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Autism Together - 32 York Street Good

Reports


Inspection carried out on 30 October 2019

During a routine inspection

About the service

Autism Together - 32 York Street is a residential house providing personal care to two people who were living with autism. The service can support up to two people.

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 service was registered for the support of up to two people and two people were using the service. The building design fitted into the residential area and the other large domestic homes of a similar size. There were deliberately no identifying signs, intercom, cameras, industrial bins or anything else outside to indicate it was a care home. Staff were also discouraged from wearing anything that suggested they were care staff when coming and going with people.

People’s experience of using this service and what we found

People were supported to have maximum choice and control of their lives and staff them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.

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.

The outcomes for people using the service reflected the principles and values of Registering the Right Support by promoting choice and control, independence and inclusion. People's support focused on them having as many opportunities as possible for them to gain new skills and become more independent.

We observed positive, friendly interactions between people and staff. People were treated with respect, dignity and kindness.

Person centered support plans were detailed and guided staff about people's needs and how to meet them. Staff supported people to make choices and decisions relating to their care and to live their lives as they wished. People's risks were identified and assessed appropriately. People and their relatives were involved in regular reviews of their care and encouraged to offer feedback.

People were supported to maintain a healthy diet and had access to healthcare professionals should they need them.

Medicines were managed safely and staff had the appropriate training to support people effectively.

The provider had systems in place to ensure that people were protected from the risk of harm or abuse. We saw there were policies and procedures in place to guide staff in relation to safeguarding adults and whistleblowing.

There were sufficient staff to meet people's needs and to enable them to engage with activities, access the community and to live their lives as independently as possible. Staff suitability to work with people was checked at recruitment. Staff completed a robust induction process, attended training and received regular supervisions to be able to provide effective support for people.

People were asked for their feedback about the service through house meetings and giving feedback to staff. A range of quality assurance systems measured and monitored the quality of care and the service overall.

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 11 April 2017).

Why we inspected

This was a planned inspection based on the previous rating.

Inspection carried out on 15 March 2017

During a routine inspection

York Street provides accommodation and support for two adults who have autism. The home is run by the Autism Together, a charity who provide services for people with autism in the local area.

The house is a terraced house based in a residential area of Bromborough. It fits in with the local neighbourhood and is in keeping with the principle of supporting people to live ordinary lifestyles in their local community. Shared space includes a lounge, dining room, kitchen and bathroom. Each of the people living at the house has a large bedroom of their own, with a smaller third bedroom used as an office and staff sleep-in room.

At the last inspection the service was rated Good. At this inspection we found the service remained Good.

We spoke with the two people who lived in the home and their relatives who all gave positive feedback about the home and the staff who worked in it.

Staff spoken with and records seen confirmed training had been provided to enable them to support the people with their specific needs. We found staff were knowledgeable about the support needs of people in their care. We observed staff providing support to people throughout our inspection visit. We saw they had positive relationships with the people in their care.

We found medication procedures at the home were safe. Staff responsible for the administration of medicines had received training to ensure they had the competency and skills required. Medicines were safely kept with appropriate arrangements for storing in place.

The registered provider understood the requirements of the Mental Capacity Act 2005 (MCA) and the Deprivation of Liberty Safeguards (DoLS). This meant they were working within the law to support people who may lack capacity to make their own decisions. We saw that people were supported to make their own decisions and their choices were respected.

Care plans were person centred and driven by the people who lived who lived in the home. They detailed how people wished and needed to be cared for. They were regularly reviewed and updated as required.

The registered manager used a variety of methods to assess and monitor the quality of the service. These included regular audits of the service and staff meetings to seek the views of staff about the service. They also regularly spoke with the people who lived in the home.

Inspection carried out on 19 December 2014

During an inspection looking at part of the service

This was an unannounced inspection carried out on 19 December 2014. York Street provides accommodation and support for two adults who have autism. The home is run by the Wirral Autistic Society, a charity who provide services for people with autism in the local area.

The house is a terraced house based in a residential area of Brombourough. It fits in with the local neighbourhood and is in keeping with the principle of supporting people to live ordinary lifestyles in their local community. Shared space includes a lounge, dining room, kitchen and bathroom. Outside, a back garden provides seating with parking on-street at the front of the house. Each of the people living at the house has a large bedroom of their own, with a smaller third bedroom used as an office and staff sleep-in room.

