Cambian Asperger Syndrome Services Limited - 14 Southwood Avenue

Cambian Asperger Syndrome Services Limited - 14 Southwood Avenue is a care home that provides accommodation and personal care for up to 7 people diagnosed with autistic spectrum disorders and learning disabilities. At the time of this inspection there were 6 people living at the home.

The service is situated in the Southbourne area of Bournemouth. The premises comprised of a three-story house with 7 bedrooms all with en-suite facilities and communal living areas. These included a kitchen/diner a separate lounge and one room referred to as a chill out room. The garden provided areas for both recreation and seating for people to use as they wish.

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

People told us they were very happy living at Cambian Asperger Syndrome Services Limited - 14 Southwood Avenue which they affectionately called “SWA” One person told us, “I’m happy living here at SWA. I don’t like leaving.”

Staff had an excellent understanding of people’s individual needs relating to their protected characteristics and their values and beliefs. Staff had been extremely responsive to the individual needs of the people living at the home creating excellent positive outcomes for people. One person told us, “It's the best thing I've ever done (coming here) I am being supported to be myself.”

Staff had supported people to be as independent as possible. Positive risk assessments had been completed with people to manage any risks incurred by taking further steps towards independence. People were supported to manage their own medicines and medicines were managed safely. One relative told us, “[person] has already progressed over and above our expectations since they moved in.”

There were enough staff to support people. This included supporting people on a 1:1 basis if required. People told us they felt safe. Staff had access to personal protective equipment (PPE), and the service had a robust infection prevention and control process in place. Lessons were learned from incidents and learning was shared with all staff to prevent re-occurrence.

Staff had assessed people’s needs before they moved in to the home. Individualised person-centred care plans had been created with people, and in consultation with people who were important to them. People were supported to eat a balanced healthy diet and could access food and drinks whenever they wanted. The service worked well with other organisations and supported people to access healthcare when required.

We could not distinguish staff from people when we arrived due to the friendly, comfortable and relaxed atmosphere of the home. People were treated as equals with dignity and respect by staff who knew them well. People told us staff were very kind and caring.

People, relatives, healthcare professionals and staff spoke positively about the registered manager and the assistant house manager. We received comments such as, “they do an amazing job”, “they are open and listen” and, “they are professional, discreet and great.”

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:

Staff supported people to have the maximum possible choice, control and independence be independent and they had control over their own lives.

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 supported people to achieve their aspirations and goals.

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 supported this practice.

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 could communicate with staff and understand information given to them because staff supported them consistently and understood their individual communication needs.

Right Culture:

People led inclusive and empowered lives because of the ethos, values, attitudes and behaviours of the management and staff.

People received good quality care, support and treatment because trained staff and specialists could meet their needs and wishes.

People were supported by staff who understood best practice in relation to the wide range of strengths, impairments or sensitivities people with a learning disability and/or autistic people may have. This meant people received compassionate and empowering care that was tailored to their needs.

Staff knew and understood people well and were responsive, supporting their aspirations to live a quality life of their choosing.

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 10 August 2019).

Why we inspected

This inspection was prompted by a review of the information we held about this service.

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 assurances that the service can respond to COVID-19 and other infection outbreaks effectively.

Follow up

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

About the service

Cambian Asperger Syndrome Services Limited - 14 Southwood Avenue is a residential care home providing personal care to eight young people with Autistic Spectrum Condition aged 16 to 25 years old. The service can support up to eight people. At the time of the inspection eight people were living at the home.

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.

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

There were enough staff on duty. However, the service had a number of vacancies and agency staff were supporting the staff team. The service had not yet explored people’s preferences and choices in relation to end of life care. The registered manager recognised the importance of this in case of sudden death. The service told us work had started on this following the inspection.

People told us they were happy and felt safe. Relatives said that staff had a good understanding of their loved ones needs and preferences. Risks had been identified and measures put in place to keep people safe from harm. Medicines were managed safely and administered by trained staff.

Staff listened to what people wanted and acted quickly to support them to achieve their goals and outcomes. Staff offered people solutions to aid their independence and develop their skills.

Staff were well trained and skilled. They worked with people to overcome challenges and promote their independence. The emphasis of support was towards inclusion and enabling people to learn essential life skills. Equality, Diversity and Human Rights (EDHR) were promoted and understood by staff.

People, professionals and their families described the staff as caring, kind and friendly and the atmosphere of the home as relaxed and engaging. 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 supported this practice.

People received pre-admission assessments and effective person-centred support. The service was responsive to people’s current and changing needs. Regular reviews took place which ensured people were at the centre of their support.

Leadership was visible and promoted good teamwork. People, professionals and staff spoke highly about the management and staff had a clear understanding of their roles and responsibilities.

Checks of safety and quality were made to ensure people were protected. Work to continuously improve the service was noted and the registered manager was keen to make changes that would impact positively on people's lives.

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.

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 January 2017).

Why we inspected

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

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.

The service had a registered manager in place. 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.

