We carried out a review of the data available to us about L'Arche Kent The Rainbow on 6 July 2023. We have not found evidence that we need to carry out an inspection or reassess our rating at this stage.
This could change at any time if we receive new information. We will continue to monitor data about this service.
If you have concerns about L'Arche Kent The Rainbow, you can give feedback on this service.
L’Arche Kent The Rainbow is a residential care home providing personal care to five people with a learning disability. The service can support up to six people.
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.
The service was a domestic property and could not be distinguished from its neighbours. There were deliberately no identifying signs, intercom, cameras, industrial bins or anything else outside to indicate it was a care home. Staff were also discouraged from wearing anything that suggested they were care staff when coming and going with people.
People’s experience of using this service and what we found
People were supported by staff who treated them with kindness and compassion. People told us staff were nice and helped them to do the things they enjoyed doing. People took part in a range of activities which were tailored to each person. People were supported to maintain relationships with their loved ones and be part of communities which were important to them such as, local churches. People were supported to stay safe and understand positive relationships. People were involved in managing their own risks where possible.
The philosophy of L’Arche is that people with and without disabilities live together in a community, so some of the staff, called assistants also lived in the service and other staff worked different shifts. People were supported to stay healthy and staff worked with health professionals to meet people’s health needs. People were involved in choosing and preparing their meals. When people were at risk of losing weight, staff followed professional guidance to prevent this.
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. People were encouraged to plan their support with staff. Care plans recorded both people’s needs and preferences. People were given information in a range of formats and were supported by staff to understand information using communication tools such as, Makaton.
There was a shared set of values which was shared by all staff, this focussed on people having a fulfilled life in a home which was theirs for life if they wished. The registered manager completed a range of audits to monitor the quality of the service. People and staff told us their views and ideas were listened to. People were supported by enough staff who were recruited safely.
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.
The outcomes for people using the service reflected the principles and values of Registering the Right Support by promoting choice and control, independence and inclusion. People's support focused on them having as many opportunities as possible for them to gain new skills and become more independent.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection
The last rating for this service was good (published 27 September 2017.)
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.
L’Arche Kent The Rainbow is home for six adults with learning disabilities. It is part of a community run by L’Arche Kent, a charitable organisation. The home is a detached property in the city of Canterbury. Each person had their own bedroom decorated in the way they chose. One bedroom was on the ground floor and the other bedrooms were on the first floor. There were two lounges, a dining room, kitchen and an enclosed garden at the back that everyone had access to. The philosophy of L’Arche is that people with and without disabilities live together in a community, so some of the staff, called assistants also lived in the service and other staff worked different shifts.
The service was overseen by a registered manager with a team leader in day to day charge. 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.
At our last inspection in November 2015, the service was in breach of two of the regulations and was rated ‘Requires Improvement’. We issued requirement notices to make sure risk assessments were relevant and gave staff up to date guidance, to make sure the monitoring and auditing processes picked up inaccurate and out dated records, and to put a visitors’ book in place to make sure there was a record of who was in the building in the event of an emergency.
The registered manager sent us an action plan outlining how they would rectify those breaches. The registered manager and team had completed all the actions on the action plan and at this inspection all the regulations were met.
The registered manager had reviewed the audits system so that it was more effective. Regular checks of the environment had been carried out and there was a system of checking that records were up to date including: risk assessments, care plans, staff files, medication records and other records.
Plans were in place so if an emergency happened, like a fire, everyone knew what to do. Safety checks were carried out regularly throughout the building and all equipment was checked to make sure it was in good working order and safe to use. The visitors’ book was in place and a record was kept of when people were in the service and this was checked regularly.
There were effective systems in place to make sure people were supported to keep safe without being restricted. Risk assessments had been carried out and written up. Risk assessments were clear and detailed so that staff had the guidance necessary to protect people as far as possible from accidents or harm whilst still encouraging independence.
People looked comfortable in the company of staff and each other and expressed that they felt safe living at the service. There were clear processes in place to safeguard people and for staff to blow the whistle. The registered manager, team leader and staff acted promptly and appropriately if there were any concerns. Staff knew how to recognise and report potential abuse outside the organisation if necessary.
