Summerlands is a service for up to nine people with learning disabilities and /or autistic spectrum disorder who may also have behaviours that can be challenging. The service is a single storey property close to the village of Charing. There were eight people living at the service when we inspected.

Summerlands 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 care service 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 any citizen.

There was a registered manager at the service who was supported by a deputy 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.

At the last inspection on 18 November 2016, we asked the provider to take action to make improvements related to concerns about applying the principles of the Mental Capacity Act, staff understanding the visions of the service, care plans relating to health not giving the guidance required. Also quality auditing systems used by the provider had not identified the shortfalls found at our inspection, issues about people receiving the correct level of one to one support and notifications had not always been submitted when required and this action has been completed.

People were supported to have maximum choice and control of their lives and staff supported people in the least restrictive way possible; the policies and systems in the service supported this. People were supported by staff who knew them well and who adapted their support to meet the needs of each person. Staff used a range of communication tools to enable people to understand decisions and express themselves. People were treated with kindness and compassion and in a way which promoted their dignity and privacy.

People were involved in developing their own care plans; this led to documents which reflected the person’s personality alongside their needs. Care plans gave staff the information they required to support people in line with their preferences and in a way, which met their needs. Staff had worked with people to develop ways to become more independent. People took part in a range of activities, which they told us they enjoyed. People’s health needs were managed well, staff had regular communication with health professionals and any advice given was incorporated in to people’s care plans. People’s medicines were managed safely and in the way they preferred. People chose what they wanted to eat and when, staff encouraged people to take part in preparation of their meals and drinks. People had been spoken to about their wishes for end of life care and plans were in place which detailed their choices.

People were supported by staff who had the training and support required to enable them to carry out their roles. Staff had received safeguarding training and understood their responsibilities in relation to reporting concerns. Staffing levels were based around people’s needs and activities and staff had been recruited using processes which ensured they were suitable to support people.

Risks to people and the environment were identified, assessed and plan were in place to mitigate risks. Accidents and incidents were analysed and reviewed for learning by the registered manager and centrally by the provider. Staff understood the principles of infection control and personal p

We carried out an announced inspection of the service on 16 and 18 November 2016. Summerlands is registered to accommodate up to nine people and specialises in providing care and support for people who live with a learning and/or physical disability. At the time of the inspection there were eight people using the service.

On the day of our inspection there was a registered manager in place. 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.

People were supported by staff who had received safeguarding adults training and understood how to reduce the risk of people experiencing avoidable harm or abuse. Risk assessments had been completed in areas where people’s safety could be at risk. People had the freedom to live their lives as they wanted to. Staff were recruited in a safe way and there were enough staff to meet people’s needs and to keep them safe.

Accidents and incidents were investigated. Assessments of the risks associated with the environment which people lived were carried out and people had personal emergency evacuation plans (PEEPs) in place. People’s medicines were stored, handled and administered safely.

People were supported by staff who received an induction, were well trained and received regular assessments of their work.

The principles of the Mental Capacity Act (2005) were applied in some cases but not all, when decisions were made for people. Deprivation of Liberty Safeguards had been applied for and where applications had been granted, appropriate safeguards were in place. People’s day to day health needs were met, but more detailed care planning for supporting people who were living with epilepsy was needed. Staff ensured people were given choices about their support needs and day to day life. People were supported to follow a healthy and balanced diet. Referrals to relevant health services were made where needed.

Staff supported people in a kind and caring way. Staff understood people’s needs and listened to and acted upon their views. Staff responded quickly to people who had become distressed. People were able to contribute to decisions about their care and support needs. People were provided with information about how to contact an independent advocate if needed. Staff understood how to maintain people’s dignity. People’s friends and relatives were able to visit whenever they wanted to.

People’s care records were person centred and focused on what was important to them. People were able to take part in the activities that were important to them, but records used to record what people had done each day, were not always fully completed. Care records were regularly reviewed. People were provided with the information they needed if they wished to make a complaint.

People spoke highly of the registered manager, although there was mixed feedback from health and social care professionals. The registered manager understood most of their responsibilities, however the CQC were not notified that a decision had been granted to deprive a person of their liberty. Auditing processes were in place, but they had not identified the lack of recording when people had received commissioned one to one support. Staff struggled to describe the values and aims of the provider. The registered manager had an ‘open door’ policy and welcomed people to talk with them. People who used the service were encouraged to provide their feedback on how the service could be improved.

We carried out an announced inspection to check the service was compliant as there was a breach in the regulations at the previous inspection on the 7th February 2014.

We spoke with two people who used the service and three members of staff. People told us that they liked the refurbished kitchen, which was clean and well maintained. However, we also saw that the cooker hood currently being used remained dusty and greasy and had not yet been replaced, although a replacement cooker hood was scheduled to be fitted. We saw that the medicines cabinets had been replaced; we saw that medication was stored safely and securely at the service.

We spoke with three of the nine people who used the service. They were positive about the service. They said they liked living there, and got on with the staff. They told us about the activities they liked to do, and showed us how they had personalised their rooms to reflect their interests. People’s needs were assessed and care was planned and delivered in line with their individual care plan, which included their healthcare needs. People who used the service were involved in their care planning, which was reviewed regularly.

People told us they liked the food, which was prepared onsite by care staff. There wasn’t a menu, but people had choices about what they wanted to eat. We saw that there was food available for people who needed special diets.

There were processes for the management and administration of medication. However, medication was not always stored safely and securely at the service.

There were processes for maintaining the building, but there could be delays with non-emergency repairs. We saw that the kitchen was in need of refurbishment, and that standard of cleaning was not always satisfactory.

The necessary recruitment checks were carried out before staff started working at the service.

People told us that they were happy with the care they were receiving and that the staff supported them to be in control of their own lives. One person said “I am very happy here” and another said “I can choose what I do”. We found that people were treated with respect and were able to make their own decisions about their care and their lives. One person told us “They listen to me”.

We saw that people gave their consent before any care was given and that the care they received met their needs. People were supported to remain as independent as they could be and to learn new skills. One person told us “I go into the kitchen and help make my lunch, I can choose what I want to eat” and another person said ”I use the washing machine”. Staff understood people’s needs and how to meet them in the way they preferred. Staff were qualified and skilled to carry out their roles.

People told us they felt safe in the home. They felt they could talk to the staff or manager about any concerns they had. People knew how to make a complaint if they needed to and felt they would be listened to.