the service well-led?

We found that the home provided consistent care to people and was well-managed. There were clear lines of responsibility and people were supervised and supported in their roles. A range of audit and monitoring systems were used by the management team to maintain an effective overview of the home�s operation. The management undertook out-of-hours monitoring visits and we saw that action had been taken to respond where issues had been identified. The views of people�s advocates and relatives were sought and acted upon. One relative told us: �I have no concerns at all.�

Inspection carried out on 5 June 2013

During a routine inspection

People�s needs were recorded in detail in the care plans and met effectively in the home. Care was delivered on an individualised basis and staff demonstrated a good understanding of people�s needs and preferences. People were encouraged to make choices where possible about their daily lives. Good records were maintained of significant day-to-day issues.

People had access to a range of activities and opportunities within the home and in the community. Their healthcare needs were met and the home liaised well with external healthcare professionals.

Individuals in the home were safe and the home acted in an advocacy role to promote and safeguard people�s best interests.

Medication was well managed in the home and records were properly maintained. Staff had received training to manage the medication and followed the procedures.

Effective recruitment and selection procedures were in place to check the suitability of applicants and staff all received an induction.

The manager had effective systems to monitor the operation of the home. The manager had sought the views of people�s representatives and involved healthcare professionals, about the care provided. Complaints were taken seriously and thoroughly investigated

Inspection carried out on 30 April 2012

During a routine inspection

We used a number of different methods to help us understand the experience of people using the service because the people themselves had complex needs which meant they were unable to tell us directly. We spoke to one person�s advocate who visited the home and an external healthcare professional. We read the quality survey forms completed recently by relatives of people in the home, their care managers and other interested parties. We also observed some of the interactions between people in the home and the staff, at lunchtime and at other points during the inspection. We examined the home�s complaints log.

People told us that the staff were committed to meeting the needs of those using the service. They said the staff worked well with external healthcare professionals and others involved in the care of people in the home. They told us that the staff supported the people in the home to make choices in their daily lives and about their care. The feedback from the recent quality monitoring survey was very positive.

Reports under our old system of regulation (including those from before CQC was created)