Potential staff were thoroughly vetted to make sure they were safe to support people. People had the time they needed to get to know potential staff before they were able to offer any support or work in the service. There were always plenty of staff in the service to support people and the registered manager kept staffing numbers under review.
Staff were enthusiastic in their roles and had received training to make sure they had the necessary skills to support people and provided person centred care. Each person had a care plan and a health action plan and these were kept up to date to give staff the guidance they needed to make sure people’s individual needs were met.
The Care Quality Commission 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). Mental capacity assessments had been carried out to determine people’s level of capacity to make decisions in their day to day lives and for more complex decisions when needed. DoLS authorisations were in place, or applications had been made, for people who needed constant supervision because of their disabilities. There were no unnecessary restrictions to people’s lifestyles.
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.
People had as many opportunities as they wanted to go out and about meet people and live an ordinary lifestyle. People were encouraged to try new experiences and develop new interests to enrich their life and increase their confidence and self-esteem.
Activities were meaningful and people were supported to develop a work ethic and be valued members of the local community. People had participated in events to raise money for charity including a recent swim-a-thon and were supported to make items that were for sale. A new enterprise had been started where people were learning to make a craft beer that was being developed and tested for the market.
Staff were caring and people’s individuality was respected and nurtured. There was a relaxed and calm atmosphere and people were treated with kindness and compassion. People were supported to keep well and healthy and if they became unwell the staff responded promptly and made sure that people accessed the appropriate services. Medicines were managed safely.
Mealtimes were social occasions and organised in the way each person preferred. People were involved in making drinks, snacks and meals as much as they wanted and were encouraged to eat a healthy diet.
There was a clear complaints procedure and process that was designed to enable people to express their views and were responded to in a way they could understand. The registered manager welcomed complaints and used the opportunity to improve the service.
There was a cycle of evaluation to monitor the quality of the service provided. Lots of different ways to gather people’s views including surveys, house meetings and meetings in the L’Arche community where discussions were held about what had gone well and what the focus of improvement would be in the coming year. People’s circle of support including family and friends, staff and visiting professionals were asked for their feedback. People were supported to express their views with a variety of communication aids and forums and following this a development plan was agreed. When a development plan had been completed there was a celebration of what had been achieved and then the next plan was put into action.
The inspection was carried out on 23 and 24 November 2015 and was unannounced. At the previous inspection in October 2013, we found that there were no breaches of legal requirements.
L’Arche Kent The Rainbow provides accommodation and personal care for up to six adults with a learning disability and there were five people living there at the time of the inspection. The philosophy of L’Arche is that people with disabilities live in a community. Therefore, some staff members also live in the home. The accommodation is over two floors, with one bedroom on the ground floor and the other bedrooms on the first floor. There are two communal lounges, a dining room and a garden to the rear of the home. .
The home was run by 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. However, the locality leader and not the registered manager were in day to day charge of the home. The locality leader was present at the home on a daily basis, organised staff rotas and training and was available to people who used the service and their relatives. The locality leader was responsible for managing the service and also part of the companies supported living scheme.
Assessments of risks to people’s safety and welfare had been carried out. However, some aspects of a persons’ daily life, such as the risks when they were out in the community, or swimming, had not been reviewed to ensure they contained up to date guidance for staff. There were clear guidelines in place for staff to follow for people whose behaviours may challenge themselves or other people. However, one of these guidelines directed to staff to lift a person off the floor which is potentially dangerous to the person and staff involved and against the person’s wishes.
Quality assurance systems were not effective. Shortfalls in risk assessments and had not been identified and action had not been taken to address shortfalls in care records which had been identified six months ago. The service was not proactive in gaining the views of relatives and stakeholders of the service. This meant that there was not a culture of continuous improvement in the home.
The home was managed on a day to day basis by a person who was not registered with the Commission to do so. The registered manager was office based, acted as a senior manager and only visited the home every two weeks. We have made a recommendation in relation to the day to day management of the service.
