The provider of this service is Canterbury Oast Trust and is referred to throughout this report as the trust.
This was an unannounced inspection carried out on 5 November 2014. The previous inspection took place on 13 August 2013 and there were no breaches of the legal requirements.
Homelands provide accommodation and personal care for up to eight people with a learning disability who have an autism spectrum disorder. At the time of the inspection there were eight people living at Homelands.
The service is run by a registered manager, who was not present in the service 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. The management arrangements in place at the time of the inspection were satisfactory.
People told us they received their medicines when they should. However we found shortfalls in some areas of medicine management. Where people were prescribed medicine “as required”, there was a lack of proper guidance to enable staff to administer these medicines safely and consistently. Staff did not always record the detail of the amount of prescribed medicines that had been administered. You can see what action we told the provider to take at the back of the full version of the report.
The service was well maintained. There were systems and checks in place to help ensure that the equipment and premises remained in good condition and working order.
People felt safe living at Homelands. The service had safeguarding procedures in place, which staff had received training in. Staff demonstrated a good understanding of what constituted abuse and how to report any concerns.
People were protected by robust recruitment procedures. Staff files contained the required information. New staff underwent a thorough induction programme, which including relevant training courses and shadowing experienced staff, until they were competent to work on their own.
People were supported by sufficient numbers of staff on duty, in order to meet their needs and facilitate their chosen activities. Staff received effective supervision, training and appraisals as well as having staff meetings, although supervision was not in line with timescales within the provider’s supervision policy.
Risks associated with people’s health and welfare had been assessed and guidance was in place about how these risks could be minimised. Risk assessments did not restrict people, but were used to promote their independence. There were systems in place to review any accidents and incidents and make relevant improvements, to reduce the risk of further occurrence.
People had opportunities for a wide range of work and leisure activities that they had chosen. Staff were familiar with people’s likes and dislikes and used different communication methods with people, to enable people to make their own choices.
People said they “liked” the food. They had a variety of meals and adequate food and drink. People were involved in the planning, preparation and cooking of meals.
People were supported to make their own decisions and choices. The registered manager and staff had received training in the Mental Capacity Act 2005 (MCA) and the Deprivation of Liberty Safeguards (DoLS), so were aware of the process, where people lacked the capacity to make their own decisions, to ensure these decisions would be taken in their best interests, although to date people had been able to make their own decisions.
People were involved in planning their care and support and some had chosen to involve their relatives. Care plans included people’s preferred routines, their wishes and preferences and skills and abilities. They had regular review meetings to discuss their support and aspirations. People’s health care needs were monitored; they had access to a variety of healthcare professionals and were supported to attend healthcare appointments to maintain good health.
People were relaxed in the company of staff, who listened and acted on what they said. People’s privacy was respected. People told us they liked the staff. Staff were kind and caring in their approach and knew people and their support needs well.
The trust had various systems in place to obtain people’s views including meetings, questionnaires and informal discussions. There were also systems in place to monitor and audit the quality of service provided. Trustees and senior managers carried out visits to the service and staff undertook various regular checks. People felt comfortable in complaining, but did not have any concerns.
Staff were aware of the vision, mission and values of the trust. They worked together as a team to support people to be as independent as possible, demonstrate respect and uphold people’s dignity.