This inspection took place on 21 and 22 May 2018 and was unannounced. This meant the provider was not aware we intended to carry out an inspection. The inspection was undertaken by one inspector. We also spoke with relatives and professionals during the weeks commencing 28 May 2018 and 4 June 2018.

Leybourne 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 home is registered to provide support for up to eight people over two floors. Residential care is provided for people with a learning disability, physical disability or those with an autistic type condition. Nursing care is not provided at the home. On both days of the inspection there were six people using 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 time of the inspection there was no registered manager registered at the home. The previous registered manager had left the home and cancelled their registration in March 2018. A new manager had been appointed but it had been in post only around three weeks. A registered manager is a person who has registered with the 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 were supported on the inspection by the manager, the previous interim manager and the provider’s nominated individual.

Prior to the inspection we were aware of a number of safeguarding issues at the home. Some of these are still ongoing and we will monitor the outcome of these investigations. Staff were aware of safeguarding issues and told us they now felt confident in reporting any concerns around potential abuse. They said they felt more confident in reporting any concerns higher up in the organisation as part of the provider’s whistleblowing policy.

Checks were carried out on the equipment and safety of the home. The majority of checks carried out on systems and equipment were satisfactory. However, some upstairs rooms did not have window restrictors fitted. It was also unclear if the home had been subject to an up to date fixed electrical check and records were not available to demonstrate that appropriate fire drills had recently been undertaken. Risk assessments linked to people’s care were available but not always clearly linked to the delivery of day to day care. Professionals we spoke with told us they felt some risk assessments lacked detail. The home was maintained in a clean and tidy manner.

Staff and relatives told us they felt there were enough staff at the home. Staff told us they were able to accompany people to access the community and support them with their personal care needs. Proper recruitment procedures and checks were in place to ensure staff employed by the service had the correct skills and experience.

We found some issues with the safe management of medicines. Medicine administration records (MARs) were not always well completed and instructions for the use of creams and lotions and ‘as required’ medicines were not always available or detailed enough. Management of medicine did not always meet NICE guidance.

The manager told us there was no overarching records of what training staff had completed. Work was ongoing to address this through a review of individual records. Staff told us they had access to a range of training and some certificates were available in staff files. Staff confirmed access to appropriate supervision had