We undertook an unannounced inspection of this service on 3 and 4 March 2016. The previous inspection took place on 17 December 2013 and found there were no breaches in the legal requirements at that time.The service is registered to provide accommodation and personal care for up to six people who have learning disabilities, including autism and some complex and challenging behavioural needs.
Accommodation is provided in a detached house in a quiet residential area of New Romney, close to public transport and local amenities and shops. Accommodation is arranged over two floors and each person had their own bedroom. The home benefitted from an enclosed back garden.
This service had a registered manager in post. A registered manager is a person who is 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 the time of inspection five people lived at the service and we were able to meet and speak with each person. People told us that they liked living in the home, they were happy, they liked the staff and the staff were kind. They thought the home provided a relaxed and comfortable living environment.
To help us understand the experiences of people did not readily communicate with us or preferred not to, we observed their responses to the daily events going on around them, their interaction with each other and with staff.
Our inspection found that whilst the service offered people a homely environment and their care needs were being supported; there were shortfalls in some areas that required improvement.
Arrangements to ensure sufficient staff were always on duty in instances of short notice absence were not always responsive enough. A recent instance meant there were insufficient staff to meet people’s needs and address the possibility of behaviour that challenged; this resulted in a member of staff being injured.
The condition, décor and flooring in one bedroom meant it could not be effectively cleaned. This presented an infection control risk.
The service had not notified us of a recent event which they were legally obliged to.
The service had access to the local authority safeguarding protocols, and incidents that warranted referrals to the authority were made.
Medicines were safely administered and stored. Checks ensured sufficient medicines were ordered, the right amount was given and that people received the right medicines when they were supposed to.
The service was responsive to people’s needs. People’s goals and wishes were progressed to encourage development of learning and exploring new activities and challenges. People told us that they felt safe in the service and when they were out with staff.
Authorisations and decisions, made under the Mental Capacity Act 2005 to deprive people of their liberty, were notified to the Care Quality Commission when they needed to be.
All staff had an understanding of the Mental Capacity Act 2005, and Deprivation of Liberty safeguards, they understood in what circumstances a person may need to be referred and when there was a need for best interest meetings to take place. Advocacy services were made available to people.
People had personalised records detailing their care and support, including well developed support plans for their emotional and behavioural needs. People were supported to access routine and specialist health care appointments. People told us staff showed concern when they were unwell and took appropriate action.
People felt comfortable in complaining, but did not have any concerns. People, relatives and visiting professionals had opportunities to provide feedback about the service provided both informally and formally. Feedback received had been positive.
People felt the service was well-led. The registered manager adopted an open door policy and sometimes worked alongside staff. They took action to address any concerns or issues straightaway to help ensure the service ran smoothly.
The provider had a set of values, which included treating everyone as an individual, working together as an inclusive team and respecting each other. Staff were aware of these and they were followed through into practice.
We found a number of breaches the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 and one breach of the Care Quality Commission (Registration) Regulations 2009. You can see what action we told the provider to take at the back of the full version of the report.