About the service: K.T.M Care Limited is an autism specialist service registered to provide personal care to children, young people and adults with autism in their own homes as well as people with a mental health need. At the time of our inspection there were 19 people using the service.

People’s experience of using this service:

People received a reliable, flexible service, with care delivered by compassionate, kind and well-trained staff.

People were supported to have maximum choice and control of their lives in the least restrictive way possible; the policies and systems in the service supported this practice.

The registered manager had clear aims and objectives for the service. Staff had a good understanding of people’s needs and provided personalised care which put people at the heart of the service.

Systems were in place to seek people’s views and monitor the quality and safety of the service, with planning for continuous improvement of the service.

People received care and support in line with the values that underpin the ‘Registering the Right Support’ and other best practice guidance. People with learning disabilities and autism using the service were supported to live as ordinary a life as any other citizen.

There were enough staff at the time of our inspection to meet people’s needs and provide personalised care in a timely manner.

Staff understood people well and their preferred methods of communication, where they lacked verbal skills. Staff had respectful caring relationships with people they supported. They upheld people’s dignity and privacy and promoted their independence.

Staff roles and responsibilities were clear. People were supported by skilled staff with the right knowledge and training. Positive, enabling relationships had developed between people and the staff who supported them.

People received their medicines as prescribed. Systems were in place for the safe management and supply of medicines. Incidents and accidents were investigated, trends analysed, and actions were taken to prevent recurrence.

Care plans were detailed with clear explanations of control measures for staff to follow to keep people safe. Support was planned and delivered in a structured way to ensure people's safety and wellbeing.

The service continued to be well led. The registered manager and deputy manager worked well to lead the staff team in their roles and ensure people continued to receive a good service. Staff and the registered manager demonstrated a genuine interest and passion to deliver personalised care.

Staff worked in partnership with professionals to deliver care and support and maintained links with the local community. The service was provided flexibly to enable people to access a varied range of work, social and leisure opportunities, according to individual needs and choice.

Rating at last inspection: Good (report published on 22 November 2016).

Why we inspected: This was a scheduled inspection based on the previous rating.

Follow up: We will continue to monitor intelligence we receive about the service until we return to visit as per our re-inspection programme. If any concerning information is received we may inspect sooner.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

K.TM Care Limited provides personal care and support for people with learning difficulties and autistic spectrum disorder. At the time of our inspection, 32 people were being supported.

This inspection took place on 9 and 16 August. This was an announced inspection. The provider was given 48 hours' notice because the location provides a domiciliary care service and we needed to know that someone would be available.

There was a registered manager in post. 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.

There were procedures and processes in place to ensure the safety of the people who used the service. Staff were provided with training and guidance in how to keep people safe and what they should do if they were concerned that a person was at risk or was being abused. Staff understood their roles and responsibilities in providing safe and good quality care to the people who used the service.

There were sufficient numbers of staff who were trained and supported to meet the needs of the people who used the service and recruitment checks were completed on new staff to ensure that they were of a suitable character.

People told us that they had good relationships with the staff that supported them. People and their relatives, where appropriate, were involved in making decisions about their care and support. People received care and support which was planned and delivered to meet their specific needs and people's consent was sought before they were provided with care and support. The service was up to date with the Mental Capacity Act 2015.

Processes were in place that encouraged feedback from people who used the service and their relatives. There was a complaints procedure in place and people knew how to make a complaint if they were unhappy with the service.

The management team were approachable and the service had an open and empowering culture. There was good leadership in the service. The service took action to address identified shortfalls and as a result the quality of the service continued to improve.

K.T.M Care Limited provided a domiciliary care service for 22 disabled children, young people and disabled adults who were on the autism spectrum. It also provided respite care for their families.

As part of this scheduled inspection, we looked at the arrangements in place for consenting to care and support, looked at the care plans for five people, the recruitment and training of staff, the quality of the service and complaints.

We spoke to the registered manager, the office manager and four care staff. We spoke on the telephone with three family members who used the service.

We considered our inspection findings to answer questions we always ask; Is the service safe? Is the service effective? Is the service caring? Is the service responsive? Is the service well-led?

This is a summary of what we found;

Is the service safe?

Staff had the relevant experience, skills and training in order to care and support children and young people safely.

Care and risk assessments were in place to ensure that children, young people and adults had the opportunity to engage in activities of their choice and continue to live full lives protected from harm.

Is the service effective?

Young people and their families were involved in their care arrangements. The service tailored the support to each individual. The service was effective as it was person centred and they had control over the way it was managed and delivered.

Systems for the training and supervision of staff were in place. This ensured that the service was more effective as staff had the necessary skills and support to carry out their role.

Is the service caring?

All of the support and administrative staff we spoke with had a caring attitude. They were knowledgeable and understanding about autism and its effect on the lives of individuals and their families.

K.T.M Care Limited offered a personalised and individual service and spoke about the people who used the service in a kind, caring and professional way. Family members said, “The best service we have ever had.” And, “They so understand our family situation.”

Is the service responsive?

The service was responsive to the needs of people who used the service. The staff worked flexibly to enable the children, young people and adults to maintain their independence and to give family carers a break from caring.

A range of health and social care professionals from the community were involved in people's care. This showed that people received their care in a joined up way.

Is the service well-led?

Systems were in place for the effective monitoring of the service. This included care planning and risk assessments, staff support and dealing with, and learning from incidents and events. This ensured that individuals and families were getting a quality service from staff who were skilled at managing it.

One family member told us, “I am very happy with the care and support my child gets from K.T.M, they are so knowledgeable about autism, more than any other agency we have used.”