This inspection was carried out on 19 April 2017. The inspection was unannounced.

Kent Autistic Trust – 11a Curlew Crescent is a care home providing personal care and accommodation for up to six adults with an autistic spectrum condition. The service is close to local amenities such as shops, pubs and public transport networks. Facilities in the home include; communal bathrooms, kitchen, laundry and lounge/diner, which has doors to the enclosed garden at the rear of the property. Kent Autistic Trust provides a range of services for people with autism including residential care, supported living, day opportunities and family support. There were six people living in the home when we inspected.

People living in the home had varying levels of communication. Some people were able to verbally communicate whilst two people did not. One person used their own sign language, which staff understood, they helped the person to communicate with others by translating what the person was communicating. Staff used different methods to communicate with each person which was individual to each of their needs.

At the last inspection on 20 April 2015, the service was rated Good overall but requires improvement in safe. This is because we had made a recommendation to move a freezer from the laundry room.

The management of the service was overseen by a board of trustees for The Kent Autistic Trust. Trustees and the chief executive officer for the trust visited the service regularly.

The service has a registered 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 this inspection we found the service was outstanding.

Staff and people received additional support and guidance from the provider’s positive behaviour support team. Strategies were in place to manage any incidents of heightened anxiety and behaviours that others may find challenging.

People and their relatives had opportunities to give feedback about the service in a variety of ways. Relatives and professionals were positive about the service received.

The service provided outstanding care and support to people enabling them to live as fulfilled and meaningful lives as possible.

The provider had sustained outstanding practice, development and improvement at the service. The provider had achieved accreditation and continued to work in partnership with organisations to develop best practice within the service. Staff were highly motivated and were actively involved in and contributed to continuous development and improvement.

The provider had a strong set of values that were embedded into staffs practice and the way the service was managed. Staff were committed and proud of the service. The provider and registered manager used effective systems to continually monitor and improve the quality of the service.

Staff knew how to protect people from the risk of abuse or harm. They followed appropriate guidance to minimise identified risks to people's health, safety and welfare. Risks associated with food storage and infection control were well managed. The chest freezer had been moved from the laundry room.

The feedback we received from relatives and health and social care professionals was excellent. They spoke very highly of the registered manager and the staff. Everyone within the organisation was highly motivated and committed to ensuring people that used the service had good quality care.

The provider operated safe and robust recruitment and selection procedures to make sure staff were suitable and safe to work with people. There were suitable numbers of staff to safely meet people’s needs. Staff received regular training and supervision to help them to meet people's needs effectively.

The inspection took place on 20 April 2015 and it was unannounced.

Kent Autistic Trust – 11a Curlew Crescent is a care home providing personal care and accommodation for up to six adults with an autistic spectrum condition. The home is set out over two floors. There were six people living in the home.

Management of the home was overseen by a board of trustees for The Kent Autistic Trust. Trustees and the chief executive officer for the trust visited the home regularly.

The home had a registered 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. The registered manager had been off work for longer than 28 days; the provider had put acting managers in place to oversee the running of the home.

People were unable to verbally tell us about their experiences. People were relaxed around the staff and in their own home. Relatives told us that their family members were safe.

Staff knew and understood how to safeguard people from abuse, they had attended training, and there were effective procedures in place to keep people safe from abuse and mistreatment.

Risks to people had been identified. Systems had been put in place to enable people to carry out activities safely with support.

The premises and gardens were well maintained and suitable for people’s needs. The home was clean, tidy and free from offensive odours. The laundry room contained a small chest freezer which contained food. Laundry baskets had been sited on top of the freezer which could cause cross infection from soiled laundry to food. We have made a recommendation about this.

Staff and people received additional support and guidance from the behaviour support manager when there had been incidents of heightened anxiety.

There were suitable numbers of staff on shift to meet people’s needs. The provider followed safe recruitment procedures to ensure that staff working with people were suitable for their roles. Robust recruitment procedures were followed to make sure that only suitable staff were employed.

Medicines were appropriately managed to ensure that people received their medicines as prescribed. Records were clear and the administration and management of medicines was properly documented.

Staff received regular support and supervision from the management team; they received training and guidance relevant to their roles.

