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Reports


Inspection carried out on 4 December 2017

During a routine inspection

Aspley House is a residential care home for two people with learning disabilities and who have behaviours which can challenge. The service is a detached house in a residential area of Sittingbourne. There were two people living at the service when we inspected.

At the last inspection, the service was rated Good. At this inspection we found the service was Outstanding.

There was a registered manager at the service who was supported by a deputy 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 2008 and associated Regulations about how the service is run.

People could become anxious and display behaviours which could have a detrimental effect on themselves and people around them. Without the right support these behaviours would occur frequently. Some people had previously had experiences which had made them feel unsafe and their lifestyles had been restrictive. Staff supported people in a way that minimised risks and protected them from harm. People were supported to have maximum choice and control of their lives and staff supported people in the least restrictive way possible; the policies and systems in the service supported this.

The providers had fully embraced the principles of Positive Behavioural Support (PBS). PBS is recognised in the UK as the best way of supporting people who display, or are at risk of displaying, behaviour which challenges.. The providers had resourced and modelled people's care in accordance with current PBS best practice principles. The provider’s philosophy focussed on using PBS alongside person centred planning (PCP) to enhance people’s lives and expand their opportunities.

People were supported by staff who had been recruited safely and staffing levels were based on people’s needs and activities. People were involved in the recruitment process in a variety of ways. The provider had a comprehensive training and support system which enabled staff to gain the specialist skills needed to fulfil their role. Staff were involved in advocating for people and spoke with pride about what people had achieved. Staff supported people with kindness and compassion using their knowledge of people to provide frequent gentle interactions that prevented people from becoming anxious or distressed. People had limited verbal communication skills and staff used a range of communication tools including Makaton and picture cards to support people to express themselves.

The service had fostered positive working relationships with health and social care professionals which led to joint working to expand people’s communication skills and identify new ways for people to access health care. People were involved in planning and preparing their own meals and trying a wider range of meals.

People were involved in planning their own care and care plans reflected their needs and wishes. Staff had the guidance required to meet people’s needs and support them through incidents of challenging behaviour whilst continuing to develop their independence. People had been supported to consider and record their wishes for the end of their life. There was a ‘no blame’ culture throughout the service, which focussed on opportunities for learning and improvement. Audits of the service were specifically designed to recognise the specialist nature of the support provided and to establish new ways to monitor the quality of the support people received.

People were supported to achieve things that had previously been thought of as ‘impossible.’ For example, planning a holiday abroad or selecting their own snacks at a local shop. People took part in a variety of activities and were continually encouraged to try new things. People told us about visiting the local cinema and theatre with their friends. The PCP t

Inspection carried out on 17 November 2015

During a routine inspection

We carried out this inspection on the 17 November 2015, and it was unannounced.

Aspley House is a privately owned care home, providing personal care and accommodation for two adults with learning disabilities. There were two people living at the service at the time of the inspection. People had complex needs, including mental health and physical health needs. Aspley House and the registered service at 201 London Road work together as one. The services are across the road from each other. The registered manager and staff work at both services and the main office of the two services is at Aspley House. Aspley House is one of a group of five care homes owned by Insight Specialist Behavioural Service Limited.

People had a limited ability to verbally communicate with us or engage directly in the inspection process. People demonstrated that they were happy in their home by showing warmth to the staff that were supporting them. Staff were attentive and communicated with people in a warm and friendly manner. Staff were available throughout the day, and responded quickly to people’s requests for care and support. We observed staff supporting people with their daily activities.

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 2008 and associated Regulations about how the service is run. The registered manager is registered as the manager of both Aspley House and 201 London Road.

CQC is required by law to monitor the operation of the Deprivation of Liberty Safeguards. The registered manager and staff showed that they understood their responsibilities under the Mental Capacity Act 2005 and Deprivation of Liberty Safeguards (DoLS).

Where people lacked the mental capacity to make decisions the home was guided by the principles of the Mental Capacity Act (MCA) 2005 to ensure any decisions were made in the person’s best interests. Staff were trained in the Mental Capacity Act 2005 (MCA) and showed they understood and promoted people’s rights through asking for people’s consent before they carried out care tasks.

Staff had been trained in how to protect people from abuse, and discussions with them confirmed that they knew the action to take in the event of any suspicion of, or actual abuse. Staff understood the whistle blowing policy and how to use it. They were confident they could raise any concerns with the registered manager or outside agencies if this was needed.

Clear guidelines were in place for staff to follow in order to support people with behaviours that may challenge. Staff demonstrated that they understood these guidelines and put them into practice to help minimise people’s anxieties and behaviours.

Staff were knowledgeable about the needs and requirements of people using the service. Staff involved people in planning their own care in formats that they were able to understand, for example pictorial formats. Staff supported people with making arrangements to meet their health needs.

Staff were recruited using procedures designed to protect people from the employment of unsuitable staff. Staff were trained to meet people’s needs and were supported through regular supervision and an annual appraisal so they were supported to carry out their roles.

Medicines were managed, stored, disposed of and administered safely. People received their medicines when they needed them and as prescribed.

People were provided with food and fluids that met their needs and preferences. Menus offered variety and choice.

There were risk assessments in place for the environment, and for each individual person who received care. Assessments identified people’s specific needs, and showed how risks could be minimised. People were involved in making decisions about their care and trea

Inspection carried out on 20 January 2014

During a routine inspection

Some of the people who used this service had limited verbal communication and therefore were not able to tell us directly about their experiences of the service. We observed staff supporting people with their daily activities.

People who lived in the home were treated with dignity and respect and were able to make decisions and choices in their daily lives. Any restrictions on people�s freedom of choice had been recorded in people�s plans of care, together with the rationale behind these decisions.

Clear guidelines were in place for staff to follow in order to support people with behaviours that may challenge. Staff demonstrated that they understood these guidelines and put them into practice to help minimise people�s anxieties and behaviours.

People were given their medicines by staff who had been trained to do so safely. Medication was stored safely and securely.

Staff received the training and support that they required to carry out their roles. Staff said that there was good communication in the home, which helped them to support people on a day to day basis.

People who lived in the home and their representatives were regularly asked for their views about the service. People rated the service as good or excellent. Comments included, �My son has flourished and is very happy to be living at Insight�; and �Everything possible is being done to make my son�s life as comfortable and occupied as possible within his given capabilities�.