The Pembury

The Pembury had been developed and designed in line with the values that underpin the Registering the Right Support, Building 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 lived as ordinary a life as any citizen.

This inspection took place on 16 October 2018. At the last comprehensive inspection in March 2016 the service was rated as Good overall. At this inspection we found the evidence continued to support the rating of good and there was no evidence or information from our inspection and on-going monitoring that demonstrated serious risks or concerns. This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection.

A registered manager was in post who had been registered with the Care Quality Commission (CQC) in 2010. A registered manager is a person who has registered with the Care Quality Commission to manage the service. The registered manager was supported by a manager who had responsibility for the day to day management of The Pembury. Both the registered manager and the manager were the registered providers for The Pembury and its sister home The Padova. 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 was not present during this inspection. The manager was in attendance.

People's care and support was centred on their individual needs and wishes. They had lived together for some time and had been supported by a core group of staff providing them with consistency and continuity of care. They had positive relationships with staff, who understood them well, anticipating what would make them anxious or uncertain. Staff treated them with kindness and compassion. They understood and respected people's diverse needs. Staff knew how to keep people safe and how to raise safeguarding concerns. Risks were well managed encouraging people's independence. There were enough staff to meet their needs. This was kept under review as people's needs changed. Staff recruitment and selection procedures ensured all necessary checks had been completed prior to employment.

People made choices about their day to day lives. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice. People were involved in the planning and review of their care and

support. They chose the activities they wished to take part in. They said they liked to go horse riding, to the cinema and to garden centres. They went on holidays, day trips, to social clubs and local places of worship. People kept in touch with those important to them.

People's preferred forms of communication were highlighted in their care records. Staff were observed promoting effective communication, taking time to engage with people. Good use was made of easy to read information which used photographs and pictures to illustrate the text. People had access to easy to read guides about safeguarding, complaints, breast screening and diabetic eye screening. People also had easy to read information about staff on duty, activities and menus.

People's health and wellbeing was promoted. A weekly menu encouraged people to have vegetables and fruit in their diet. They helped to prepare and cook their meals. People had access to a range of health care professionals. They had annual health checks. People's medicines were safely managed. People had expressed their wishes about how they would like to be cared for at the end of their life. They were supported during stays at hospital and when discharged home. A relative commented, "The love and care they have all shown to [Name] at this time of her life is so lovely and heart-warming."

People, their relatives and staff were invited to give feedback through quality assurance surveys, meetings, complaints and compliments. They had information about how to raise a complaint. The manager and provider completed a range of quality assurance audits to monitor and assess people's experience of the service. Any actions identified for improvement were monitored to ensure they had been carried out. The manager worked closely with local organisations and agencies and national organisations to keep up to date with current best practice and guidance. Comments about The Pembury included, "It's absolutely outstanding" and "It's fantastic."

Further information is in the detailed findings below.

The five questions we ask about services and what we found