Wolverton Court

Wolverton Court is a residential care home that provides personal care for up to six people with autism and learning disabilities. It is a specialist service for people that have anxious or emotional behaviour that has limited their quality of life and experiences. At the time of our inspection there were six people living there.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

People’s experience of using this service:

¿ Since the last inspection staff and the registered manager have continued to drive improvements in the service, promoting and achieving exceptionally positive outcomes for people.

¿ During the inspection, we observed interactions between staff and people, it was clear to see engaging, empowering relationships between staff and people.

¿ People and staff told us, of their achievements. These included positive risk taking in the form of people being supported to achieve things which were previously unattainable for example people with extreme levels of anxiety in crowds being supported to attend major events in London.

¿ People had been supported to have their first home visit as an adult and take part in activities of their choosing that previously would have caused them anxieties.

¿ People had goals and aspirations that they worked towards and achieved. These were person centred, for example one person had progressed to gaining voluntary employment, whilst another person was supported to go on holiday for the first time.

¿ People had been supported to live the least restrictive lives possible, with restrictions that had been in place for many years being lifted for the first time.

¿ People had been supported so effectively by staff, that they had successfully reduced the amount of medicines people were taking without any adverse effects on people.

¿ Staff worked closely with healthcare professionals to enhance people’s communication, which resulted in a reduction in previously high levels of behaviour that could be challenging.

¿ Staff and the registered manager embraced a culture of placing people at the heart of everything at Wolverton Court. Every aspect of the service was person-centred, and staff were passionate about people they supported living the fullest most fulfilled life.

The home has been developed and designed in line with the principles and values that underpin Registering the Right Support and other best practice guidance. This ensured that people could live as full a life as possible and achieved the best possible outcomes. The principles reflect the need for people with learning disabilities and autism to live meaningful lives that include control, choice, and independence. The people living at the service received planned and co-ordinated person-centred support that was appropriate and inclusive for them.

Rating at last inspection:

At the last inspector the service was rated Outstanding. (27 October 2016)

Why we inspected:

This was a planned inspection based on the rating at the last inspection.

Follow up:

We will continue to monitor intelligence we receive about the service until we return to visit as per our re-inspection programme. If any concerning information is received, we may inspect sooner.

Wolverton Court is a service for six people who have autism and learning disabilities. It is a specialist service for people that have anxious or emotional behaviour that has limited their quality of life and experiences. Wolverton Court is a large home providing accommodation for five people and there is a separate flat for one person. The home is set in a rural area and is surrounded by a large secure field and garden with access onto a terraced area with seating that is covered in tarmac and Astroturf for safety. There is a good sized car park to the side of the property.

A registered manager and deputy manager were based at the service. 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.

What was particularly noticeable about the service provided was the freedom that people had. People were listened to. People had the support they needed to express their needs and wishes. People were able to make decisions and choices. People were trying new experiences, going on holiday for the first time, going for trips to places and doing activities that they had previously not had the confidence to try.

A person’s relative described the service as “fantastic”, and went on to say, “I can’t praise it enough. Since [person] has been at Wolverton [person’s] life has changed completely. The difference is unbelievable.”

The difference the service was making to people’s lives was visible. People who had previously displayed anxious and emotional behaviours that had led to restrictive lifestyles were now being supported in a different way. People needed a significant amount of consistent support to make sure they felt secure and understood; to prevent the need for behaviours to make their needs known or to express dissatisfaction and they were receiving this. The warmth of the relationships with each other and the staff and the opportunities for new experiences that they were given were serving to enable people to blossom.

As a result of consistent support, good teamwork, and good planning and delivery of person centred care, people were experiencing opportunities to attend events and go on holiday that they had never done successfully before. One person was a keen football supporter. Tickets had just been booked for them to attend the England Spain match at Wembley in the autumn. This was a huge achievement considering the person’s past struggles. Another person had spent several weeks planning a holiday, going abroad for the first time. Something this person had not been able to consider and cope with before. The person spoke excitedly about their impending holiday and staff talked enthusiastically about the planning and how the person had chosen their destination.

The atmosphere in the service throughout the two days of the inspection visit was calm, bright and active. People were able to share with us their experiences through us spending time with them, through their photos and with help from staff explaining people’s lifestyles in the presence of the person who was smiling and gesturing in agreement.

There was a really positive and inspiring culture in the service. Instead of seeing people as having limitations, the registered manager and staff team found innovative and creative ways to help people overcome perceived limitations and take as much control of their own lives as possible. When talking about the work they did the registered manager commented that he was always looking at “How we can do things better?” and “How can we get people to reach their heights of potential?”