During the inspection we spoke with both people who lived at the home and with two members of staff. We also spoke with the registered manager. 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. Following the inspection we spoke with relatives of both of the people living at the home.

We last inspected the home in January 2014. At that inspection we looked at the support people had received with their care, welfare and nutrition, we also looked at staffing levels, the premises and whether people were treated with respect and involved in their care. We found that the provider had met regulations in these areas.

The home met the requirements of the Mental Capacity Act 2005 (MCA) and associated Deprivation of Liberty Safeguards (DoLS).

People were consulted about their care and were supported to make choices about their everyday lives. Relatives commented that they felt communication between staff and themselves could be improved.

Care plans provided sufficient information to inform staff about peoples support needs. This included information about their health, chosen lifestyles and the support they needed with their autism.

People were supported to choose their meals and were involved in planning, shopping for and preparing their food and drink.

Medication practices at the home were safe. Medication was stored safely and people received their medication as prescribed and on time.

Staff had received training and understood their role in identifying and reporting any potential incidents of abuse. People told us that they considered York Street a safe place to live. No referrals for safeguarding adult’s investigations had occurred since our last inspection in January 2014.

There were enough staff working at the home to support people with their daily lives. This included pursuing their work and hobbies and getting out and about in their local community. Staff had received the training they needed to support people safely and well. The staff team remained as consistent as possible. Staff knew the people living at York Street well and were able to support them and communicate with people in a way they understood and responded to.

Quality assurance systems were in place to assess the quality of the service provided and identify area for improvement.

Inspection carried out on 27 January 2014

During a routine inspection

Two men lived at 32 York Street. They had both been supported by Wirral Autistic Society for a considerable length of time and had lived in this house for several years. Both were able to communicate verbally with the staff and they had regular contact with their families.

The manager told us about the various activities that people were involved in. One person participated in daytime services in the community provided by Wirral Autistic Society. The other person had an external work placement and he told us that he enjoyed this very much.

The individual care needs of the people who lived at the home were recorded in their care files, which were well ordered and comprehensive. Each person had a full review every year with the support team and family members. The people living at 32 York Street were generally fit and well and the person we spoke with said �I don�t have any health problems, I feel great, full of life.�

People were able to choose what they would like to eat and drink. Meals were planned weekly and the people who lived at the home participated in weekly shopping trips.

The house was comfortably furnished and provided a safe and homely environment. People had individualised their bedrooms with personal belongings.

The home had a team of six staff who all had a national vocational qualification in care. Each of the people who lived at the home had one to one support between 7:30am and 11pm and one member of staff slept in the home at night.

Inspection carried out on 14 January 2013

During a routine inspection

Neither of the people who live at 32 York Road were in when we started our visit to the home. We were able to speak with the previous Registered Manager of this home as well as the new recently appointed Registered Manager. Later we were able to speak to one of the people who lives at York Street when they returned from work with their support worker. The person we spoke with told us that they were very happy living at York Street. They said "This is my home and the staff are my friends. We all get on really well together". They told us that they were able to make choices and said "I have a lot of autonomy".

We looked at care plans and found that they were clear and informative and the person we spoke to told us "I am involved in the planning of my care". We found that 32 York Street had safeguarding measures in place and that staff were trained to identify and act if there were any safeguarding issues.

We found that staff received regular training so that they were able to support people's needs and the new Registered Manager told us that he was planning supervisions with his staff.

We found that 32 York Street had systems for monitoring quality assurance and we looked at a service user questionnaire where feedback had been received and acted upon.

Inspection carried out on 6 December 2011

During a routine inspection

We visited 32 York Street on a day when both of the people who live there were at home. One of the people who lives at the home told us that he is happy living there and feels that the home, and the support he receives, meet his needs well. He is able to make his own decisions and would speak to the manager if there was anything he was not happy about.

Following our visit we spoke with a close family member of the other person. She said that the care staff �do a great job�. Because her relative is very sensitive to noise, it suits him much better to live in a quiet environment. She has regular contact with him and is involved in making decisions about his support.

Reports under our old system of regulation (including those from before CQC was created)