9 November 2022
During a routine inspection
About the service
Autism Plus – York and North Yorkshire is a supported living service for people with autism, learning disabilities, mental health needs, physical disabilities or sensory impairment. The service provides personal care to people who live in individual or shared houses within the community. At the time of the inspection there were 12 people using the service.
Not everyone who used the service received personal care. CQC only inspects where people receive personal care. This is help with tasks related to personal hygiene and eating. Where they do, we also consider any wider social care provided.
People’s experience of using this service and what we found
Right Support:
People were supported by staff who knew them well, however more detail was needed within the care records to ensure all aspects of people’s care had been recorded. Risks to people had been assessed, however, these records again, needed expanding to ensure all areas of risk were identified and mitigated. Audits and the governance systems used by the provider had failed to highlight these areas. People received their medication when prescribed, however, records were inconsistent across the service so we could not be fully assured that medications were managed safely.
People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible. However, documentation which provided information about people's capacity and ability in decision making was not always available to staff in the care records. Records for the decisions made in people's best interests were not always clear to fully evidence the principles of the Mental Capacity Act had been considered. We have made a recommendation about this.
Staff focused on people’s strengths and promoted what they could do, so people had a fulfilling and meaningful everyday life. People were supported by staff to pursue their interests. Staff did everything they could to avoid restraining people. The service recorded when staff restrained people, and staff learned from those incidents and how they might be avoided or reduced.
Right Care:
People received kind and compassionate care. Staff protected and respected people’s privacy and dignity. They understood and responded to their individual needs. Staff understood how to protect people from poor care and abuse. The service worked well with other agencies to do so. Staff had training on how to recognise and report abuse and they knew how to apply it. The service had enough appropriately skilled staff to meet people’s needs and keep them safe. People who had individual ways of communicating, using body language or sounds, could interact comfortably with staff and others involved in their care and support because staff had the necessary skills to understand them.
People and relatives were happy with the care provided by staff, one person told us, “They are all good.” A relative said, “Staff are caring and compassionate and sorts things out. They are approachable and supportive. They take [Person’s] needs into consideration.”
Right Culture:
Staff knew and understood people well and were responsive, supporting their aspirations to live a quality life of their choosing. Care was delivered by a core team who knew the people, this helped ensure a consistent level of care. Some areas of the care plans needed more detail to fully reflect the support people required. However, staff knowledge helped to mitigate this shortfall. Staff ensured risks of a closed culture were minimised so that people received support based on transparency, respect and inclusivity.
The provider collected feedback from people and their relatives to help develop the service. However, it was raised by two relatives and the provider that more work was needed in this area to ensure their views were collected and heard.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection
The last rating for the service at the previous premises was requires improvement, published on 22 June 2020. We used the previous rating to inform our planning when re-inspecting the service under the new premises.
Why we inspected
The inspection was prompted by a review of the information we held about this service and to provide a rating for the service at the new premises.
We have found evidence that the provider needs to make improvements. Please see the safe, effective and well led sections of this full report. You can see what action we have asked the provider to take at the end of this full report.
Enforcement and Recommendations
We have identified a breach of regulation, in relation to the providers records and governance at this inspection. We have made a recommendation in relation to the providers understanding of the Mental Capacity Act 2005.
Please see the action we have told the provider to take at the end of this report.
Follow up
We will request an action plan from the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.