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Inspection carried out on 25 February 2020

During a routine inspection

Field View is a care home providing personal care for up to eight younger adults in a residential setting who have a learning disability and/or autism. The service consists of a main building and two individual bungalows. At the time of our inspection eight people lived at the service and one person received a supported living service in their own home.

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.

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

People, their relatives and the staff who supported them provided positive feedback about the benefits the service had on supporting people to have positive outcomes. Care and support was tailored to each person's needs and preferences. Individuals who knew people well were fully involved in developing and updating their planned care.

The provider had systems in place to safeguard people from abuse and staff demonstrated an awareness of safety and how to manage any identified risks.

People were supported to gain work experience and engaged in activities and events

that were of interest to them. Staff responded to people’s personal preferences and individual beliefs to ensure they received care and support in a way they liked. Evaluations of people’s needs ensured planned goals remained relevant and achievable.

People received information in a way they could understand. Staff demonstrated effective skills in

communication. Sufficient, regular and skilled staff worked at the service. People were able to choose their support worker and recruitment checks ensured all staff were suitable to work at the service. Staff received training and support to enable them to carry out their roles following best practice guidance.

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

People received their medicines safely and on time. The service worked closely with a range of health professionals which benefitted people’s wellbeing. Dietary requirements were monitored, and healthy eating promoted.

Relatives and staff told us the registered manager was approachable and accountable. The registered manager was supported in their role by the provider. Oversight and checks helped to maintain a high standard of service and highlighted any areas for improvement.

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

Rating at last inspection

The last rating for this service was good (published 6 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 reinspection programme. If we receive any concerning information we may inspect sooner.

Inspection carried out on 1 June 2017

During a routine inspection

The National Autistic Society operates Field View care home and it is registered to provide accommodation and personal care for up to a maximum of 8 people with autism and learning disabilities. There were 7 people living at the service at the time of this inspection. The service is situated in Goole and provides communal living and dining space, a sensory room and a large amount of safe outside space for people to access.

At the last inspection in March 2015, the service was rated good, although the well-led domain was rated as requiring improvement. We identified a breach in regulation for failing to establish and operate systems or processes to effectively assess, monitor and improve the quality and safety of the service. This included a lack of staff supervisions, staff and relatives meetings and reviewing of quality auditing. The registered provider sent us an action plan in response to the breach we identified stating what measures they were going to take in order to address the issues. At this inspection we found the registered provider had taken the action required of them to meet the regulation.

This comprehensive inspection took place on 1 June 2017 and was announced. At this inspection we rated all the domains as good and therefore the service remained ‘Good’.

The service had a manager who was registered with the Care Quality Commission (CQC) in March 2016. A registered manager is a person who has registered with the CQC 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.

We found improvements to the quality assurance systems at the service. The registered manager had implemented an effective quality assurance system which ensured the service was continually improving and a range of audits and checks were completed regularly to ensure that good standards were maintained. Staff were receiving regular supervision and team meetings were held frequently. People’s relatives were receiving regular updates in the form of a ‘letter home’ from the service.

People were relaxed with staff. Staff had a good understanding of how to safeguard adults from abuse and who to contact if they suspected any abuse. Risks assessments were individual to people's needs and minimised risk whilst promoting people's independence.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice. People's permission was sought before any care or support was given.

Staff demonstrated good communication with people and supported them to express their views. They had clear strategies and aids in place where people had difficulties with communication. The staff were familiar with the needs of people living with autism and learning disabilities.

Staff supported people in a positive way and were able to recognise when people may require additional support. They had received bespoke training to intervene when people were at risk from behaviour that may challenge others.

Staff were well supported and had access to additional training specific to people's individual needs. The training was monitored and refresher courses made available. We found some gaps in the training records at the service. We discussed this with the registered manager who addressed this immediately after the inspection and provided us with updated records and an action plan to ensure this remained relevant.

There were enough staff to provide a good level of interaction. Staff felt that they were able to contact the registered manager at any time if they needed support or guidance. People were supported by staff that had the knowledge and skills to understand and meet their health needs.

Effective recruitment and selection processes were in

Inspection carried out on 11 March 2015

During a routine inspection

Field View is a residential care home that provides accommodation for up to eight people who require support with their personal care and all aspects of daily living. The service supports people with Autism and Learning Disabilities. At the time of the inspection there were eight people permanently living at the service. The service has a communal lounge and dining area, sensory room and ample outdoor space featuring allotments and seating areas.

