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Inspection carried out on 8 November 2018

During a routine inspection

This inspection took place on 8 November 2018 and was announced.

Eastry Villa’s is a ‘care home’ for up to 11 people with learning disabilities. People in care homes receive accommodation and 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. At the time of the inspection, there were three people living at the service. The service was going through a transition where a number of people had moved out of the service, and people with different needs were being supported to transition into this service.

The accommodation was set out across a main house, a self contained flat and a separate bungalow. All bedrooms baring one had en-suite facilities. There was a communal lounge, dinning area and kitchen in the main house. There was access to a garden at the back of the house.

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. The service ethos is to enable people with learning disabilities and autism to live as ordinary a life as any citizen.

At our last inspection on 31 March 2017, we rated the service Good. We re-inspected this service earlier than planned due to concerns that had been raised about people’s safety. At this inspection we found that the evidence continued to support the rating of Good.

At this inspection we found the service remained ‘Good’

The service did not have a registered manager in post. The last registered manager left the service in July 2018, a new manager was appointed in September 2018. 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. During this period of time the service has not been consistently well led. Staff told us there was a lack of support and guidance for them when supporting people to move into the service.

People continued to be safeguarded from potential harm and abuse. Staff knew about abuse, and how to report any concerns they had. Risks to people had been assessed and minimised where possible, with detailed guidance in place for staff to follow. Accidents and incidents had been recorded and used to improve the service. Medicines were stored and administered safely. Risks to the environment had been assessed and well managed. The service was clean and well maintained, and had been adapted to meet the needs of the people living there.

There were sufficient staff to meet people’s needs. There were staffing vacancies which were being covered by consistent regular agency staffing. People had been recruited following safe recruitment processes. There continued to be an effective induction system in place, followed by regular training which staff informed us supported them to complete their roles.

People’s needs were assessed before they moved into the service and in line with good practice. People were supported to eat and drink sufficient amounts to maintain a balanced diet. People with specific diet related healthcare conditions had been supported to manage these well, and maintain good health.

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 were treated with kindness, compassion and respect. Positive relationships had formed with staff and people. Staff were aware of how to adapt their communication styles to meet people’s needs. People’s privacy and dignity was maintained by staff.

People were supported in a person centred way. People had individu

Inspection carried out on 31 March 2017

During a routine inspection

This inspection took place on 31 March 2017 and was unannounced.

The service is in the village of Eastry near to the main towns of Sandwich, Deal and Ramsgate. There were nine people living at Eastry Villa’s and each person had their own bedroom. All bedrooms, apart from one have en-suite facilities. There are communal rooms which are open plan in style with access to the garden at the back of the house. There is a main house, a separate bungalow for one person and a separate flat for one person that all make up Eastry Villa’s.

There was a registered manager at the service who was present on the day of 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 2008 and associated Regulations about how the service is run.

At our last inspection in January 2016, the service was in breach of some of the regulations and was rated ‘Requires Improvement’. The registered manager sent us an action plan outlining how they would rectify those breaches. The registered manager and team had worked hard to update policies, care planning, staff training and recruitment and develop communication support and person centred care. At this inspection all the regulations were met and improvements had been made, although there were some areas that still required improvement.

There were some different areas of improvement identified at this inspection that the registered manager agreed to address. There was a lack of communication to visitors to make sure that they did not inadvertently trigger people having anxious and emotional behaviours. One person needed emergency medicine to be administered if they became unwell and because not all the staff were trained they had been limited in how often they had been able to go out. Sometimes staff had limited people’s opportunities to go out if they had behaviour that challenged earlier in the day and this had not always been addressed by the registered manager. The registered manager agreed that these were areas for improvement and said they would address them.

There was a clear complaints process but there was a lack of clarity about what should be considered a complaint. A recent concern raised by a relative had been missed, not resolved and had happened again because the issue had only been written in the team’s communication book and not acted on as a complaint. We brought this to the registered manager’s attention who agreed to respond to it.

Staff we spoke with knew about different types of abuse and had attended training in safeguarding people from harm and abuse. Recruitment checks on staff were thorough. References were requested and any issues were followed up. Health declarations had been completed and prospective staff had provided proof of their qualifications.

There were enough staff on duty to meet peoples’ assessed needs and it was clear who was receiving one to one support and how these hours were allocated. People were participating in a variety of activities both in and outside their home. There were planned activities that people could choose from and the right number of staff to support them. If people changed their minds about activities this was respected and alternatives were offered or the activities were offered at a different time.

There was a good range of training that staff had attended to make sure they had the skills to support people. Staff had regular team meetings and one to one meetings with the registered manager or senior members of the staff team and said they felt well supported and were able to air their views. The deputy manager worked alongside staff to provide additional guidance and support the change of culture from doing for people to supporting people to develop their lifestyles.

