This inspection took place on 30 October 2018 and was unannounced.

Church Lane is a 'care home'. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

Church Lane is registered to provide accommodation and personal care for up to 20 adults who have learning disabilities and may also have physical disabilities. The upstairs of the service is called Inglewood and this provides accommodation and personal care for eight people and the ground floor is referred to as Church lane and provides accommodation and personal care for ten people. There were 17 people using the service at the time of the inspection.

At our last inspection we rated the service as Good. At this inspection, we found the evidence continued to support the rating of Good and there was no evidence or information from our inspection and ongoing monitoring that demonstrated serious risks or concerns. This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection.

At this inspection we found the service remained Good.

A registered manager was employed at the home. A registered manager is a person who has registered with the Care Quality Commission to manage the home. 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 home is run.

People had their support needs assessed and where possible were involved in the development of their care plan. Staff had access to people's care plans and received regular updates where people's needs had changed. Care plans were updated and included changes to peoples' support needs.

People were supported to attended routine and specialist health checks.

People felt staff were kind and caring, and their privacy and dignity was respected in the delivery of care and their choice of lifestyle. Where possible people were aware of their care plans and they were involved in care plan reviews. Staff prompted people's choices and respected their decisions.

People were provided with a choice of meals that matched their dietary and cultural needs and choices.

There were sufficient numbers of staff deployed to meet people's needs. Staff received ongoing training to support them in their role. Safe recruitment practices were followed.

People continued to be protected from abuse. Staff understood how to identify and report concerns Staff were aware of whistleblowing and what assistance was available from external bodies to report suspected abuse on to and follow up alleged incidents.

The service was clean and staff followed infection control processes. They had completed infection control and food hygiene training.

The service had an open and inclusive culture and staff were positive about the support they received from staff and the registered manager.

Quality monitoring systems and processes were in place to help drive continual improvements. An action plan had been developed which recorded where action needed to be taken. Feedback was being sought to capture people views on the overall quality of the service.

People’s personal information had been stored securely within the registered office, this protected people’s confidentiality.

Services are required to prominently display their CQC performance rating. The provider had displayed the rating in the entrance hall. The rating can be found on the Caretech website.

Further information is in the detailed findings below.

The inspection was carried out on 21 and 22 April 2016 and was unannounced. At our previous inspection on 7 May 2015 we found breaches of three regulations of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. The provider sent us an action plan which stated they would meet the regulations by the 25 September 2015. At this inspection we found that improvements had been made to meet the relevant requirements.

Church Lane is a care home providing accommodation and personal care for up to 20 adults who have learning difficulties and may also have physical difficulties. The upstairs of the service is called Inglewood and this provides accommodation and personal care for eight people who have learning disabilities and the ground floor of the service is referred to as Church Lane. The ground floor provides accommodation and support for ten people who have learning and physical disabilities. Some people had sensory impairments, epilepsy, limited mobility and difficulties communicating. CareTech Community Services Ltd owns the home.

At the time of out inspection a new manager had been in post for a period of seven weeks but they had not applied to become the registered manager. The previous registered manager had left at the same time as the new manager started. 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 Care Quality Commission (CQC) monitors the operation of the Deprivation of Liberty Safeguards (DoLS) which applies to care services. At the time of the inspection, the previous registered manager had applied for DoLS authorisations for some people living at the service, with the support and advice of the local authority DoLS team. The manager and the management team understood their responsibilities under the Mental Capacity Act 2005. Mental capacity assessments and decisions made in people’s best interest were recorded.

People experienced a service that was safe. Staff and the management team had received training about protecting people from abuse, and they knew what action to take if they suspected abuse. Risks to people’s safety had been assessed and measures put into place to manage any hazards identified. The premises were maintained and checked to help ensure people’s safety.

Staff told us the manager and deputy managers were approachable and they were confident to raise any concerns they had with them. Staff were supported to fulfil their role in meeting people’s needs. A complaints policy and procedure was in place which was accessible to people using the service.

There were enough staff on duty with the right skills to meet people’s needs. Staff had been trained to meet people’s needs. Recruitment practices were safe and checks were carried out to make sure staff were suitable to work with people who needed care and support.

People received their medicines safely and when they needed them. Policies and procedures were in place for the safe administration of medicines and staff had been trained to administer medicines safely. People were supported to remain as healthy as possible with the support of external health and social care professionals.

