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The Kent Autistic Trust - 165 Jemmett Road Good

Reports


Inspection carried out on 6 April 2018

During a routine inspection

Care service description

165 Jemmett Road is a residential care home for six people with learning disabilities. The service is a detached property, set over two floors in a residential area of Ashford.

165 Jemmett Road 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. 165 Jemmett Road accommodates six people in one adapted building.

Rating at last inspection

At the last inspection, the service was rated Good in Safe, Effective, Caring, Responsive and, Requires improvement in Well-Led

Rating at this inspection

At this inspection we found the service remained Good in Safe, Effective, Caring, Responsive and had improved to Good in Well-Led

Why the service is rated Good

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 life as any citizen.

At the time of the inspection a registered manager was not in post, which is a condition of the service’s registration. 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 provider had recruited a manger that was going through the registration process at the time of our inspection. The service was managed day to day by the manager, who is referred to as such in this report.

The service continued to safeguard people from potential harm or abuse, and worked closely with the local safeguarding team. Risks to people had been assessed and mitigated, and people were being supported to take risks. People were supported by a stable staff team, that knew them well and had been recruited safely. There was an effective process in place for ordering, administering and disposing of medicines, which meant people received their medicines when needed. People were protected by the prevention and control of infection, the service was clean and tidy without odour. Lessons were learnt when things went wrong, and improvement plans put in place to ensure the best outcomes for people.

People’s needs continued to be assessed, and the service and Provider learnt from, and implemented best practice. Staff continued to be offered consistent training, which enabled them to care for people in the best way. People were encouraged to maintain a healthy diet, and were involved in the menu choice, and food ordering or shopping. During the inspection we saw examples of the service working internally and externally to deliver the best health outcomes for people. This included making sure people had access to a wide range of healthcare services and professionals. Staff had worked to adapt the service to meet the needs of people, supporting them to personalise areas, and creating spaces such as the sensory room for people to relax and enjoy. People’s consent was sought, and staff were working within the principles of the Mental Capacity Act (MCA). 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 was consistently caring. People continued to be treated with kindness and respect. People clearly liked the staff supporting them, and relative feedback was that people were consistently treated with compassion. People were supported in a variety of ways to have their views known, and the service continued to explore new communication m

Inspection carried out on 12 and 14 October 2015

During a routine inspection

The unannounced inspection took place on the 12 and 14 October 2015. 165 Jemmett Road provides accommodation and support for up to six people who have a learning disability or autistic spectrum disorder. The service had last been inspected in November 2013 and had been compliant with our regulations.

There were six people living at the service at the time of our inspection. Each person had their own room on the first floor of the property. On the ground floor was a communal kitchen, lounge, dining room, office, laundry room and toilet facilities. There were also two shared bathrooms on the first floor. There was a large well maintained garden which could be accessed from most rooms on the ground floor. All people were able to access the shared facilities of the home. People could not freely leave as there was a keypad system on the main entrance/exit. People living at the service had been subject to the Mental Capacity Act 2005 (MCA) and Deprivation of Liberty Safeguards (DOLS). During our visit one person was away visiting their family. All other people living at the service attended day services from Monday until Friday form 10:00am until 04:00pm.

A registered manager was not in post at the time of our visit which is a requirement of the registration of the service. However, a new manager had been appointed and visited the service during the inspection 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.

Staff had not received regular supervision to fulfil their role since the previous registered manager had left. Staff were having to work extra hours to keep up to date with paperwork and cover the shortfall in staff numbers while recruitment was underway.

Maintenance of the service was not always responded to in a timely way and some areas of the service had been left in need of repair. Although the provider had taken action to address these issues with the owners of the property the repairs had been unresolved.

Some documentation had not been updated recently. Internal audits that the provider had made had also identified this. However, individual care plans were personalised and detailed and written in a format to help the person understand its content.

Statutory notifications had not been submitted to the Commission without delay which is a requirement of the regulations, although processes had been put into place to improve this.

Staff understood the Mental Capacity Act 2005 and the service has taken the appropriate steps to meet the requirements of this law.

Staff were trained to recognise and report abuse. There was up to date safeguarding and whistle blowing policies and procedures to follow which were in an easy read format. Staff were able to describe the actions they would take if they suspected or saw abuse.

Risk assessment were person centre and identified how people could be supported in a way which reduced risks and considered their preferences. Risk assessments were written in a format which would help people understand their content.

Staff had suitable skills, knowledge and experience to meet the needs of people. People received a high level of support and the service adapted support levels when people’s needs changed. Safe recruitment processes were followed and staff only commenced work once the required safety checks had been completed. New staff were offered a comprehensive induction package including mandatory training.

Staff received support from the organisations internal specialist team who helped with behaviours and communication. The behaviour specialist would analyse incidents and help staff implement new ways of working to help people manage their behaviours.

Robust processes were in place to ensure people received their medicines safely and in a way which suited their needs. Medicine was stored, administered, recorded and audited safely. Staff had a good understanding around the process and importance of handling medicines safely.

People were encouraged to make individual choices around their food and drink. People could have snacks and drinks when they wished. Peoples health needs were responded to promptly and referrals to outside professionals were made without delay.

People were supported by staff who showed care and compassion. People were spoken to in a way which was respectful and dignified, staff understood people’s needs well. People were free to move around their home and staff responded to their wishes.

There was an up to date complaints policy in an easy read format to help people understand how to complain.

Inspection carried out on 25 November 2013

During a routine inspection

We visited the people and staff on a Monday morning, but found that most people had already left for their planned day. We spoke briefly with one person and observed the support provided to another. One person signed they were ‘OK’, and then indicated to leave them alone. This was respected fully and staff explained that it was important the person’s getting ready to go out routine remained consistent.

We spoke with two staff, the manager and a visiting manager from another part of the organisation. We observed that people were supported by staff who knew them well. We saw that the two people who were at home were supported exactly as described in their written care plan. We read that where people had become distressed, the service had carried out an effective fact finding process and had worked out the problem. They had then made adjustments to the way support was provided, helping the person to remain happy and calm.

We saw that care and support was highly individualised and focused on increasing people’s skills and independence. We saw that consent was obtained from people, and for more complex decisions, using their circle of support for a best interests review.

We found people were given support to purchase and make food which was nutritious.

Staff and management had a full working knowledge of safeguarding people from abuse. Medicines were managed safely and in line with the organisational policy.

Inspection carried out on 13 March 2013

During a routine inspection

At the time of inspection five people were living at the service. We used different methods to help us understand the experiences of people because they had complex needs which meant they were not able to tell us their experiences. A relative told us that the service meets their relative’s needs “very well. The staff really do understand [their relative] so well; it is the next best thing to [their relative’s] family or being at home.” Another relative told us the service accommodated their relative’s preference for specific staff to support them and the manager was always polite and kept them updated about their relatives care. Their relative had regular dental check ups and they intended to find out about the plan to manage their long term dental needs.

We saw that people were involved in making day to day decisions, including their menu and decoration of their bedroom. There was a process in place to assess people’s needs before they moved into the service. We saw that care was delivered in line with their care plans and this was regularly reviewed.

We saw that the environment was suitable in layout for people to move about freely and was well maintained.

Staff told us they were trained and well supported to be able to undertake their role safely and effectively. One staff member told us “we plan activities and staff know what people like”.

We saw that there were effective systems in place to regularly monitor service delivery.

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