A health and social care professional commented, “I have noticed a huge change. The home appears cleaner and well organised and the staff keen and positive. The clients are engaged more and appear to have an improved quality of life.”

People met new staff as part of their recruitment and were given the opportunity to be involved as much as possible, including being present during interviews. There were enough staff to support people to have a varied lifestyle. Staffing levels were reviewed and changed in response to people’s needs. The staff were motivated and willing to work flexibly to support people’s activities including going on holiday with people.

Staff and the management team had an excellent understanding of managing risks and were supporting people to reach their full potential through the challenges that past experience and their anxieties presented. People said or expressed that they felt safe in the service and staff had a very clear understanding of what could be abuse. Staff spoke up for people if they thought they may be at risk of potential abuse.

The whole service was led by the people living there, who were clearly in control of their own lives. Staff were committed to supporting and being there when needed to reassure people and were very clear about people making their own decisions and choices with the right balance of support to help when needed without taking over.

Staff told us how they always asked people for their consent as they provided the care. They described how they supported people to make their own decisions and choices. Some people chose to be supported by their relatives when making more complex decisions. Staff had received training on the Mental Capacity Act (MCA) 2005. The MCA provides the legal framework to assess people’s capacity to make certain decisions, at a certain time. When people were assessed as not having the capacity to make a decision, a best interest decision was made, involving people who knew the person well and other professionals, when relevant.

Each person had a key worker and co-key worker. Key workers were members of staff who took a key role in co-ordinating a person’s care and promoted continuity of support between the staff team. People were enabled to choose their key workers and all had key workers that they got on well with. Staff were lively and enthusiastic when interacting with people and treated them with respect. People were comfortable and at ease with the staff.

The home environment was set up to help people be as independent as possible and to support people to express themselves. There were posters, noticeboards, photos and pictures all around the home to assist people to say what they wanted when they wanted it and to celebrate their achievements. People had planners for regular activities and were given opportunities to try new things. Every achievement was celebrated and they were encouraged to move to the next goal and the next new experience.

People were encouraged to try new experiences and develop new interests. Staff helped people to express themselves and supported people so that they felt secure enough to try unfamiliar things. People had access to the internet and social media and used this to follow their interests and keep in touch with family and friends.

Mealtimes were social occasions and were organised around people’s preferences and lifestyle. The kitchen was designed so that it was an open space that was practical for people to use. Everything was accessible and only high risk items such as sharp knives were kept securely out of the way when not being used. People were supported to make their own meals. Everyone participated in choosing the menu from photo cards and recipes. The evening meal was generally organised so that everyone sat down together. The rest of the day people were out and about eating at different times including eating out.

People were supported to maintain a healthy active lifestyle. Clear easy read plans were designed to help people manage health conditions that needed monitoring. Health and social care professionals were involved with people’s support when needed and their advice was included in the care provided. Staff had worked together with community professionals to prepare people for health care checks, including compiling photo stories and going through the practical steps with any equipment to help people understand and cope with necessary procedures.

When people needed to take medicines these were kept under review and there were safe administration procedures. People were helped to understand their medicines and were supported to take control of them as much as possible.

There were excellent, informative records that were completed at the time, so they were accurate. Tiny changes in a person’s responses and developments in their skills and interests were noticed and used to continue helping people increase their opportunities.

People were given the opportunity to contribute and become valued members of the local and wider community. One person had recently participated in a charity walk and other people were supported to work to help others.

The registered manager used effective systems to continually monitor the quality of the service and had ongoing plans for improving the service people received. There was a clear complaints procedure and process that was designed to enable people to express their views and were responded to in a way they could understand.

Emergency plans were in place so if an emergency happened, like a fire, the staff knew what to do. There were regular fire drills so people knew how to leave the building safely. Safety checks were carried out regularly throughout the building and the equipment to make sure they were safe to use.

We used a number of different methods to help us understand the experiences of people who used the service, because some of the people using the service had complex needs which meant they were not able to tell us their experiences. These included observing the care and interactions between the people and staff. People expressed themselves by using sounds, gestures, body language and pointing to objects and pictures. They indicated that the staff treated them with respect and that they felt reassured to be in their company. They indicated that they received the health and personal care they needed and that they were comfortable in their home.

To help us to understand the experiences people had we used our Short Observational Framework for Inspection (SOFI) tool. The SOFI tool allowed us to spend time watching what was happening in a service and helped us to record how people spent their time, the type of support they received and whether they had positive experiences.

People spoken with and observations made did not raise any concerns with regard to the quality of care received. All staff spoken with demonstrated experience and knowledge to enable them to support people who lived at the service with their needs.