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Inspection carried out on 31 July 2019

During a routine inspection

About the service

Leybourne is a residential care home providing personal care for up to eight people with physical and/or learning disabilities. There were seven people living there at the time of the 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 and what we found

People received a personalised service from supportive staff. People said they liked the staff and enjoyed being with them. Staff made sure people had enjoyable experiences and a happy social life.

People were encouraged to make their own decisions and staff understood how people communicated their choices. People were enabled to achieve independent living goals. Staff made sure that people were treated with dignity and respect and in a way that was free from discrimination.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.

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

Staff received the relevant training and support to assist people in the right way with their individual lifestyles.

There had been significant improvements in the way the service was managed. The provider had addressed the previous shortfalls in how medicines, complaints and quality assurance systems were managed.

Staff praised the values and ethos of the management and staff team. They were committed to providing high quality, person-centred support for people to be able to live fulfilled lives.

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

Rating at last inspection and update

The last rating for this service was requires improvement (published 1 August 2018) and there were multiple breaches of regulation. The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection we found improvements had been made and the provider was no longer in breach of regulations.

Why we inspected

This was a planned inspection based on the previous rating.

Follow up

We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.

Inspection carried out on 21 May 2018

During a routine inspection

This inspection took place on 21 and 22 May 2018 and was unannounced. This meant the provider was not aware we intended to carry out an inspection. The inspection was undertaken by one inspector. We also spoke with relatives and professionals during the weeks commencing 28 May 2018 and 4 June 2018.

Leybourne 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. The home is registered to provide support for up to eight people over two floors. Residential care is provided for people with a learning disability, physical disability or those with an autistic type condition. Nursing care is not provided at the home. On both days of the inspection there were six people using 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.

At the time of the inspection there was no registered manager registered at the home. The previous registered manager had left the home and cancelled their registration in March 2018. A new manager had been appointed but it had been in post only around three weeks. A registered manager is a person who has registered with the CQC 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. We were supported on the inspection by the manager, the previous interim manager and the provider’s nominated individual.

Prior to the inspection we were aware of a number of safeguarding issues at the home. Some of these are still ongoing and we will monitor the outcome of these investigations. Staff were aware of safeguarding issues and told us they now felt confident in reporting any concerns around potential abuse. They said they felt more confident in reporting any concerns higher up in the organisation as part of the provider’s whistleblowing policy.

Checks were carried out on the equipment and safety of the home. The majority of checks carried out on systems and equipment were satisfactory. However, some upstairs rooms did not have window restrictors fitted. It was also unclear if the home had been subject to an up to date fixed electrical check and records were not available to demonstrate that appropriate fire drills had recently been undertaken. Risk assessments linked to people’s care were available but not always clearly linked to the delivery of day to day care. Professionals we spoke with told us they felt some risk assessments lacked detail. The home was maintained in a clean and tidy manner.

Staff and relatives told us they felt there were enough staff at the home. Staff told us they were able to accompany people to access the community and support them with their personal care needs. Proper recruitment procedures and checks were in place to ensure staff employed by the service had the correct skills and experience.

We found some issues with the safe management of medicines. Medicine administration records (MARs) were not always well completed and instructions for the use of creams and lotions and ‘as required’ medicines were not always available or detailed enough. Management of medicine did not always meet NICE guidance.

The manager told us there was no overarching records of what training staff had completed. Work was ongoing to address this through a review of individual records. Staff told us they had access to a range of training and some certificates were available in staff files. Staff confirmed access to appropriate supervision had