Health and safety checks were effective in ensuring that the environment was safe and that equipment was in good working order. The service carried out regular fire drills and checks of firefighting equipment to ensure it was in good working order. However, visitors to the home did not always sign the visitors book, and no visitors signed the book when they left the home. Therefore, there would not be accurate records of who was in the home in the event of a fire.
Medicines were managed appropriately and staff received medicines training yearly. An area to consider for improvement is for staff to have their competency in giving medicines checked on a regular basis by staff who have received training in how to do so, in addition to yearly medication training.
Clear and comprehensive guidance was in place for staff about how to recognise and respond to abuse and staff knew how to put it into practice. Accidents and incidents were recorded and any learning from these events had been incorporated into people’s assessments of risk, in order to help keep them safe.
People’s health and dietary needs had been assessed and clear guidance was in place for staff to follow, to ensure that their specific health care needs were met. Staff were knowledgeable about people’s health care and dietary needs and the service liaised with a number of health professionals as appropriate.
Comprehensive checks were carried out on all staff at the home, to ensure that they were fit and suitable for their role. Staffing levels were flexible and reflected people’s assessed needs.
New staff received a comprehensive induction, which included shadowing more senior staff. Staff were trained in areas necessary to their roles and staff had completed some additional specialist training to make sure that they had the right knowledge and skills to meet people’s needs effectively.
CQC is required by law to monitor the operation of the Deprivation of Liberty Safeguards. Staff showed that they understood their responsibilities under the Mental Capacity Act 2005. DoLS applications had been made for people who lived in the home to ensure that people were not deprived of their liberty unnecessarily.
Good positive relationships had developed with staff who treated people with kindness and compassion. Relatives were extremely positive about the kind, caring and supportive relationships that had developed between staff and people. Visiting professionals commented on the calm atmosphere in the home and enjoyed spending time at the service. Staff communicated with people using a variety of different methods to help them understand and respond to people’s individual needs and choices. People led active, busy lives and were fully involved in community life with L’Arche and the wider community.
Relatives said they had no complaints and would recommend the service as it integrated people into life in the L’Arche and wider community. Professionals said they enjoyed spending time at the home as it was calm and peaceful and one professional said they would place a relative at the home if they needed the care the service provided. Staff were aware of the aims and values of the service to treat people who used the service as equals.
We found three breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2010. You can see what action we told the provider to take at the back of the full version of the report.
People were taking part in activities in the community including swimming, visiting the library and shopping on the day of our visit. Others were relaxing at home. People were encouraged to be fully involved in the running of the service including taking part in the cooking and cleaning.
People told us about their recent holidays which were arranged to meet people's individual needs and preferences. People's hobbies and interests were supported and people had support to achieve the personal goals and aspirations.
People maintained good health because the service worked closely with health and social care professionals. The service responded well to people's changing needs. The home was safe and well maintained and suited people's needs.
Staff were supported and supervised and given the training they needed to provide a good quality service. There was enough skilled and experienced staff to meet people's needs and staff engaged with people in a calm, respectful and reassuring manner.
The robust quality assurance and monitoring systems ensured that the service was safe. Checks were made on staff, as part of the recruitment process, to make sure that people were safe and supported by appropriate staff. There were suitable arrangements in place to ensure the service was properly managed.
People looked happy and relaxed in the company of each other and staff. We saw that people took part in a range of community based activities that they enjoyed and were involved in the local and wider community. People had support to take part in household tasks and had the opportunity to go food shopping and prepare their own meals. Everyone was fully involved and included in the running of the service.
People told us or indicated that they felt safe and well looked after. People told us or indicated that they could express any problems to the staff who would listen and act. People said that they thought the staff were kind and caring. Staffing was planned around individual needs and activities.
People's health needs were supported and the service worked closely with health and social care professionals to maintain and improve people's health and well being.
The home was clean and homely and everyone we spoke to said or expressed that they were happy with their bedrooms and other facilities.
People told us or expressed that the staff were kind and helpful and that they felt safe.
Peoples' hobbies and interests were supported and people had support to keep in touch with and visit their family and friends. Cultural needs were supported and respected. People were part of the local and wider community.
The service worked closely with health and social care professionals to ensure that people had the support they needed to remain well and healthy.