Autism Wessex - Middle Path

Autism Wessex - Middle Path is a residential care home for up to 4 people who are autistic or who have other complex needs linked to brain injury. The home comprises of the main house, which accommodates 3 people and an attached 1 bedroom annexe. At the time of the inspection there were 3 people living in the main part of the home and 1 person living in the annexe.

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

We expect health and social care providers to guarantee people with a learning disability and autistic people respect, equality, dignity, choices and independence and good access to local communities that most people take for granted. ‘Right support, right care, right culture’ is the guidance CQC follows to make assessments and judgements about services supporting people with a learning disability and autistic people and providers must have regard to it.

Right Support:

Risks to people were assessed and regularly reviewed. People told us they felt safe. Relatives and a health professional agreed. A familiar and consistent group of care staff meant staff knew people well and understood their individual needs.

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

Right Care:

Staff understood how to protect people from poor care and abuse. People received their medicines on time and had annual reviews to ensure they were not over medicated. People could communicate with staff and understand information given to them because staff supported them consistently and understood their individual communication needs.

Right Culture:

Inconsistent management of the service since the last inspection in 2018 had impacted the culture, team cohesion and had made staff feel unsettled. Staff told us they did not always feel supported by the management. A manager had started at the home 2 months prior to the inspection, recognised the issues we found and was working with the provider and staff on a service improvement plan to address the issues and provide stability.

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 15 March 2018).

Why we inspected

This inspection was prompted by a review of the information we held about this service. As a result, we undertook a focused inspection to review the key questions of safe and well-led only.

We looked at infection prevention and control measures under the safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.

For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating.

The overall rating for the service has remained good based on the findings of this inspection.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Autism Wessex – Middle Path on our website at www.cqc.org.uk.

Follow up

We will continue to monitor information we receive about the service, which will help inform when we next inspect.

At our last inspection we rated the service good. 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.

There was a registered manager in post, at the time of the inspection the registered manager had given the service notice to leave. 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. The deputy manager was managing the home in the absence of the registered manager.

The care service has been developed and designed in line with the values that underpin the Registering 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 can live as ordinary a life as any citizen.

People were protected from abuse because staff understood how to keep them safe. All staff informed us they were confident concerns would be followed up if they were raised. People appeared happy and relaxed in the company of the staff.

People received their medicines safely. There were enough suitable staff to meet people’s needs.

Risk assessments were carried out to enable people to retain their independence, we found a risk assessment wasn’t completed following one incident, staff confirmed there was minimal risk to the person and the deputy manager told us they would complete this following our inspection.

Staff received training to ensure they had the skills and knowledge required to effectively support people. People were involved in planning their menus and supported to eat and drink according to their likes and dislikes.

Where people lacked capacity to make specific decisions and staff had best interest decisions on their behalf, in one instance the least restrictive option had not been considered. This was going to be reviewed by the deputy manager.

We observed that staff were kind and knew people well. People were involved in decisions about the care and support they received. People received care and support which ensured they were able to make choices about their day to day lives.

People were supported to engage in activity programmes. People told us they would talk to staff if they were unhappy and there were a range of opportunities for them to raise concerns with the staff.

Further information is in the detailed findings below.

We observed the interaction between the staff and the people who used the service. People were comfortable with staff and responded well to the communications between them. Staff knew the needs and preferences of the people and provided support in a positive and friendly manner. One person showed me their room, which they were very happy with.

We saw evidence that peoples' needs were assessed on an on-going basis; additional information from local authority care plans, speech and language therapists, psychologists and psychiatrists were incorporated into the support plans. A psychiatrist visited the home every three to six months. The support plans were updated when people's needs changed.

The 'goals and achievements' section in the support plans were seen to set goals that people had been able to achieve. Staff said 'through promoting their independence they've come a long way and are more able to do things for themselves such as getting their evening meal'.

There was evidence that the views of people who used the service were obtained weekly via house meetings, when they were able to discuss menu planning, activities and any concerns they had.

People confirmed they were well cared for and that staff were available when they needed them. People were supported to maintain relationships with their friends and family members. One person said 'I am very happy living here.'

People were able to explain they felt well cared for and safe living in the home. No concerns were raised with us during our inspection. Each member of staff we spoke with said the home was a 'safe place' for people to live.

People who lived in the home told us they liked the staff who supported them and staff were available when they needed them. One person said the staff were 'kind' and another person told us 'the staff are nice.' The care staff we observed supporting people clearly knew them well and understood their needs.

The provider had various systems in place designed to monitor the quality of the service provided to people and to ensure people remained safe. These systems were used effectively. Changes or improvements were made to the service where this was possible and practical.