Archived: The Kent Autistic Trust - 30 The Close

The Kent Autistic Trust – 30 The Close is a small care home for up to six people with learning disabilities and/or autistic spectrum disorder aged 18 years and over. There were four people living at the service at the time of inspection.

The service has been developed and designed in line with the principles and values that underpin Registering the Right Support and other best practice guidance. This ensures that people who use the service can live as full a life as possible and achieve the best possible outcomes. The principles reflect the need for people with learning disabilities and/or autism to live meaningful lives that include control, choice, and independence. People using the service receive planned and co-ordinated person-centred support that is appropriate and inclusive for them.

People’s experience of using this service:

The outcomes for people using the service reflected the principles and values of Registering the Right Support in the following ways; staff recognised that people had the capacity to make day to day choices and supported them to do so. People were encouraged to be independent. People were engaging in the community, for example using their local community to utilise ordinary community resources, shops, access leisure activities and to access day services and recreational activities to ensure they had a good day. People were also supported to take holidays.

The provider and staff were very responsive and worked continuously to make improvements to the service and provide people with high quality care. The provider and staff demonstrated a detailed knowledge of the people they supported and over time had developed trusting relationships with them, so that people felt safe receiving support. The provider had been responsive to people’s needs and had supported people with understanding and processing the death of loved ones in a way they understood. Staff had recognised that people were unhappy in some situations and had supported them to make positive changes to their environment which resulted in people being happy. People were happy and smiling, relatives were very happy with the service. One relative said, “We are very happy. He is very happy and they take good care of him.”

The service was well-led. The management team knew people very well, the registered manager spent time on shift working with people and staff. The management team carried out the appropriate checks to ensure that the quality of the service was continuously reviewed, improved and evolved to meet people’s changing needs. The provider promoted an open culture and was a visible presence in the service, staff felt supported by the provider and the registered manager, they felt listened to and valued. Relatives were surveyed for their views and felt these were acted upon. 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.

Staff were well trained and received consistent support and guidance. For people, this meant that they were always placed at the heart of decisions about the way in which they received support. Support plans guided staff in the support they provided to people in accordance with their needs and preferences. People were provided with individualised care and support as well as activities both in the service and in the community to keep them occupied and stimulated. A relative told us, “Staff are experienced and have a good knowledge of autism.”

People received a safe service and were protected from harm, staff had a detailed understanding of individual risks and danger for each person. Staff understood the measures in place to keep people safe. People were supported by enough staff with the right skills and knowledge to understand their needs and provide support in a person-centred way. The provider took care in their selection of staff, and all required checks helped ensure they were recruited safely.

People were involved in food shopping, planning their menu and where possible the preparation of food and cooking. People were encouraged and supported to be as independent as possible. People were supported to access routine and specialist healthcare appointments when they needed to.

The service continued to provide effective and safe support to people living with a learning disability and or autism. People were provided with good support to communicate, staff knew people well and understood their communication. People were supported to manage their emotions and had positive behaviour support strategies in place. Relatives told us that they had seen a positive change in their loved ones. People were supported to feedback on their experiences and contribute to planning their own support in ways which were suitable for their communication needs. For example, through using pictures, stories, signing and electronic communication.

Staff treated people with dignity and respected their privacy. Staff communicated well with relatives and welcomed them into the service, and sought their feedback about the service, which relatives felt was listened to and acted upon.

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.

The service met the characteristics of Good in all areas. For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection:

The service was rated Good at the last inspection on 06 September 2016 (the report was published on 28 October 2016).

Why we inspected:

This inspection was a scheduled inspection based on previous rating.

Follow up:

We will visit the service again in the future to check if there are changes to the quality of the service.

The Kent Autistic Trust – 30 The Close is a care home providing personal care and accommodation for up to six adults with an autistic spectrum condition. The home is set out over three floors. There were six people living in the home on the day of our inspection.

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.

The service had a registered manager. 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 and associated Regulations about how the service is run. The registered manager was on holiday when we inspected.

At our previous inspection on the 22 May 2015 we found a breach of Regulation 12 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014, medicines had not been well managed. We asked the provider to take action in relation to Regulation 12 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. At this inspection, we found improvements had been made to the management of medicines.