Staff respected peoples’ privacy and

Inspection carried out on 6 January 2016

During a routine inspection

This inspection took place on 6 and 7 January 2016 and was unannounced.

The service is in the village of Eastry near to the main towns of Sandwich, Dover and Ramsgate. There were nine people living at Eastry Villa’s and each person had their own bedroom, all bedrooms, apart from one have en suite facilities. There are communal rooms which are open plan in style with access to the garden at the back of the house. There is a main house, a separate bungalow for one person and a separate flat for one person that all make up Eastry Villa’s.

There was a registered manager at the service who supported both days of 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 2008 and associated Regulations about how the service is run.

The registered manager started working at the service recently in August 2015. He had identified lots of areas where improvements were needed and had written an action plan. The registered manager had lots of ideas to improve the service and was working through the action plan, which meant that some of his ideas had not yet been implemented. The registered manager said that there was ‘a lot to do’ and ‘it was a work in progress’.

Staff we spoke with knew about different types of abuse but not all of the staff had attended training in safeguarding people from harm and abuse. Recruitment checks on staff were not as thorough as they should be. Unsatisfactory references had not been questioned and followed up and some staff had no written references on file. Some staff had not declared that they were healthy and fit for the role and provided proof of their qualifications.

Some people needed additional one to one and two to one support hours that had been assessed and funded for. People were not all directly receiving these additional support hours and the use of these hours was not recorded. When people were at home, activities were limited leading to low levels of engagement and participation in everyday activities, including cooking and cleaning, as well as educational and learning activities. Some people, but not all, had an individual activity plan but these activities did not always happen, leaving people at home with not much to do.

Staff attended basic training courses; however, subjects related to peoples’ needs were limited. Staff had not had training in person centred planning, learning disability awareness, positive behaviour support and active support. Staff had not had the opportunity for regular one to one meetings and staff meetings were not held regularly. The registered manager said that he planned to hold more regular staff meetings and one to one meetings with staff. The registered manager agreed that the training for staff could be improved and he would talk to the provider about this. Staff respected peoples’ privacy and dignity and, on the whole, were kind and caring.

The registered manager understood the principles of the Mental Capacity Act 2005 and Deprivation of Liberty Safeguards (DoLS). People were subject to constant supervision by staff and restrictions to their liberty, for example, some external doors were locked and access to the kitchen was restricted. These restrictions must be agreed by the person’s local authority who agree a DoLS authorisation. Seven people were currently being restricted unlawfully as their DoLS authorisations expired in October 2015. Restrictions had not been reviewed to ensure that they were the least restrictive option. Following the inspection the provider told us that the applications have been made and are in the process of being authorised by their funding authorities. We will check this at the next inspection.

Each person had a health action plan that gave staff details about the person’s health needs. Th

Inspection carried out on 19 August 2013

During a routine inspection

Many of the people who used the service were unable to communicate and tell us what they thought of the quality of the care due to their communication difficulties. Through observation however, 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 and involving people in making choices.

One person who used the service was able to tell us of their experiences of receiving care. They said they were happy with the care and support they received and that their needs were being met in all areas. They said that the staff treated them with respect, listened to them and supported them to raise any concerns they had about their care. They said �staff are very good they help me with many things. They help me to lead the life I want to lead�.

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. Daily reports were written showing things such as, what a person had done that day, what support they had and what they had eaten.

Inspection carried out on 13 December 2012

During a routine inspection

We spoke to and spent time with all the people living in Mill House. One person said, "Its good here. I am learning skills to be more independent." Not everyone living in the home was able to talk about their lifestyle with us so we observed the interactions between the people and staff. We saw people who were visually and hearing impaired being supported with a variety of sensory stimulation activities so that they could interact with the people around them and their environment as much as possible.

People received support to maintain a healthy, active lifestyle. They were supported to attend health care checks and community health professionals were involved to provide advice and support when needed. A healthy balanced diet was offered to people who were able to choose the food they ate from photos if they did not understand the menu. People were supported to develop their independence skills, including making snacks and drinks.

People were supported to express their views and make important decisions because the staff supported them with their communication and spent time with them.

There were a clear recruitment process and staff said they received the training they needed and were well supported when starting work in the service.

Inspection carried out on 23 November 2011

During a routine inspection

Not all the people living in the home were able to tell us about their experiences so we observed the interactions between the people living in the home and the staff.

Staff were kind and respectful to the people living in the home.

People were offered choices as part of the day to day routine in a way that they could understand.

People smiled and laughed when participating in various activities with the staff. People talked about some of the things they liked to do.

People said they liked the home and the staff were good.

We observed people looking comfortable and at ease in the home and with staff.

People were given the opportunity to tell staff how they wanted to be supported.