The Kent Autistic Trust - 14 High Street

Updated 28 June 2019

The inspection:

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. This inspection was planned to check whether the provider was meeting the legal requirements and regulations associated with the Act, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

Inspection team:

The inspection was carried out by one inspector.

Service and service type:

The Kent Autistic Trust - 14 High Street is a domiciliary care agency. It provides personal care to younger adults with an autistic spectrum condition in supported living self-contained flats across Medway and Canterbury.

The service had managers registered with the Care Quality Commission. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.

Notice of inspection:

We gave the service 48 hours’ notice of the inspection visit because it is small and the manager is often out of the office supporting staff or providing care. We needed to be sure that they would be in.

Inspection site visit activity started on 18 February 2019 and ended on 11 March 2019. We visited the office location on 18 February 2019 to see the managers and office staff; and to review care records and policies and procedures. We visited people in their flats and met staff providing support to people on 19 February 2019. We made telephone calls to staff and relatives between 20 February 2019 and 11 March 2019. We met with the management team on 13 March 2019 at their offices to provide feedback.

What we did:

Before the inspection the provider completed a Provider Information Return. Providers are required to send us key information about their service, what they do well, and improvements they plan to make. This information helps support our inspections. We took this into account when we inspected the service and made the judgements in this report. We reviewed the information we held about the service including previous inspection reports. We also looked at notifications about important events that had taken place in the service, which the provider is required to tell us by law. We used all this information to plan our inspection.

We spent time with four people who received a service. We also spent time speaking with one person. We spoke with two people’s relatives. One person’s relative left us written feedback. Some people were not able to verbally express their experiences of staying at the service. We observed staff interactions with people and observed care and support in communal areas.

We contacted health and social care professionals to obtain feedback about their experience of the service. These professionals included local authority commissioners and local authority safeguarding coordinators.

We spoke with 14 staff including; support workers, senior support workers, assistant managers, registered managers, the quality and compliance manager, the nominated individual for the provider and the business development manager.

We looked at five people’s personal records, care plans and people’s medicines charts, risk assessments, staff rotas, staff schedules, two staff recruitment records, meeting minutes, policies and procedures.

We asked the management team to send us additional information after the inspection. We asked for copies of the quality audits. These were received in a timely manner.

Updated 28 June 2019

About the service:

The Kent Autistic Trust – 14 High Street is a domiciliary care agency. It provides personal care to people living in their own flats and supported environments.

The Kent Autistic Trust – 14 High Street provides care and support to people living in five ‘supported living’ settings, so that they can live as independently as possible. People’s care and housing are provided under separate contractual agreements. CQC does not regulate premises used for supported living; this inspection looked at people’s personal care and support.

The service had two supported living properties in Strood, one in Chatham and one in Brompton, all of which are in Medway, Kent. In these premises people had their own flats. There were offices on site and communal spaces where people and staff could come together. The service also had a Canterbury supported living service. This had a selection of self-contained flats on the upper floor and a large ground floor flat which three people shared. They each had their own bedrooms, but shared the kitchen, dining room, lounge, laundry and the garden. There was an office on site.

Not everyone using The Kent Autistic Trust – 14 High Street receives regulated activity; CQC only inspects the service being received by people provided with ‘personal care’; help with tasks related to personal hygiene and eating. Where they do we also take into account any wider social care provided. The service was providing personal care to 11 people diagnosed with learning disabilities and autistic spectrum disorder 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:

The outcomes for people using the service reflected the principles and values of Registering the Right Support in the following ways; staff recognised that people had the capacity to make day to day choices and supported them to do so. People were encouraged and supported to be independent. People were engaging in the community, for example utilising their local community to utilise ordinary community resources, shops, access courses, access day services and activities to ensure they had a good day. People were also supported to take holidays both in the UK and abroad.

The provider and staff were exceptionally responsive and worked continuously to make improvements to the service and provide people with high quality care. The provider and staff demonstrated a detailed knowledge of the people they supported and over time had developed trusting relationships with them, so that people felt safe receiving support. The provider had been extremely responsive to people’s needs and designed services specifically to meet people’s changing needs. People were happy and smiling, relatives were very happy with the service. One relative said, “I can’t praise them enough, they do a wonderful job.”

The service was well-led. The management team knew people very well, the registered managers and assistant managers spent time on shift working with people and staff. The management team carried out the appropriate checks to ensure that the quality of the service was continuously reviewed, improved and evolved to meet people’s changing needs. The provider promoted an open culture and was a visible presence in the service, staff felt supported by the provider and the registered managers, they felt listened to and valued. Relatives were surveyed for their views and felt these were acted upon. The provider had a strong set of values that were embedded into each staff member's practice and the way the service was managed. Staff were committed and proud of the service.

Staff were well trained and received consistent support and guidance. For people, this meant that they were always placed at the heart of decisions about the way in which they received support.

People received a safe service and were protected from harm, staff had a detailed understanding of individual risks and danger for each person. They understood the measures in place to keep them safe. People were supported by enough staff with the right skills and knowledge to understand their needs and provide support in a person-centred way. The provider took care in their selection of staff, and all required checks helped ensure they were recruited safely.

People were involved in food shopping, planning their menu and where possible the preparation of food and cooking. People were encouraged and supported to be as independent as possible. Where people were unable to cope with completing their food shopping in busy supermarkets they were supported to put a shopping list together and to shop on the internet. People were supported to access routine and specialist healthcare appointments when they needed to.

The service continued to provide effective and safe support to people living with a learning disability and or autism. People were provided with good support to communicate, staff knew people well and understood their communication. People were supported to manage their emotions and had positive behaviour support strategies in place. Relatives told us that they had seen a positive change in their loved ones. People were supported to feedback on their experiences and contribute to planning their own support in ways which were suitable for their communication needs. For example, through using pictures, stories, signing and electronic communication.

Staff treated people with dignity and respected their privacy. Staff communicated well with relatives and welcomed them into the service, and sought their feedback about the service, which relatives felt was listened to an acted upon.

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.

Support plans guided staff in the support they provided to people in accordance with their needs and preferences. People were provided with an individualised care and support as well as activities both in their homes and in the community to keep them occupied and stimulated.

The service met the characteristics of Outstanding in one area and Good overall. For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection: Good when we inspected on 30 June 2016 (the report was published on 19 August 2016).

Why we inspected:

This inspection was a scheduled inspection based on previous rating.

Follow up:

We will visit the service again in the future to check if they are changes to the quality of the service.