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Inspection carried out on 25 April 2019

During a routine inspection

About the service:

Whitstable Road is a residential care home that accommodates up to six people with a learning disability. At the time of the inspection there were six people living at the service.

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.

People’s experience of using this service:

People's outcomes were consistently good and feedback about the service confirmed this.

People were supported by a core team of consistent staff, who knew people well and trusting relationships had been developed. Staff were available to support people when they needed it. Staff understood the importance of being on hand to assist people to promote people’s independence. 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.

Staff treated people with dignity and kindness. They understood changes in people’s body language and how to communicate with people who had limited verbal communication. Staff received effective support from the management team and were motivated to provide personalised care.

People could be assured that staff understood their health, social and personal care needs. People continued to receive their medicines when they were needed. Advice from health care professionals was sought when it was needed. Risks to people’s well-being and in the environment continued to be effectively managed.

People were given informed choices about how to spend their time. They joined in local events and activities and kept in contact with family members and people who were important to them. People’s relatives were kept up to date with their well-being.

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

Rating at last inspection: Good (last report published 27 October 2016)

Why we inspected: This was a planned inspection based on the rating at the last inspection. The service remains Good.

Follow up: We will continue to monitor this service and plan to inspect in line with our re-inspection schedule for those services rated Good.

Inspection carried out on 25 August 2016

During a routine inspection

The inspection was carried out on 25 August 2016 and was unannounced.

The service provides care and support for up to seven people with a learning disability and/or autism. At the time of our inspection there were five people using the service, one of whom was developing dementia. The accommodation was provided in a large house over two floors. People’s communication styles varied, some were able to tell us about their experiences and others used body language, mood and behaviours to communicate.

A registered manager was not employed 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. However, the provider had appointed a manager who intended to apply to register with the Care Quality Commission.

People were supported by staff to keep their home clean. However, some parts of the premises needed additional cleaning and consistent measures to prevent the spread of infection.

We have made a recommendation about this.

People were kept safe by staff who understood their responsibilities to protect people living with learning disabilities. Each person had a key worker who assisted them to learn about safety issues such as how to evacuate the building in an emergency and to speak to if they felt unsafe. The manager had plans in place to ensure that people who may not understand what to do would be individually supported by a member of staff if there was an emergency. Staff had received training about protecting people from abuse. The management team had access to and understood the safeguarding policies of the local authority and followed the safeguarding processes.

The manager ensured that they had planned for foreseeable emergencies, so that should they happen people’s care needs would continue to be met. The premises and equipment in the service were maintained to promote safety. However, it was not clear if people could easily escape from the garden, for example during a fire.

We have made a recommendation about this.

The Care Quality Commission (CQC) monitors the operation of the Deprivation of Liberty Safeguards (DoLS) which applies to care services. Restrictions imposed on people were only considered after their ability to make individual decisions had been assessed as required under the Mental Capacity Act (2005) Code of Practice. The manager understood when an application should be made. Decisions people made about their care or medical treatment were dealt with lawfully and fully recorded.

The manager and care staff used their experience and knowledge of caring for people with learning disabilities and autism effectively. Staff assessed people as individuals so that they understood how they planned people’s care to maintain their safety, health and wellbeing. Risks were assessed within the service, both to individual people and for the wider risk from the environment. Staff understood the steps to be taken to minimise risk when they were identified. The provider’s policies and management plans were implemented by staff to protect people from harm.

There were policies and procedures in place for the safe administration of medicines. Staff followed these policies and had been trained to administer medicines safely.

People had access to GPs and their health and wellbeing was supported by prompt referrals and access to medical care if they became unwell. Good quality records were kept to assist people to monitor and maintain their health. Staff had been trained to assist people to manage the daily health challenges they faced from conditions such as epilepsy and diabetes.

We observed and people described a service that was welcoming and friendly. Staff provided friendly compassionate care and support. People w

Inspection carried out on 2 July 2014

During an inspection looking at part of the service

During our visit of 16 May 2014 we found that medicines were dispensed by the pharmacy in a way which did not make it possible for staff to identify individual tablets. We visited the service on 2 July to check whether they had taken action to ensure that medicines were dispensed appropriately and were administered correctly.

