Background to this inspection
Updated
16 April 2020
The inspection
We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Care Act 2014.
Inspection team
One inspector carried out this inspection.
Service and service type
Education and Services for People with Autism Limited - 7 The Cedars is a ‘care home’. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.
The service had a manager registered with the Care Quality Commission. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.
Notice of inspection
We gave the service 48 hours’ notice of the inspection. This was because the service is small and people are often out and we wanted to be sure there would be people and staff at home to speak with us.
What we did before the inspection
We reviewed all the information we held about the service, including notifications of changes, events or incidents that the provider is legally obliged to send us within the required timescales. We contacted professionals in local authority commissioning teams and safeguarding teams. We reviewed the service’s previous inspection reports.
The provider was not asked to complete a provider information return prior to this inspection. This is information we require providers to send us to give some key information about the service, what the service does well and improvements they plan to make. We took this into account when we inspected the service and made the judgements in this report. The registered manager told us about what the service does well and planned improvements during the inspection.
During the inspection
We spoke with one person. People receiving personal care were unable to speak with us at length so we spoke with four relatives about their experience of the care provided. We spoke with five members of staff: the registered manager, assistant manager, two support workers and the cook. We observed interactions between staff and people who used the service.
We reviewed a range of records. This included three people’s care records and medication records. We looked at staff files in relation to recruitment. We reviewed a variety of records relating to the management of the service, including training, accidents, incidents, safeguarding, auditing, policies and procedures.
After the inspection
We contacted a further four health and social care professionals.
Updated
16 April 2020
About the service
Education and Services for People with Autism Limited - 7 The Cedars is a residential service for up to seven people with autism spectrum condition. The accommodation for six people is within a large detached house and the seventh place is within a separate converted coach house in the grounds. At the time of this visit there were seven people using the service.
The service has been developed and designed in line with the principles and values that underpin Registering the Right Support and other best practice guidance. This ensures that people who use the service can live as full a life as possible and achieve the best possible outcomes. The principles reflect the need for people with learning disabilities and/or autism to live meaningful lives that include control, choice, and independence. People using the service receive planned and co-ordinated person-centred support that is appropriate and inclusive for them. The home was well personalised, with no obvious signage indicating it was a care home. The feel of the service was homely, relaxed and determined by people’s needs.
People’s experience of using this service and what we found
The service had a pioneering and holistic approach to assessing and acting on people’s needs. Staff worked exceptionally well with external health and social care professionals to ensure people could access healthcare. People enjoyed a range of significantly improved health and wellbeing outcomes thanks to the service’s approach to health screening, reasonable adjustments and incorporating of best practice into processes and training.
Adaptations to the service were innovative, person-centred and had a demonstrable impact on people’s wellbeing and ability to act independently.
People were safe. Staff supported people positively to reduce anxieties, agitation and to empower people to take part in positive activities. Risk assessments were comprehensive and person-centred.
Staff were knowledgeable regarding medicines and worked closely with external specialists.
Staffing levels were safe. Premises were well maintained and clean.
Relatives and external healthcare professionals were confident in staff and their ability to keep people safe.
Incidents, accidents and safeguarding matters were documented and analysed. Staff understood their safeguarding responsibilities and were well supported and trained by the provider.
Staff received excellent training and support, including bespoke additional training from the registered manager.
People's needs were comprehensively assessed and regularly reviewed. Staff had a sound understanding of people’s communication needs.
Activities were geared towards people’s interests and had regard to people’s aspirations. The provider’s day centre was nearby and there were strong community links in place.
People’s rooms were well personalised. Communal areas and outdoor spaces offered people a range of options.
Staff interacted with people affectionately and with appropriate humour; people were comfortable with staff who they had got to know over several years in some cases.
Relatives, external health and social care professionals and staff though the service was well-managed. There were clear quality assurance and auditing processes in place. The registered manager continually sought ways to improve the service with a view to improving health and wellbeing outcomes for people.
The service applied the principles and values of Registering the Right Support and other best practice guidance. These ensure that people who use the service can live as full a life as possible and achieve the best possible outcomes that include control, choice and independence. People's support focused on them having as many opportunities as possible for them to gain new skills and become more independent.
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 this service was good (published 13 July 2017).
Why we inspected
This was a planned inspection based on the previous rating.
Follow up
We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.