This was a comprehensive inspection which took place on 13th June 2018 and was unannounced. A previous inspection carried out in May 2016 did not identify any concerns.

Tamarisk 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.

Tamarisk accommodates people with a learning disability and some with complex needs. At the time of our inspection there were 3 people at the service.

The service also provides personal care support for a further five people living independently in the community. This inspection will focus on all eight-people receiving the regulated activity of personal care.

The premises are set in a quiet residential road on the outskirts of Greatstone. There is access to local shops including a pub, hairdressers and newsagents and the beach within walking distance. The service has three bedrooms, a wet room, lounge and kitchen and spacious rear garden.

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.

At our last inspection we rated the service 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.

Why the service is rated good.

People were protected from abuse and the service had safeguarding procedures that staff understood. Individual risk assessments provided staff with the information they needed to reduce and manage risks whilst ensuring people’s individuality was respected.

There were sufficient numbers of trained staff to meet people’s needs and staff rostering allowed flexibility to ensure that staff could support people’s activities and appointments. Staff felt supported and received regular training and supervision. Robust staff recruitment procedures included statutory checks, induction training and mentoring by experienced staff, prior to starting work.

People received their medicines from trained staff and medicines were stored and recorded safely.

People’s individual needs were met through the design of the building. The service was clean, and people were protected from cross contamination and infection. Incidents had been recorded appropriately with systems for follow up and learning in place.

People’s needs had been assessed and were reviewed to reflect their choices and wishes and their support plans gave staff the information they needed to provide effective care in line with best practice and legislation.

People were supported to eat and drink to maintain a balanced diet and stay in good health and their consent was sought about day to day issues such as what they ate and drank.

People were supported to have maximum choice and control of their lives and staff support them in the least restrictive way possible; the policies and systems in the service support this practice. Advocates were available to ensure that the provider worked in line with the principles of the Mental Capacity Act 2005 (MCA) and associated Deprivation of Liberty Safeguards (DoLS). DoLS applications had been submitted appropriately.

People had access to routine health care with follow up referrals made to health and social care professionals as required.

People were happy and relaxed with staff and had been supported to express their views. The staff team were long standing members who knew the people well and treated them with kindness and dign

This inspection took place on 4 May 2016 and was unannounced. The previous inspection was carried out in June 2014 and there were no concerns identified.

Tamarisk provides personal care and accommodation for up to three people who have a learning disability. It also provides a personal care service to a small number of people living in supported living accommodation within the Greatstone area. The service is in a quiet residential area of Greatstone; within a short walk are the beach, pub, newsagents, hairdressers and shops. There is a local bus service to the nearby towns of Lydd and New Romney.

The service has a registered manager, who was present throughout the inspection. 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 and associated Regulations about how the service is run.

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). The people at the service had been assessed as lacking mental capacity to make complex decisions about their care and welfare. At the time of the inspection the registered manager had applied for DoLS authorisations for people who were at risk of having their liberty restricted. They were waiting for the outcome from the local authorities who paid for the people's care and support. There were records to show who people's representatives were, in order to act on their behalf if complex decisions were needed about their care and treatment.

People were protected from the risk of abuse. Staff had received safeguarding training. They were aware of how to recognise and report safeguarding concerns both within the company and to outside agencies like the local council safeguarding team. Staff knew about the whistle blowing policy and were confident they could raise any concerns with the provider or outside agencies if needed.

Equipment and the premises received regular checks and servicing in order to ensure it was safe. The registered manager monitored incidents and accidents to make sure the care provided was safe. Emergency plans were in place so if an emergency happened, like a fire, the staff knew what to do. Quality assurance audits were carried out to identify any shortfalls within the service and how the service could improve. Action was taken to implement improvements. The complaints procedure was on display in a format that was accessible to people.

Before people moved into the service their support needs were assessed to make sure the service would be able to offer them the care that they needed. The care and support needs of each person were different, and each person's care plan was personal to them. People had in detailed care plans, risk assessments and guidance in place to help staff to support them in an individual way.

Staff encouraged people to be involved and feel included in their environment. People were offered varied activities and participated in social activities of their choice. Staff spoke about people in a respectful way which demonstrated that they cared about people's welfare. Staff knew people and their support needs well.

Staff were caring, kind and respected people's privacy and dignity. There were positive and caring interactions between the staff and people and people were comfortable and at ease with the staff.

People were encouraged to eat and drink enough and were offered choices around their meals and hydration needs. People were supported to make their own drinks and cook when they wanted to. Staff understood people's likes and dislikes and dietary requirements and promoted people to eat a healthy diet.

People rece

On 13 May 2013 we inspected Tamarisk and found non-compliance in the area relating to recruitment of staff. This was a follow up inspection to check compliance against that area. We did not speak with people who used the service as no new staff had been recruited since our last inspection and previously people felt the service recruited the right calibre of staff. We visited the office and spoke with the registered manager.

We found that there were robust recruitment procedures in place, in order to protect people who used the service.

This was the first inspection since the service was registered with the Commission in July 2012. We visited the location where three people received a personal care and accommodation service. Due to the communication needs of people we did not speak with people, but observed how people spent their time and their interactions with staff. We also visited one of the supported living houses. We spoke with four people who used the supported living services and five staff.

People had consented to their care and support and were happy living in supported living. One person said, “I am happy living here.” People talked about the community activities they were involved in and how they “do things for themselves”. Another person said, “I like going swimming, I go on Tuesdays”.

People we spoke with told us they were satisfied with their support. People confirmed that they had been involved in discussions about their support with staff. They said they had attended a review meeting. This was a meeting for them with their social worker, families and staff to discuss their care and support.

People talked about how they did some of the household chores and that the house was always clean and tidy. People spoke positively about the staff. One person said, “Yes, the staff are all nice.” However we found shorts in recruitment processes. People told us they did not have any concerns, but if they did they would speak with the staff and were confident things would be “sorted out”.