People had access to the food that they enjoyed and were able to access drinks with the support of staff if required. People’s nutrition and hydration needs had been assessed and recorded. Staff met people’s specific dietary needs and received specialist training where required. People were asked for feedback on their food and action was taken if required.

People were treated with kindness and respect. People’s needs had been assessed to identify the care they required. Care and support was planned with people and their loved ones and reviewed to make sure

The inspection was carried out on 07 May 2015. Our inspection was unannounced.

Church Lane is a care home providing accommodation and personal care for up to twenty adults who have learning disabilities and may also have physical disabilities. The upstairs of the home is called Inglewood and this provides accommodation and personal care for eight people who have learning disabilities and the ground floor of the home is referred to as Church Lane. The ground floor provides accommodation and support for 10 people who have learning and physical disabilities. Some people had sensory impairments, epilepsy, limited mobility and difficulties communicating. The home is located close to the centre of Bearsted Green near Maidstone.

The service had a registered manager. A registered manager is a person who has registered with the Care Quality Commission (CQC) 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.

We found a number of breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.

Risk assessments had been carried out to identify and reduce risks relating to the premises. The control measures identified within these risk assessments had not always been followed. People were exposed to trip hazards in a corridor, and the door to the cellar had been left ajar and unlocked which presented a serious risk to people moving around the home. The hallway and area to the bottom of the stairs had been used to store filing cabinets and files, which had caused a narrow point. We made a recommendation about this.

The premises and gardens were generally suitable for people’s needs. However, there had been a number of water leaks above the ground floor dining room and staff office. These had been temporarily repaired but left looking unsightly.

Policies and procedures were available for staff had not been updated and reviewed in line with changes in legislation and good practice guidance.

Fridge and freezer temperatures had not always been monitored and recorded in line with good practice and guidance to ensure food had been stored at the correct temperature. We made a recommendation about this.

Policies and procedures relating to consent had not been updated to reference the Mental Capacity Act 2005. There was no guidance included in the policy about how, when and by whom people’s mental capacity should be assessed. We made a recommendation about this.

Staff did not have a good understanding of mental health issues that may affect people and they had not had any mental health awareness training.

People were mostly communicated with effectively. However there was one period of thirty minutes during the day where this was not the case. We made a recommendation about this.

There were limited planned activities within the ground floor of the home. Some people had a schedule of activities, sometimes these didn’t go ahead as planned, which meant that people did not have activities to stimulate them. Staff told us that they felt there could be more activities for people.

Staff were clear about their roles and responsibilities and knew who to report to if they suspected abuse.

There were suitable numbers of staff on shift to meet people’s needs. The provider followed safe recruitment procedures to ensure that staff working with people were suitable for their roles.

People received safe care and support with their medicines because medicines were appropriately managed to ensure that people received their medicines as prescribed. Records were clear and the administration and management of medicines was properly documented.

Staff received good support from their manager. They had access to training and supervisions took place regularly which meant that staff had opportunities to discuss their practice, seek guidance and discuss training.

The Care Quality Commission (CQC) monitors the operation of the Deprivation of Liberty Safeguards (DoLS) which applies to care homes. DoLS applications to the local authority had been made for most people. The registered manager understood when an application should be made and how to submit one and was aware of a Supreme Court Judgement which widened and clarified the definition of a deprivation of liberty.

People had access to nutritious food that met their needs. The cook had a good knowledge of preparing and cooking food for people with different dietary needs. The cook had met with a speech and language therapist as part of their induction to gain guidance specific to people who lived in the home.

The kitchen of the home was well stocked and included a variety of fresh fruit and vegetables. Food was prepared in a suitably hygienic environment and we saw that good practice was followed in relation to the safe preparation of food.

People living in the upper floor of the home were supported by staff to make their own food on a daily basis. There was a kitchen rota in place and each person took it in turns to cook.

People received effective, timely and responsive medical treatment when their health needs changed. Records evidenced that people received treatment from their GP, hospital, nurse, chiropodist, dentist and had regular optician appointments.

People were supported by staff who understood their needs and how they communicated. We saw that when staff interacted with the people they asked them about things that they liked to do and this was consistent with what was in their care plans. Staff made efforts to ensure that people received the support they needed.

