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Inspection Summary


Overall summary & rating

Good

Updated 17 January 2017

We carried out the unannounced comprehensive inspection of Chylidn on 30 November 2016. A previous comprehensive inspection of the service was completed on 2 December 2015found breaches of the regulations in relation to staff support, record keeping and risk management. The provider subsequently produced an action plan setting out how they intended to ensure the service became compliant with the regulations. This inspection was completed to check the planned action had been successful. In addition, in June 2016 a focused inspection of the service was completed to investigate concerns we had received in relation staffing levels, training and the management of the service. The findings of both these previous inspection can be viewed by selecting the 'all reports' link for Chylidn on our website at www.cqc.org.uk.

Chylidn provides care and accommodation for up to five people who have autistic spectrum disorders. At the time of the inspection four people were living at the service.

During our previous inspection we found that people’s needs were not being met and some people’s autonomy was restricted due to adverse interactions between people living in the service.

At this inspection we found the provider had taken significant action to address and resolve this issue. A new self-contained flat had been created for one person who particularly valued personal space. During this inspection we found that people were now more comfortable and relaxed. Staff told us, “I do think the changes mean it works a lot better for [everyone]. [People] don’t have to be worried about anything now.”

People relative’s told us, “I think [My relative] is safe and well looked after” while staff said, “People are safe and seem to be happy.” Staff understood there role in protecting people from abuse and avoidable harm and records showed all necessary pre-employment checks had been completed to ensure people’s safety.

Risk were managed appropriately to ensure people’s safety while enabling each person to live full and active lives. Where accidents or incidents occurred these were fully investigated. Where necessary people’s care plans were updated with additional guidance on how to protect the person for any additional risks identified during the incident investigation process.

On the day of our inspection the service was short staffed because a member of staff had become unwell. Staff rotas and daily care records showed this was unusual and that the service was normally fully staffed. Staff confirmed the service was normally staffed at safe levels and told us, “Staffing levels have got a lot better” and “Staffing levels have been great, there is the odd bit of sickness but it is not a problem here.”

All new staff received two weeks of formal training before they began working in the service and records showed established staff received regular training updates. Staff said, “The training was very useful, I think it was pretty good” and “All my training, except food hygiene and infection control, is up to date and those two are booked in.”

In December 2015 we found that staff had not received regular supervision. At this inspection staff told us they were well supported by the registered manager. Staff had received regular formal supervision and annual performance appraisals were due to be reintroduced.

Managers and staff understood the requirements of the Mental Capacity Act 2005, and appropriate applications had been made to the local authority for the authorisation of potentially restrictive care plans.

Relatives told us, “The food is absolutely the tops” and we saw people were supported by staff to plan, shop for and prepare meals within the service.

Staff knew people well and understood how communicate effectively with the people they supported.

People’s care plans were detailed and informative. They provided staff with clear instructions on how to meet each person’s individual care and support needs. Staff told us, “All of the information is accessible and easy to use” and “The care plans definitely have enough information.”

The quality of daily care records had improved since our previous inspection and these documents now accurately reflected the care and support people had received.

People were supported to live active and varied lives and their relative told us: “[My relative] has been doing lots of activities. He gets to do what he wants.” On the day of our inspection people were supported to engage with a wide variety of activities both within the service and the local community.

The service was well led by the registered manager. Staff told us the registered manager was; “really easy to talk to” and “brilliant to work for.” Staff felt confident that any issues they reported to the registered manager would be addressed and resolved. People relative’s commented, “[The manager] is on the ball and has really pulled all the stops out for [My relative].”

There were systems in place to ensure any complaints received were fully investigated and relatives told us, “If you report things they do get addressed by [The registered manager].” In addition, the service valued people‘s feedback and the registered manager actively supported people to comment on the its performance.

Inspection areas

Safe

Good

Updated 17 January 2017

The service was safe. Recruitment procedures were safe and staff understood local procedures for the reporting of suspected abuse.

There were normally sufficient staff available to meet people assessed care needs.

The risks management procedures were robust and designed to protect people from harm while enabling them to engage in a wide variety of activities in the local community.

Medicines were managed safely and there were systems in place to support people with their finances.

Effective

Good

Updated 17 January 2017

The service was effective. Staff were well trained and there were appropriate procedures in place for the induction of new members of staff.

Staff and the registered manager understood the requirements of the Mental Capacity Act.

Caring

Good

Updated 17 January 2017

The service was caring. Staff knew people and could communicate effectively together.

People were supported to maintain relationship that were important to them.

People’s privacy and dignity was protected and there choices respected.

Responsive

Good

Updated 17 January 2017

The service was responsive. People’s care plans were detailed and personalised. These documents provided sufficient guidance to enable staff to meet people’s identified care needs.

People were supported and encouraged to engage with a wide variety of activities both within the service and in the local community.

There were systems in place to ensure all complaints were fully investigated.

Well-led

Good

Updated 17 January 2017

The service was well led. Staff were well motivated and had been provided with appropriate leadership and support by the registered manager.

Quality assurance systems were appropriate and records within the service were well organised.