The inspection was carried out on 06 September 2016. Our inspection was unannounced.

The Kent Autistic Trust – 30 The Close 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 three floors. There were six people living in the home on the day of our inspection.

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 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 and associated Regulations about how the service is run. The registered manager was on holiday when we inspected.

At our previous inspection on the 22 May 2015 we found a breach of Regulation 12 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014, medicines had not been well managed. We asked the provider to take action in relation to Regulation 12 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. At this inspection, we found improvements had been made to the management of medicines.

People were unable to verbally tell us about their experiences. People were relaxed around the staff and in their own home. We received positive feedback from relatives about all aspects of the service.

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. One risk assessment needed updating following an incident. We made a recommendation about this.

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

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.

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. Staff had supported people to understand decisions that needed to be made with regard to their health.

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 management team had made appropriate applications.

People had access to drinks and nutritious food that met their needs and they were given choice.

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 and took appropriate action.

Relatives told us that staff were kind, caring and communicated well with them. Interactions between people and staff were positive and caring.

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.

People’s views and experiences were sought during meetings and by

The inspection took place on 22 May 2015 and it was unannounced.

The Kent Autistic Trust – 30 The Close 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 three 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.

Some 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.

We found a breach of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.

Medicines were not appropriately managed, recorded or stored. Medicines records did not match with medicines in stock.

People’s weights had not always been recorded. We made a recommendation about this.

Staff received training relevant to their job roles. Update training had not taken place in a timely manner, the provider had recognised this and had taken action to ensure staff completed their update training.

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.

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

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.

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. 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 and they were given choice.

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.

Relatives told us that staff were kind, caring and communicated well with them. 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 meetings. Relatives were also encouraged to feedback during meetings and by completing questionnaires.

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 provider and 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.

You can see what action we told the provider to take at the back of the full version of this report.

Some of the people who lived in the home had limited verbal communication and therefore were not able to tell us directly about their experiences of the service. We spoke with one person who used lived at the home and observed staff supporting people with their daily activities.

People’s care needs had been clearly assessed and guidance was in place to help staff to support their individual needs. People were supported to take part in daily living skills and access the local community.

Staff supported people to maintain their health. People were offered food choices and their dietary needs were assessed and monitored.

Staff had received training in how to recognise and respond to any form of abuse in the home. One person told us that they would talk to the home manager if they had any concerns.

The home was clean and procedures were in place to minimise the spread of any infection.

Systems were in place to monitor the quality of the care in the home. People who lived in the home 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 swimming, camping and holidays.

We saw people involved in preparing their evening meal and drinks and told us that they were involved in planning their menu. One person said he "liked meatballs with onion" but had also made some without for those who didn`t.

We found that staff communicated using a variety of techniques in order to meet individual needs such as touch, sign language and the use of pictures.

We saw that staff treated people with dignity and respect, were seen to knock on doors and provided personal assistance in a kind and discreet manner.

There was a relaxed and comfortable atmosphere within the home and the staff we spoke to understood how to support people, assisted them to make choices and maintain as much independence as possible.

Family members we spoke to told us that the standard of care provided was excellent and the place was "just like home." It`s a "normal environment." They said people had "much more freedom to choose what to do" and the home enabled them to "settle in well due to the environment and staff."

At the time of our initial visit the people living in the home were attending a day centre and were not available. We therefore returned at a later date to speak with people and observe care and support.

Not all of 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 therefore used our observations to help inform some of our judgements