We inspected Watchbell House on 23 and 25 August 2016. Watchbell House provides accommodation and support for up to six people. Accommodation is provided from a listed building in a residential area.

The age range of people living at the service is 23 – 52. The service provides care and support to six people living with a range of learning disabilities. There were six people living at the service on the day of our inspection.

We last inspected Watchbell House on 6 February 2014 where we found it to be compliant with all areas inspected.

A registered manager was 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 and associated Regulations about how the service is run.

Although there were established systems to monitor the quality of service the documentation being used did not consistently afford senior staff with clear oversight of all areas of the service.

People appeared happy and relaxed with staff. There were sufficient staff to support them. Checks were undertaken to ensure staff were suitable to work within the care sector. Staff were knowledgeable and trained in safeguarding and knew what action they should take if they suspected abuse was taking place. A wide range of training was provided to ensure staff were confident to meet people’s needs.

It was clear staff had spent considerable time with people, getting to know them, gaining an understanding of their personal history and building rapport with them. People were provided with a choice of healthy food and drink ensuring their nutritional needs were met.

People’s needs had been assessed and detailed care plans developed. Care plans contained risk assessments for a wide range of daily living needs. People consistently received the care they required, and staff members were clear on people’s individual needs. Care was provided with kindness and compassion. Staff members were responsive to people’s changing support needs. People’s health and wellbeing carefully monitored and staff regularly liaised with a range of healthcare professionals for advice and guidance.

Medicines were managed safely in accordance with current regulations and guidance. There were systems in place to ensure that medicines in use were stored, administered, and disposed of appropriately.

The CQC monitors the operation of the Deprivation of Liberty Safeguards (DoLS) which applies to care homes. We found that the manager understood when an application should be made and how to submit one. Where people lacked the mental capacity to make specific decisions the home was guided by the principles of the Mental Capacity Act 2005 (MCA) to ensure any decisions were made in people’s best interests.

People were provided with opportunities to take part in a range of activities and hobbies and to regularly access the local and wider area. People were supported to take an active role in decision making regarding their own routines and those of the home.

The registered manager felt well supported by the provider and staff spoke positively about working at Watchbell House and about the support they received from senior staff.

People were supported to give consent to the care and treatment they received. Staff were aware of deprivation of liberties issues and had attended mental capacity training.

For each person living in the home there was a person centred, detailed plan of care in place. Staff worked with healthcare professionals to ensure people’s physical and emotional healthcare needs were met.

There were policies and procedures in place to safely manage people’s medication and staff had received the relevant training.

People were being cared for by an experienced and well trained staff team. Staff that spoke with us confirmed they received supervision and annual appraisal.

There was a complaints policy in place and processes to record concerns, carry out investigations and feedback outcomes to complainants in a timely manner.

A family member that spoke with us said. “My daughter is cared for to the highest standard and the care provided is excellent. The staff are always available and there is a lovely ambience in the home.”

People said that they were treated with kindness and they were able to make their own choices, which were respected. They said that they received the support they needed and felt safe living at Watchbell House. People were confident that if they had a complaint it would be acted upon and they felt they had a say on what went on in the home.

We spoke with four people who used the service, two members of staff, the manager of a sister care home and a senior member of staff from Canterbury Oast Trust.

One person showed us round the home and said that they, “Like to take responsibility.” Everyone we spoke with told us that the staff were caring and supportive. People chose what they did each day.

We observed kind support with good communication and interaction between staff and the people they cared for. We saw evidence of regular activities for people who used the service, some of whom were able to travel to these unsupported. People who lived there told us what they had done in the day. There were opportunities for people to achieve City and Guilds qualifications.

We observed an evening meal that one person had cooked with support from a member of staff. People said they enjoyed the food.

We saw evidence of accurate record keeping with regular review of people’s care plans. There was a medicines management system in place.

Staff told us that they felt well trained and supported by management. We saw evidence of training and regular updates. Staff demonstrated a good knowledge and understanding of the people they cared for and supported.