The inspection took place on 11 March 2015 and it was an announced inspection, which meant we provided the service with 24 hours notice before the inspection took place. We did this because the service is small and we wanted to ensure that the manager and some of the people who use the service would be available on the day.

During the inspection we spoke with one person living at the service. The reason we only spoke with one person was because the verbal communication of the people who used the service was severely limited. We also spoke with five support staff, one relative and the current manager. The service has a registered manager in place but they are on extended leave. The National Autistic Society has been using interim arrangements to cover the registered manager’s position by utilising managers from other services.

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. Since our inspection the Care Quality Commission has received a notification asking for the registered manager to be deregistered which means the service is currently without a registered manager.

The last inspection took place on 26 September 2013. At that inspection we found the provider was compliant with all of the standards we assessed.

We found that the service was safe in its delivery of care. Staff had a good knowledge of individual’s needs and knew how to keep people safe from harm. There were sufficient staff numbers to support and respond to people’s needs. Staff had been employed through robust recruitment procedures and we saw clear documentation for reporting and responding to accidents.

People had clear, personalised care plans in place which enabled staff to work towards goals and outcomes. Individual’s choices and preferences were clearly documented and risk assessments were in place to enable people to complete the activities they enjoyed whilst keeping risks minimised.

Staff told us they completed a variety of training from classroom based learning to computer e-learning programmes. The evidence we saw within the training records and from speaking with staff showed us that staff were equipped with the knowledge required to enable them to carry out their role effectively.

We saw that people living at the service took part in a range of activities. Information we received prior to our inspection from the local authority contracts team confirmed that lots of meaningful activities took place at the service.

Family and friends were able to visit the service whenever they wanted to and people living at the service were encouraged to participate in activities and daily living chores as much as possible.

People’s communication needs were taken into account and all staff used the Picture Exchange Communication System (PECS) to enable people with limited verbal communication to make choices and be involved in decision making.

We observed positive interactions between staff and those who used the service during our inspection. We saw people reading, singing and laughing together. Relatives told us they were happy with the care their loved one received living at the service.

Staff told us things had been unsettled at the service since the registered manager had gone on leave. We saw from records that staff supervision, team meetings and residents meetings had not regularly taken place. We found that quality audit records have not been reviewed or updated for over a year and although surveys requesting feedback had been sent out, a relative we spoke with said they never received any feedback from this process. Staff told us that now they had a new manager in the service things were improving and they were hopeful things would get better.

This was a breach of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2010, now replaced by the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see what action we told the provider to take at the back of the full version of this report.

Inspection carried out on 26 September 2013

During a routine inspection

Field View is a service for people with Autism and related conditions. We found that people who used the service were well cared for and the support provided was personalised to the individual. Care plans were detailed and gave staff clear guidance on the ways people wanted to be supported. There was a varied activity timetable available for people. One person told us �I do lots of things I like�.

We looked at the ways nutrition was managed and found people were able to choose what they ate and where necessary weight and dietary intake was monitored effectively. The service was clean and hygienic and infection control procedures were followed well by staff.

We found that staff were well supported to carry out their roles and were able to access a wide variety of training. Staff supervision and appraisals were regular and thorough. One staff member told us �My progress and performance is discussed at each supervision meeting, which is really useful�. There was a robust system in place for monitoring the effectiveness of the service and people who used the service and families were involved in the development and improvement of the service.

Inspection carried out on 26 February 2013

During a routine inspection

We observed that staff were supportive in their roles and reflected a good knowledge of how people who used services communicated with others. Staff had knowledge of people's individual needs.

People were supported through a care planning process to have their needs met and care plans included a large amount of information about the individual and how they were to be supported.

We saw that there was a staff recruitment process in place and that all staff had completed this to help ensure that people were only supported by staff suitable for the role.

We saw that staffing levels ensured support to maintain peoples one to one hours and that any shortfalls were covered by regular staff in the home.

There was a quality assurance system in the home that included the views of relatives and was being developed to include the views of people who lived in the home.

Inspection carried out on 3 January 2012

During a routine inspection

Some people who lived in the home had complex needs and we were unable to verbally communicate with them about their views and experiences

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