Kingston House 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.

Kingston House accommodates up to nine adults who have a learning disability and who may also have an autistic spectrum disorder and mental health needs. Kingston House is a large detached house situated in a quiet residential area in Leigh on Sea and close to all amenities. The premises is set out on three floors with each person using the service having their own individual bedroom and adequate communal facilities are available for people to make use of within the service.

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 the last inspection on 1 December 2015, the service was rated ‘Good’. At this inspection we found the service remained ‘Good’.

This inspection was completed on 21 November 2017 and there were seven people living at Kingston House.

A registered manager was in post. 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.

Our key findings across all the areas we inspected were as follows:

• Suitable arrangements were in place to keep people safe. Policies and procedures were followed by staff to safeguard people and staff understood these measures. Risks to people were identified and managed to prevent people from receiving unsafe care and support. The service was appropriately staffed to meet the needs of the people using the service. People received their medication as prescribed and in a safe way. Recruitment procedures were followed to ensure the right staff were employed. People were protected by the providers arrangements for the prevention and control of infection. Arrangements were in place for learning and when things go wrong.

• Staff had a thorough induction to carry out their role and responsibilities effectively. Staff had the right competencies and skills to meet people’s needs and received regular training opportunities. Suitable arrangements were in place for staff to receive regular formal supervision. People’s nutritional and hydration needs were met and they were provided with drinks and snacks throughout the day. People received appropriate healthcare support as and when needed from a variety of professional services. The service worked together with other organisations to ensure people received coordinated care and support. 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 were treated with care, kindness, dignity and respect. People received a good level of care and support that met their needs and preferences. Staff had a good knowledge and understanding of people’s specific care and support needs and how they wished to be cared for and supported.

• Support plans were in place to reflect how people would like to receive their care and support, and covered all aspects of a person's individual circumstances. Social activities were available for people to enjoy and experience both ‘in house’ and within the local community. Information about how to make a complaint was available and people’s representatives told us they were confident to raise issues or concerns.

• Suitable arrangements were in place to

This inspection took place on 1 December 2015.

Kingston House provides accommodation for up to seven people who have a learning disability. There were seven people living in the service on the day of our inspection.

There was a registered manager in post. 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.

Staff had the necessary skills and knowledge to meet people’s assessed needs safely. Staff were well trained and supported. There were sufficient staff who had been recruited safely to ensure that they were fit to work with people.

People told us that they felt safe and comfortable living at Kingston House. Staff had a good understanding of how to protect people from the risk of harm. They had been trained and had access to guidance and information to support them in maintaining good practice.

Risks to people’s health and safety had been assessed and the service had support plans and risk assessments in place to ensure people were cared for safely. People received their medication as prescribed and there were safe systems in place for receiving, administering and disposing of medicines.

The manager and staff had an understanding of the Mental Capacity Act (MCA) 2005 and Deprivation of Liberty Safeguards (DoLS) and had made applications to the Local Authority as needed to ensure that people’s rights were protected. The Mental Capacity Act 2005 (MCA) provides a legal framework for making particular decisions on behalf of people who may lack the mental capacity to do so for themselves. The Act requires that as far as possible people make their own decisions and are helped to do so when needed. When they lack mental capacity to take particular decisions, any made on their behalf must be in their best interests and as least restrictive as possible. DoLS are a code of practice to supplement the main Mental Capacity Act 2005. These safeguards protect the rights of adults by ensuring that if there are restrictions on their freedom and liberty these are assessed by appropriately trained professionals.

People were supported to have sufficient amounts of food and drink to meet their needs. People’s care needs had been assessed and catered for. The support plans provided staff with good information about how to meet people’s individual needs, understand their preferences and how to care for them safely. The service monitored people’s healthcare needs and sought advice and guidance from healthcare professionals when needed.

Staff were kind and caring and treated people respectfully. People participated in a range of activities that met their needs. Families were made to feel welcome and people were able to receive their visitors at a time of their choosing. Staff ensured that people’s privacy and dignity was maintained at all times.

There were systems in place to monitor the quality of the service and to deal with any complaints or concerns.

On the day of inspection there were five people living at Kingston House.

We spoke with four people who lived at the home, but in some cases due to their needs we were not able to have long conversations with them. In response to our question, "Do you like living here," one person replied, "Yes." Another person said, "I like living here; all of the staff are very nice." We observed the care and attention that people received from staff. All of the interactions we saw were appropriate, respectful, encouraging and friendly.

The accommodation was adapted to meet the needs of the people living there. We found the home was warm, clean and was personalised to the people who lived there.

We observed that before people received any care or treatment they were asked for their consent and the provider acted in accordance with their wishes. Where people did not have the capacity to consent, we found the provider acted in accordance with legal requirements.

We saw that people's support plans and risk assessments reflected their needs and were up to date. Staff we spoke with were aware of the contents of the support plans, which enabled them to deliver appropriate and safe care.

The provider had systems in place that ensured the safe receipt, storage, administration and recording of medicines. Staff recruitment systems were robust.

We used a number of different methods to help us understand the experiences of people using the service. This was because people using the service had complex needs which meant that some people were not able to tell us their experiences. Due to this we observed how staff interacted with people using the service. We spoke with one person using the service who told us that they liked living at the service and that staff gave them support. They told us that the food was, “Very nice.”

We spoke with two relatives who told us that the care was, “Excellent.” One relative said that the service was, “Like a big family.”

We looked at three care plan files and found that people’s individual needs had been considered and plans detailed the support required. We found that people’s capacity to consent to care and treatment was not consistently assessed and recorded.

There were effective systems in place to reduce the risk and spread of infection. However we found that some systems in place were not effective to ensure that the premises were safe and suitable for people using the service.

We found that people were cared for, or supported by, suitably qualified, skilled and experienced staff. There were systems for people using the service and others to raise any concerns, complaints or compliments they had and staff took appropriate action as required.

We have clarified since our inspection that Michelle Lee Jones is the registered manager for Kingston House.

People with whom we spoke, told us that they were very satisfied with the staff, the food and their activities. They told us that they were able to choose their new furniture and that they helped to make up their support plan. People told us that staff supported them in accessing the local and wider community, so that they could take part in their chosen interests and activities. People also told us that they were satisfied with the way the home is run and with staff attitudes towards them.