Chitty Barn is a care home. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection. The service is registered for three people with complex learning disabilities and who, at times, may present behaviours which can challenge. The service is a bungalow in the centre of Dover. The front door of the home leads directly into the living room. There are three bedrooms, a kitchen, bathroom and separate laundry room. Outdoor space is limited as there is no back garden and a paved forecourt at the front of the service. At the time of the inspection two people were living at the service.

At the last inspection, the service was rated Good. At this inspection we found in some areas the service remained Good whilst in others the service was Outstanding.

Chitty Barn has been developed and designed in line with the values that underpin the Registering the Right Support and other best practice guidance. These values include choice, promotion of independence and inclusion. People with learning disabilities and autism using the service can live as ordinary a life as and citizen.

People living at Chitty Barn had complex needs, which included restrictive routines which impacted on their daily lives which could at times last for many hours. With the help of health care professionals, individual behaviour training sessions and consistent staffing this behaviour had been reduced and people were now able to access the community, and visit their local GP.

At times people could become anxious which led to their behaviour becoming challenging. Without the correct support this could have a negative effect on themselves and others. The service was working with health care professionals to support people in the least restrictive ways as possible.

Staff were passionate about how to uphold people’s rights and supporting them to have control over their lives. They demonstrated awareness about people having the same opportunities as themselves to lead fulfilling lives of their choice.

The provider had a positive approach to support people to reach their full potential, whilst reducing risks and keeping them safe. Staff had a good understanding of how to protect people from harm whilst upholding their rights to make choices and take risks to enhance their lives and seek new adventures.

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 support this practice

People said they felt safe living at Chitty Barn. Staff had completed training on how to keep people safe and understood their responsibility to report any incidents to the management. Robust systems were in place to make sure people’s finances were protected.

Checks on the premises were in place, including cleaning schedules, to reduce the risk of infection and keep the premises clean. Repairs to the premises were recorded and acted on promptly to make sure the premises were safe. The design of the premises was based around a family home and. adaptations had been made to some of the furniture to reduce the risk of people harming themselves and others if they displayed behaviour that could be challenging.

Accidents and incidents were recorded and sent electronically to the management team for further assessment. This enabled them to look for patterns and trends, take any further appropriate action and learn from incidents when things went wrong.

People received their medicines from trained competent staff. Medicine records were clear, checked and in good order to ensure people received their medicines safely. People’s medicine was reviewed regularly to make sure they were receiving the right medicines they needed to keep well.

When people came to live at the service a thorough care needs assessmen

This unannounced inspection took place on 2 December 2015. This is the first inspection since the service was registered on 10 August 2014.

The service is registered to provide accommodation and personal care for up to three people who have learning disabilities .The service is a bungalow in the centre of Dover and close to the town centre and the local park and beach. The front door of the home leads directly into the living room. There are three bedrooms, at the front of the house, which has an en suite bathroom and two towards the back, with a communal bathroom located between the rooms. There is a kitchen, which has a breakfast bar, and a separate laundry room. Outdoor space is limited as there is no back garden and a paved forecourt at the front of the service. At the time of the inspection three people were living at the service.

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.

People told us they felt safe living at the service. The care and support they received was personal to their preferences and needs. Potential risks to people in their everyday lives had been identified and detailed guidance was in place to ensure that risks were reduced to a minimum without restricting peoples’ activities or their lifestyles.

Safeguarding procedures were in place to keep people safe from harm. The staff had been trained and understood their responsibility to recognise and report safeguarding concerns. They demonstrated a good understanding of what constituted abuse and how to report any concerns. Staff were aware of the whistle blowing policy and were confident that if they raised concerns the provider would take the necessary action to protect the people living at the service.

Accidents and incidents had been recorded, investigated and appropriate action had been taken to reduce the risks of them happening again. Plans were in place in the event of an emergency and people had personal evacuation plans in the event of a fire. Checks on the equipment and the environment were carried out to make sure the premises were safe. There was a plan in place to paint the outside of the premises, and repairs and maintenance were completed on a regular basis.

People were being supported by sufficient numbers of staff that had the right skill mix, knowledge and experience to meet their needs. At certain times of the day, staffing levels increased to make sure people were supported with activities of their choice. Recruitment procedures were in place to check that staff were of good character and suitable for their job roles. New staff were given a detailed induction, and completed a probationary period to make sure they were suitable to work in the service. The training programme ensured that staff had the right skills, knowledge and competencies to carry out their roles. Specialist training such, as epilepsy had also been provided.

The management team supported staff through their one to one meetings and staff meetings. Each member of staff had received an annual appraisal to discuss their ongoing training and development needs.

When people came to live at the service their needs were assessed to ensure that people’s care was delivered in line with their preferences and choices. Care and support plans were designed around people’s individual interests and needs. These were written in a way people could understand and included pictures and photos.

Where people did not have the capacity to consent, the provider acted in accordance with

legal requirements. 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).

People’s health was monitored and when it was necessary, health care professionals were involved to make sure people remained as healthy as possible. People were encouraged and supported to have a nutritious and healthy diet. The management of medicines was robust with daily checks undertaken to make sure people received their medicines safely.

People said they liked the food. They were involved in the menu planning and also went shopping to buy the food. People had their weight monitored and if they needed further support with their dietary needs they were seen by a dietician to make sure they continued to receive a healthy diet.

There was a strong emphasis on person centred care and care plans covered people’s preferred daily routines and lifestyle. People talked about their support plans and showed they were involved in the planning of their care. The plans were reviewed on a regular basis so that staff had the current guidance to meet people’s changing needs. The registered manager ensured that staff had a full understanding of people’s support needs and had the skills and knowledge to meet them. Staff knowledge was monitored to make sure they knew people well and how to support them in a way that suited them best. The service was flexible and responded positively to change. They supported people to follow their own pathway and reach new goals.

People were relaxed in the company of staff and staff listened and acted on what people said. People were treated with dignity and respect and their privacy was respected. Staff were kind and patient in their approach. They knew people well and had developed good relationships with them. People were encouraged to enjoy their social lives and meet with their family and friends regularly. People were able to express their opinions and were encouraged and supported to access the local and wider community.

Feedback about the service was gathered from people, their relatives and other stakeholders about the service. Their opinions had been summarised and analysed to promote and drive improvements within the service. Staff told us that the service was well led and that the management team were very supportive.

Comprehensive quality monitoring was in place with detailed checks regularly undertaken to identify any shortfalls within the service and how the service could be continuously improved. There was a culture of openness and inclusion within the service.

People indicated they did not have any concerns. There were regular meetings to make sure they were involved in the day to day running of the service. The complaints procedure was in a format that people could understand. There had been no complaints this year.