14 Southwood Avenue is a care home registered to provide accommodation and personal care for up to eight people diagnosed with autistic spectrum disorders and learning disabilities. Five people were living at the home at the time of our inspection. The registered manager explained that the home was a 38 week service meaning people who live there go back to their families during college holidays as the home closes during these times.

On the ground floor there was a communal kitchen, dining room, living room and games room. There was also a staff office, medical room and toilet. On the first floor there were four bedrooms and a communal bathroom. There were a further four bedrooms on the second floor. All bedrooms had a sink and a toilet, six of these had showers. Two people shared a bathroom.

Staff had a good understanding of the Mental Capacity Act and training records showed that they had received training in this. The home was starting to complete capacity assessments and record best interest decisions where appropriate.

We were told the food is good. There was an effective menu planning system in place for people who received meals from the service. Other people chose to be independent with their cooking. Food records we looked at did not show us how the service was supporting people with nutrition. The service was able to explain and show how they were. Capacity assessments were currently being completed to reflect this and evidence how people had been given appropriate support and information to make informed decisions. People told us cooking was important to them.

People were supported to access healthcare appointments as and when required and staff followed professional’s advice when supporting people with ongoing care needs. An advocate visited the service on a regular basis and contact information was seen on the people’s notice board.

People, relatives and staff told us that the service was safe. Staff were able to tell us how they would report and recognise signs of abuse and had received training in this.

Southwood Avenue had comprehensive risk management systems in place. There was a signing in and out book for people which referenced risk assessments relevant to the activity taking place.

Care files were in place which detailed the care and support people needed to remain safe whilst having control and making choices about how they chose to live their lives. Each person had an individual risk assessment in place which linked to their behaviour support plans. These ensured risks to people were managed and that people were protected.

Medicines were managed safely, securely stored, correctly recorded and only administered by staff that were trained to give medicines. Medicine administration records reviewed showed no gaps in the recording of medicines administered. People were being supported to manage their own medicines safely.

Staff had a good knowledge of people’s support needs and received regular mandatory training as well as training specific to their roles for example, autism, positive behaviour support and incident report writing.

Staff told us they received regular supervisions which were carried out by management. We reviewed records which confirmed this.

People and relatives told us that staff were caring. We observed positive interactions between staff and people. This showed us that people felt comfortable with staff supporting them.

People had their care and support needs assessed before using the service and care packages reflected needs identified in these. Outcomes were set by people and outcome focused reviews took place. These evidenced that people were actively supported to work towards their individual goals and outcome areas. We saw that these were reviewed annually by the service with people, families and health professionals when available. A relative told us, “Review meetings are important and gives us an opportunity to raise concerns”.

People, staff and relatives were encouraged to feedback through house meetings, one to one time with their keyworker and termly quality surveys. We found that feedback from people was listened to and improvements made in response. This told us that the service listened to people’s experiences and concerns.

There was a system in place for recording complaints which captured the detail and evidenced steps taken to address them. We saw that there were no outstanding complaints. This demonstrated that the service was open to people’s comments and acted promptly when concerns were raised.

People, their families and staff all told us they felt the service was well managed. They told us the registered manager, staff and the management team were all approachable, knowledgeable, that there was good communication and they were efficient. Staff had their own lead responsibilities and spoke enthusiastically about the positive teamwork and support they received.

The registered manager had a good understanding of their responsibilities for sharing information with CQC and our records told us this was done in a timely manner.

Quality monitoring visits and audits were completed by the management team. These included environment, medicines and safeguarding. There were also spot checks carried out by the management and additional audits completed by other registered managers from the other local Cambian services. This showed that there were a number of good monitoring systems in place to ensure safe quality care and support was provided to people.

We also examined records, and spoke with the registered manager and three other staff. We observed staff supporting people in communal areas.

Before people received any care or treatment they were asked for their consent and the provider acted in accordance with their wishes. Where people did not have the capacity to consent, the provider acted in accordance with legal requirements.

People experienced care, treatment and support that met their needs and protected their rights. For example, one person told us that staff supported them in the way they needed. The provider had a robust risk management system in place that enabled people to take positive risks whilst receiving safe and supportive care.

People were protected against the risks associated with medicines because the provider had appropriate arrangements in place to manage medicines.

People were cared for by staff who were supported to deliver care and treatment safely and to an appropriate standard.

The provider had an effective system to regularly assess and manage the quality of the service and risks to people's health, safety and welfare.

Throughout the inspection we noted staff were polite, sensitive and respectful in their communication with individuals living at Southwood Avenue.

A relative we spoke was impressed with Southwood Avenue's understanding of Asperger Syndrome and Autism; they said 'the expertise is outstanding'. A care worker we spoke with told us the 'house is nice and homely'.

We found that people's needs were assessed and care and treatment was planned and delivered in line with their individual care plan. Care plans were drawn up from assessments and were person centred and regularly reviewed.

People who use the service were protected from the risk of abuse, because the provider had taken reasonable steps to identify the possibility of abuse and prevent abuse from happening.

The provider had a robust recruitment policy that meant people were cared for, or supported by, suitably qualified, skilled and experienced staff.

There was an effective complaints system available; this was in an accessible format that was widely displayed around the house. Comments and complaints people made were responded to appropriately.