People were unable to verbally tell us about their experiences. People were relaxed around the staff and in their own home. We received positive feedback from relatives about all aspects of the service.

Staff knew and understood how to safeguard people from abuse, they had attended training, and there were effective procedures in place to keep people safe from abuse and mistreatment.

Risks to people had been identified. Systems had been put in place to enable people to carry out activities safely with support. One risk assessment needed updating following an incident. We made a recommendation about this.

Medicines were appropriately managed to ensure that people received their medicines as prescribed. Records were clear and the administration and management of medicines was properly documented.

Staff and people received additional support and guidance from the behaviour support manager when there had been incidents of heightened anxiety. Staff received regular support and supervision from the management team.

There were suitable numbers of staff on shift to meet people’s needs. The provider followed safe recruitment procedures to ensure that staff working with people were suitable for their roles. Robust recruitment procedures were followed to make sure that only suitable staff were employed.

Procedures and guidance in relation to the Mental Capacity Act 2005 (MCA) was in place which included steps that staff should take to comply with legal requirements. Staff had supported people to understand decisions that needed to be made with regard to their health.

The Care Quality Commission (CQC) monitors the operation of the Deprivation of Liberty Safeguards (DoLS) which applies to care homes. Best interests meetings had taken place with relevant people. Where people were subject to a DoLS, the management team had made appropriate applications.

People had access to drinks and nutritious food that met their needs and they were given choice.

People received medical assistance from healthcare professionals when they needed it. Staff knew people well and recognised when people were not acting in their usual manner and took appropriate action.

Relatives told us that staff were kind, caring and communicated well with them. Interactions between people and staff were positive and caring.

People and their relatives had been involved with planning their own care. Staff treated people with dignity and respect. People’s information was treated confidentially and personal records were stored securely.

People’s views and experiences were sought during meetings and by completing questionnaires.

People were encouraged to take part in activities that they enjoyed, this included activities in their home and in the local community. People were supported to be as independent as possible.

The complaints procedure was on display within the service, this was also available in an easy read format to support people’s communication needs.

Relatives and staff told us that the service was well run. Staff were positive about the support they received from the senior managers within the organisation. They felt they could raise concerns and they would be listened to.

Communication between staff within the service was good. They were made aware of significant events and any changes in people’s behaviour. Handovers between staff going off shift and those coming on shift were documented, they were detailed and thorough.

The provider and registered manager had notified CQC about important events such as safeguarding concerns these had been submitted to CQC in a timely manner.

Audit systems were in place to ensure that care and support met people’s needs and that the service was suitable for people. Actions arising from audits had been dealt with quickly.

People's care needs had been clearly assessed and guidance was in place to help staff to support their individual needs. People were supported to take part in daily living skills and access the local community.

Staff supported people to maintain their health. People were offered food choices and their dietary needs were assessed and monitored.

Staff had received training in how to recognise and respond to any form of abuse in the home. One person told us that they would talk to the home manager if they had any concerns.

The home was clean and procedures were in place to minimise the spread of any infection.

Systems were in place to monitor the quality of the care in the home. People who lived in the home and their relatives were regularly asked for their views about the service.

We found that people were treated with respect and dignity. People were supported in promoting their independence and were involved in activities of their choosing like swimming, camping and holidays.

We saw people involved in preparing their evening meal and drinks and told us that they were involved in planning their menu. One person said he "liked meatballs with onion" but had also made some without for those who didn`t.

We found that staff communicated using a variety of techniques in order to meet individual needs such as touch, sign language and the use of pictures.

We saw that staff treated people with dignity and respect, were seen to knock on doors and provided personal assistance in a kind and discreet manner.

There was a relaxed and comfortable atmosphere within the home and the staff we spoke to understood how to support people, assisted them to make choices and maintain as much independence as possible.

Family members we spoke to told us that the standard of care provided was excellent and the place was "just like home." It`s a "normal environment." They said people had "much more freedom to choose what to do" and the home enabled them to "settle in well due to the environment and staff."