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Inspection carried out on 2 May 2019

During a routine inspection

About the service:

Ebbsfleet House is a residential care home that provides personal care for up to five people who may have autism or a learning disability. It is a specialist service for people that have anxious or emotional behaviour that has limited their quality of life and experiences. At the time of our inspection there were five people living there.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

People’s experience of using this service:

The home applied the principles and values of Registering the Right Support and other best practice guidance. These ensured people who live at the home can live as full a life as possible and achieve the best possible outcomes that include control, choice, inclusion and independence.

Since our last inspection people had been supported to achieve goals that were previously considered out of reach. For example, one person had been supported to go shopping, an activity which previously caused a lot of anxiety, and resulted in the person displaying behaviour that could challenge. People were very active, and part of the local community, involved in the local sports centre, and horse-riding stables.

Incidents of behaviour that could challenge had reduced since our last inspection, leading to a decrease in restrictions in place for people. Alongside this, incidents of physical restraint had reduced, and staff worked with external healthcare professionals to reduce the levels of restraint used, which has a positive impact on people. People had been supported to take positive risks, including re visiting activities which previously caused increased levels of anxiety. Staff worked with people, providing picture references to increase understanding of activities, and food choices, as well as to support understanding of healthcare appointments. People had been supported to safely reduce the medicines they were taking.

There was a positive culture within the service, with mutual respect between people and the staff supporting them. Staff were passionate about providing positive outcomes for people and has formed excellent relationships with people. People were supported to express their views and be involved in their care.

The service continued to meet the characterises of Good in all domains.

Rating at last inspection:

At the last inspection the service was rated Good. (28 September 2016)

Why we inspected:

This was a planned inspection based on the rating at the last inspection.

Follow up:

We will continue to monitor intelligence we receive about the service until we return to visit as

per our re-inspection programme. If any concerning information is received, we may inspect sooner.

Inspection carried out on 28 September 2016

During a routine inspection

This inspection took place on 28 September 2016.

Ebbsfleet House is a service for five people who have Autism and learning disabilities. It is a specialist service for people that have anxious or emotional behaviour that has limited their quality of life and experiences. Accommodation for four people is in the main house and there is a separate flat for one person. The home is set in a rural area in a small street with a few other houses nearby. There is a good size garden behind the house and a separate garden alongside the flat. Both are secure. There is a small car park to the side of the property and further parking on the street.

A registered manager and deputy manager were based at the service. 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.

There was a culture of warmth and openness. People were cared for and supported to develop their independence in a secure environment so that their confidence could grow. There were plenty of staff who were well organised to support people’s needs and interests. Staff were committed and worked hard to get to know people so that they could provide a service that suited each person and increased their quality of lifestyle.

The home was run in a family style. It was warm, friendly and everyone’s individuality was respected and nurtured. Staff were trained and competent to carry out their roles. Staff were supervised and had yearly appraisals. All staff were checked before they started work at the service to make sure they were of good character and safe to work with people. People said or expressed that they felt safe in the service and staff had a clear understanding of what could be abuse and how to report it.

There was a clear system of risk assessment to protect people as much as possible without limiting their experiences. Each situation and opportunity was assessed for how it would enhance the person’s quality of life and what the potential risks were. Positive risks taken to help people develop their independence.

Mealtimes were social occasions and were organised around people’s preferences and lifestyle. The kitchen was designed so that it was an open space that was practical for people to use. Everything was accessible and only high risk items such as sharp knives were kept securely out of the way when not being used. People were supported to make their own meals.

The Care Quality Commission is required by law to monitor the operation of the Deprivation of Liberty Safeguards. The registered manager and staff showed that they understood their responsibilities under the Mental Capacity Act 2005 and Deprivation of Liberty Safeguards (DoLS). Mental capacity assessments had been carried out to determine people’s level of capacity to make decisions in their day to day lives and for more complex decisions when needed. DoLS authorisations were in place, and applications had been made for renewal, for people who needed constant supervision because of their disabilities. There were no unnecessary restrictions to people’s lifestyles.

Staff found ways to help people overcome the barriers to their relationships with other people, and that had limited their opportunities to go out and about and live an ordinary lifestyle. Each person had a key worker and co-key worker. Key workers were members of staff who took a key role in co-ordinating a person’s care and promoted continuity of support between the staff team. People were making progress with their social skills and awareness, managing their health and wellbeing and developing their daily living skills.

People were able to express what they wanted using gestures, objects, pictures and photos and had the support of community professionals to d

Inspection carried out on 27 November 2013

During a routine inspection

People who used the service were unable to communicate with us and tell us what they thought of the quality of the care due to their communication difficulties. Through observation during the inspection, we were able to observe staff supporting people who used the service in a respectful way and observed staff taking time to explain, where possible, the options available whilst involving people in making choices.

Through direct observation, discussions with staff and records we viewed, we saw that the service actively encouraged people to be members of the wider community. The service provided imaginative and varied opportunities for people to develop and maintain social, emotional, communication and independent living skills.

We were able to observe people who used the service being supported with their hobbies and interests. People also took part in many every day activities. These included going for a walk and shopping. People were also supported to carry out household chores such as cooking and laundry.

Inspection carried out on 5 November 2012

During a routine inspection

People who lived at Ebbsfleet House had a learning disability and communication difficulties. We were therefore unable to directly speak with them and ask them about their experiences living within the service.

Through observation however during the site visit we were able to observe staff supporting people who use the service in a respectful way and that staff took time to explain where possible the options available and involved them in many activities.

We were also able to speak with a visiting parent during the inspection who expressed her opinions of the service. She felt that the service provided good care, that her son was happy living there and that she had an active say in his care and that the manager and staff team were very good in supporting her son with his needs.

Through direct observation, discussions with staff and records viewed we could see that the service actively encouraged people to be members of the wider community. The service provided imaginative and varied opportunities for people to develop and maintain social, emotional, communication and independent living skills. The staff had a strong ethos and focused on involving people in all areas of their lives.

Inspection carried out on 4 April 2012

During an inspection looking at part of the service

People who use the service were unable to communicate and tell us what they thought of the quality of the care or their environment due to their communication difficulties.

Inspection carried out on 12 December 2011

During a routine inspection

People who use the service were unable to communicate and tell us in any detail what they thought of the quality of the care due to their communication difficulties. Through observation however during the site visit we were able to observe staff supporting people who use the service in a respectful way and that staff took time to explain where possible the options available and involved them in the running of the service. Examples of this were cooking, housework and shopping.

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