Autism Care UK (Bedford) Also known as Larchwood House

On this page

• Overview
• Learning culture
• Safe systems, pathways and transitions
• Safeguarding
• Involving people to manage risks
• Safe environments
• Safe and effective staffing
• Infection prevention and control
• Medicines optimisation

Safe – this means we looked for evidence that people were protected from abuse and avoidable harm.

At our last inspection we rated this key question Requires improvement. At this inspection the rating has changed to Good. This meant people were safe and protected from avoidable harm.

People were safe using the service. Staff were trained in safeguarding and knew how to report concerns if necessary. There were enough suitably trained and competent staff to support people. Risks to people were assessed and mitigated as far as possible and people were supported safely with their medicines. Staff supported people to take positive risks and knew how to support people when they were upset or anxious. The environment at the service was safe and staff followed good IPC procedures to help keep the service clean.

This service scored 72 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

The provider had a proactive and positive culture of safety, based on openness and honesty. Staff listened to concerns about safety and investigated and reported safety events. Lessons were learnt to continually identify and embed good practice. When incidents and accidents happened, these were reviewed and discussed with the staff team so any improvements could be implemented. For example, staff had started supporting one person in a different way following more incidents happening whilst the person was with staff members. This had a positive impact for the person and enabled them to continue to take part in their preferred activities whilst being safe. One relative told us, ‘‘Staff are very in tune with [family member] and know when they are feeling upset and not happy. Staff do reports and make changes to make sure they are safe but still able to do what they want to do.’’

The provider worked with people and healthcare partners to establish and maintain safe systems of care, in which safety was managed or monitored. They made sure there was continuity of care, including when people moved between different services. Staff contacted professionals such as GP’s or psychologists if people needed support. If professionals gave advice that needed to be followed, this was communicated and shared with the staff team. One person told us, ‘‘[Staff] help me with all my appointments. I needed a check-up about [health condition] the other day and they came and helped me talk about what I wanted to happen.’’

People and their relatives told us they/ their family member were safe living at the service. Staff were trained in safeguarding and knew what signs may indicate potential abuse and how to report concerns to external partners such as the local authority or CQC. Safeguarding concerns were reported, and any actions were taken seriously by the management and staff team. One person said, ‘‘I like it here and feel safe because I live here.’’ Another person used signs to tell us they felt safe and showed us the equipment staff used to support them, indicating they felt safe when staff supported them to use this.

People had detailed care plans and risk assessments in place to guide staff in supporting them and mitigating risks as far as possible. Staff were knowledgeable about the risks people faced and how to support them to be safe. People were supported to do what they wanted to do and staff fully supported this, mitigating risks as far as possible whilst fully enabling people to take positive risks. For example, 1 person became unhappy whilst going to the shops which was an important part of their daily routine. Staff supported this person to discuss what happened take part in the routine again the next day. This meant a lot to the person, and they happily showed us how they had completed this routine, showing us the items they had bought. The person told us they were a ‘happy man’ because of this’. Another person told us, ‘‘I can ask the staff to do whatever I want, and they will help me do it safely.’’

The provider did not always take action to deal with potential risks in people’s home environments. Whilst the majority of environment related risks reported by staff were rectified by the provider, known issues related to some fire doors had been left unattended for a long period of time. The provider rectified this at the beginning of our inspection, however we could not be sure this would have happened if our inspection had not prompted this. The provider told us they would look in to why this happened and showed us evidence this was not a regular occurrence. Other elements of the service environment and the equipment people used, such as hoists were safe. Staff completed checks to make sure this was the case, and these checks were audited regularly. One person said, ‘‘I love this building. It is my house. I like my bedroom.’’

There were enough staff to support people safely. People had the correct staffing level throughout the day. For example, people who needed 2 staff to support them in the community always had this available. Staff told us there were enough staff to support people and people’s assessed staffing levels were adhered to at all times. Staff were very present at the service, always being on hand to support people at any given moment. One person said, ‘‘There are enough staff and always someone about when you need them.’’ Another person was visibly happy when they were told who would be supporting them later in the day.

Staff had the training they needed to support people and their competency to support people was checked after their training. Staff were knowledgeable about their training, particularly in relation to supporting autistic people and people living with learning disabilities. The provider recruited staff safely in line with legislation to help ensure they were suitable for their job roles. One person told us, ‘‘The staff are good’’ and gave us a sign to show they were happy with the staff team. A relative said, ‘‘There are always enough staff, and the deputy manager supports everyone really well. All the staff know what they are doing when it comes to looking after [family member].’’

The provider assessed and managed the risk of infection. Staff were trained in infection and prevention control (IPC) and told us they had the necessary equipment to keep the service clean. We observed the service to be visibly clean. Staff supported people to take part in cleaning some areas of the service if they chose to do so. Audits and checks were in place to monitor the cleanliness of the service and the effectiveness of the IPC measures in place. One person said, ‘‘It’s very clean here. I hoover and dust. The staff help me.’’

The provider made sure that medicines and treatments were safe and met people’s needs, capacities and preferences. Staff involved people in planning, including when changes happened. Staff were trained to safely administer people’s medicines and their competency to do this was regularly checked. The management team audited and had checks in place to make sure medicines were being administered safely. The staff and management team proactively worked with health professionals to reduce the use of medicines used to help support people when they were feeling anxious. Staff supported people with other techniques when they felt anxious, and this had a positive impact on people’s quality of life. One relative said, ‘‘In the past [family member] used to need [medicines] to help them when they felt unhappy. This is no longer necessary, and the staff always let me know if things change.’’