The home had ensured that changes had been made to the dispensing of medicines by the pharmacy. This meant that each medicine was contained in an individual pot which contained the name of the person, the name and dosage of the medicine and the time of day that it should be administered. Therefore, there were effective systems in place for the safe storage and administration of medicines.

Inspection carried out on 16 May 2014

During a routine inspection

We considered our inspection findings to answer questions we always ask;

� Is the service safe?

� Is the service effective?

� Is the service caring?

� Is the service responsive?

� Is the service well-led?

This is a summary of what we found. The summary is based on our observations during the inspection, discussions with staff and people using the service. We also looked at records.

If you want to see the evidence supporting our summary, please read our full report.

Is the service safe?

The service had systems in place to ensure that equipment relating to the environment and health and safety was regularly maintained.

Recruitment practice was safe and through. People did not start work at the home until all relevant checks had been carried out.

CQC monitors the operation of the Deprivation of Liberty Safeguards (DoLS) which applies to care homes. The home manager told us that some applications for DoLs needed to be submitted and that further advice would be sought to ensure this was done correctly.

The home used a monitored dosage system for administrating medicines. A number of medicine tablets were contained in one pot, but there was not a comprehensive guide in place to identify each medicine. This meant that there was a risk that staff did not know which medicine they were giving each person. We have asked the provider to tell us what they are going to do ensure that medication administration is safe in the home.

Is the service effective?

People�s health and care needs were assessed with them or their relatives and they were involved in the development of their plans of care. Care plans were up to date and reflected people�s current needs.

It was clear from our observations and from speaking with staff that they had a good understanding of the people�s care and support needs. Staff knew how to communicate with people according to their individual needs.

Is the service caring?

People were supported by staff who took time to explain things clearly to them and to listen to their responses. They were able to do things at their own pace and were not rushed.

One relative who had completed a satisfaction survey was positive about the support that was provided at the home.

Is the service responsive?

Records confirmed people�s preferences, interests, goals and spiritual needs had been recorded and care and support had been provided in accordance with people�s wishes. One person told us that they went to see a local football club. People met with their key worker to discuss what was important to them.

People had access to activities outside the home, but were limited in activity choices within the home.

Is the service well-led?

The service had a quality assurance system and records showed that it had identified most actions that needed to be taken.

The service was not always proactive in seeking people�s views as it had sought limited feedback from relatives and other representatives of people who used the service.

Staff were clear about their roles and responsibilities and said that the management team were approachable.

Inspection carried out on 28 May 2013

During a routine inspection

People who used the service who were able to, told us that they were happy at the home. One person told us "I love my room , the staff are good they help me alot". We used our SOFI (Short Observational Framework for Inspection) tool. The SOFI tool allowed us to spend time watching how staff and people who use the service interacted and helped us record how people spent their time and whether they had positive experiences. This included looking at the support that was given to them by the staff.

We observed that overall people who used the service had positive experiences and the staff used a person focused approach when providing support. People who used the service were encouraged to make choices and were supported to engage in activities of daily living in a positive and effective manner.

Inspection carried out on 2 November 2012

During a routine inspection

People who used the service were not able to talk to us directly to tell us about their experiences. However, by using our SOFI tool we were able to establish that people who used the service were happy with their care and had built good relationships with the staff. We saw that staff had a person centred approach and people who used the service showed that they knew the staff well and were happy with their care.

People had their own bedrooms which they had been encouraged to personalise making them into their own private spaces.

We saw that people were being encouraged to be as independent as possible and were being supported to access the community.

However, we found that some of the arrangements used to assess the special needs of people who lacked capacity to consent to decisions were not robust. This had resulted in some people not fully being supported by family representatives or advocates to make informed decisions that were in their best interests.

Inspection carried out on 10 November 2012

During a routine inspection

People told us that the care and support they received was good and they felt safe and well looked after.