Procedures and guidance in relation to the Mental Capacity Act 2005 (MCA) was in place which included steps that staff should take to comply with legal requirements. The Care Quality Commission (CQC) monitors the operation of the Deprivation of Liberty Safeguards (DoLS) which applies to care homes. Best interests meetings had taken place with relevant people. Where people were subject to a DoLS, the registered manager had made appropriate applications.

Relatives told us that they had been involved in meetings to discuss best interests. They told us that the registered manager had kept them informed about Deprivation of Liberty Safeguards (DoLS) applications.

People had access to drinks and nutritious food that met their needs, they were given choice and special diets were catered for.

People received medical assistance from healthcare professionals when they needed it. Staff knew people well and recognised when people were not acting in their usual manner. The staff ensured people received effective, timely and responsive medical treatment when their health needs changed.

Relatives told us that staff were kind, caring and communicated well with them. People were supported by staff who understood their needs and adapted their communication styles to meet people’s needs.

Interactions between people and staff were positive and caring. People responded well to staff and engaged with them in activities.

People and their relatives had been involved with planning their own care. Staff treated people with dignity and respect.

People’s information was treated confidentially and personal records were stored securely.

Relatives told us that they were able to visit their family members at any reasonable time, they were always made to feel welcome and there was always a nice atmosphere within the home.

People’s view and experiences were sought during review meetings and by completing questionnaires. Relatives were also encouraged to feedback.

People were encouraged to take part in activities that they enjoyed, this included activities in the home and in the local community. People were supported to be as independent as possible.

The complaints procedure was on display within the foyer of the home and this was also available in an easy read format to support people’s communication needs.

Relatives and staff told us that the home was well run. Staff were positive about the support they received from the senior managers within the organisation. They felt they could raise concerns and they would be listened to.

Communication between staff within the home was good. They were made aware of significant events and any changes in people’s behaviour. Handovers between staff going off shift and those coming on shift were documented, they were detailed and thorough.

The registered manager had notified CQC about important events such as injuries and Deprivation of Liberty Safeguards (DoLS) these had been submitted to CQC in a timely manner.

Audit systems were in place to ensure that care and support met people’s needs and that the home was suitable for people. Actions arising from audits had been dealt with quickly.

Some of the people who used this service had limited verbal communication and therefore were not able to tell us directly about their experiences of the service. We spoke with three people who used the service, and observed staff supporting people with their daily activities.

People were supported to take part in daily living skills and access the local community. One person told us that they were going to play golf and visit their family; another person told us that they were going shopping and to visit their Mum and Dad. There were enough staff on duty to meet people’s assessed needs.

Staff supported people to maintain their health and to safely take the medicines that they needed to promote their health and welfare.

People were offered food choices and their dietary needs were assessed and monitored.

People lived in a home that was safe, comfortable and well maintained.

Systems were in place to monitor the quality of the service. People who used the service and their relatives were regularly asked for their views about the service.

Not all the people who used this service were able to tell us about their experiences but those who were told us about the activities they enjoyed doing. We used our observations and discussions with family members to help inform some of our judgements.

We found that people were treated with respect and dignity. People were supported in promoting their independence and were involved in activities of their choosing like horse riding, gym activities, cycling and swimming. People expressed their enjoyment of the activities they participated in "I like the gym", "the fire station was good."

We saw people involved in preparing their evening meal and drinks and people told us they were involved in planning their menu, "I can choose what I eat."

We found that staff communicated using a variety of techniques in order to met individual needs such as touch, sign language and use of widget (picture) boards,

Family members we spoke with told us that peoples views were taken into account and gave an example of a person being supported with choosing to continue with medication, "it makes me happy." We were told that "care was excellent" and "gives satisfaction that he is looked after properly"

Staff we spoke to told us they felt well supported "training was available," "manager is there when you need her." Interaction between staff and people who used the service was observed to be good which helped to create a comfortable and relaxed atmosphere.

People told us, or indicated that they liked the home and the staff. One person showed us around the home and told us that they were happy and liked living there.

People told us that staff helped them do the things they wanted to do. One person told us that “Staff are helpful and listen to me”.

People we spoke with said that there was plenty to do both inside and outside the home. They told that they had recently enjoyed a trip to the local theatre to see a pantomime.

We saw that people were being supported around the home by staff in a kind and sensitive manner, in a way that promoted individual independence.