Relatives told us that they had been involved with planning their family member’s care; however we did not see evidence to show that relatives and people had been involved. Where people had made decisions about their lives these had been respected.

Staff made efforts to preserve people’s privacy and dignity, such as closing doors and using shower curtains when giving care. People’s information was treated confidentially.

Relatives told us that they were able to visit their family members at any reasonable time.

Relatives were encouraged to provide feedback about the service provided to their family members.

There was a complaints and comments folder that contained the complaints procedure. An accessible version of the complaints procedure was available which described in simple terms and pictures how people should complain. Staff knew how to support people to complain.

Effective procedures were in place to keep people safe from abuse and mistreatment. Staff were aware of the whistleblowing procedures and voiced confidence that poor practice would be reported.

Staff told us they felt valued, they felt there was an open culture at the home and they could ask for support when they needed it. Staff communicated well with each other regarding the needs of people.

The registered manager demonstrated that they had a good understanding of their role and responsibilities in relation to notifying CQC about important events such as injuries and abuse, as these had been made in a timely manner. The registered manager explained that they had good support from their manager.

A number of audits were carried out by the provider in order to identify any potential hazards and ensure the safety of the people.

You can see what action we told the provider to take at the back of the full version of this report.

At our inspection on 4 September 2013 we found evidence that there was not enough staff on shift to meet the needs of the people who lived at the home. When we visited on 12 March 2014 we found that steps had been taken to address this concern and there were enough staff to ensure that the nurse call bell was answered in a prompt manner for example. Staff told us that they would be offered additional hours if another staff member was absent. We reviewed the staff rotas and saw that cover had been arranged in advance and that the needs of the people living at the home were met as a result.

We spoke with one person and they told us that they liked living at the home because they were able to take part in activities they enjoyed. We saw that staff interacted with people at the home in a respectful manner and involved them in day to day decisions about their care. We saw that people had opportunities to take part in a range of activities that met their social and recreational needs.

We used a number of different methods like observation and a Short Observational Framework Inspection (SOFI) for thirty minutes on six people to help us understand the experiences of people who used the service, as people had complex needs which meant they were unable to tell us about their experiences.

Care and treatment was not planned and delivered in a way that was intended to ensure people's safety and welfare.

We observed that people were comfortable in the presence of staff and the atmosphere at the home was friendly.

People who lived in the home expressed their views and were involved in making decisions about their care and treatment. One person said “We have house meetings here and I am able to discuss what I want and what I would like to do". A member of staff said, “People who lived in the home have opinions and are listened to by staff”.

We spoke with two people who used the service about their experience of living in the home. They told us that they liked their home. They commented "I like it here”. “I like the way I am supported by staff” and “I choose to go to college once a week and I enjoy it”.

There were effective systems in place to reduce the risk and spread of infection.

The provider had taken steps to provide care in an environment that was suitably designed and adequately maintained.

There were effective recruitment and selection processes in place.

Staff told us they received good training opportunities and we saw staff training records that confirmed this.

People were made aware of the complaints system.

The inspection was carried out and lasted for seven hours. We used a number of different methods like observation to help us understand the experiences of people who used the service, as people had complex needs which meant they were unable to tell us about their experiences. We found that staff treated people respectfully, and encouraged people to be independent where possible. Staff took the time to make sure that they involved people in decisions about their care. We saw for instance someone being asked if they would like a drink and about their preferred desert after lunch.

We spoke with staff, read records, looked round the home and made observations of the care and support that people received. One person who used the service told us “I like it here”, I cooked pie yesterday”. This demonstrated that staff supported people to carry out individual activities in the home.

We observed that people were comfortable in the presence of staff and that the atmosphere at the home was friendly and relaxed. We carried out a Short Observational Framework Inspection (SOFI) for forty minutes.

We found that there were some outstanding maintenance issues. The provider’s monthly report dated September 2012 indicated that water temperature urgently requires attention as the water is either too hot or too cold. As at the time of our visit, the problem that was reported to the provider in January 2012 by the manager had not been addressed.

Communication difficulties meant that people who lived in the home were not able to engage directly with us during our visit. We saw staff working with people, helping them with their day to day needs. We saw that staff were careful to protect people’s privacy and dignity. The atmosphere was relaxed and routines were flexible. The people we spent time with during our visit were content most of the time we were in the home.