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Alderwood L.L.A. Limited - Hayway Outstanding


Inspection carried out on 9 January 2018

During a routine inspection

Alderwood LLA Hayway is a ‘care home’ for people with autism. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection. Alderwood LLA Hayway accommodates 2 people in one adapted residential house on a residential street . 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.

This inspection took place on 9 January 2018 and was unannounced.

At the time of our inspection the provider confirmed they were providing care to 2 people .

At the last inspection in October 2015, the service was rated Good. At this inspection we found that the service was now outstanding.

People were supported to work towards and complete major achievements in their lives. The service had continued to strengthen their positive links with resource centres for people with a learning disability, local leisure facilities, health and wellbeing providers, and employers who offered work placements. The service was flexible and adapted to people's changing needs and desires, enabling positive outcomes for all concerned. People felt a part of their community, and were able to take pride in their achievements.

Professionals involved in people’s care confirmed that the service was focused on individuals needs and the service had been able to meet people’s high level of needs where other services had failed. Staff had gone the extra mile to ensure that people received the medical treatment that they needed and they had taken innovative steps in complying with the accessible information standard.

The provider was involved with the development of a national initiative to try and prevent the over medication of people with learning disabilities, autism or both and this ethos was firmly embedded within the service. The provider continued to be awarded by external bodies for educating the wider community about positive approaches to autism, and for the on-going investment into the strong development within their staff team.

The service had a consistently high level of engagement with relatives of people that used the service. Feedback from relatives was extremely positive and commented on the unique nature of the service, and how their own lives had been improved as well as their relative using the service.

Staff were well supported by the registered manager and senior management team. The registered manager had a clear vision for the service and its development. Staff were passionate and dedicated to their roles and had belief in the ethos of the support they received, and that of the provider in general. Staff at all levels had a strong belief that they were providing the best possible care for people, and were confident and empowered in their roles because of the strong leadership and management across the company. Staff were innovative in their approach to support, and were enthusiastic about supporting people to overcome life’s hurdles.

There was a registered manager in post. 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.

Staff had an understanding of abuse and the safeguarding procedures that should be followed to report abuse. Safeguarding procedures were followed accurately and alerts made when required. Detailed risk assessments and behaviour management plans were in place to manage all risks within a person’s life. Staf

Inspection carried out on 12 October 2015

During a routine inspection

Alderwood LLA Ltd Hayway provides accommodation, personal care and support for up to two people with a learning disability and autistic spectrum disorder. It is situated in a residential part of Rushden. On the day of our inspection there were two people living in the service.

The inspection took place on 12 October 2015.

The service had a registered manager. 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.

We found a really positive, caring and progressive atmosphere within the service. People were placed firmly at the heart of the service and all aspects of care had been centred on them and their needs. There was lots of laughter and good humour, with kind and trusting relationships evident between staff and people. People were involved in the planning of their care and told us they felt included in discussions, being able to have their say at each step of the way. Staff were passionate about their work and driven by a desire to provide high quality care. They were flexible and adaptable, ensuring that people participated in their own care and achieved their full potential, helping them to lead a meaningful life, doing things that were important to them. The provider philosophy was that people should be able to access the best of everything in life and have ample opportunities to achieve their goals.

The service was led by a dedicated and impassioned registered manager, who was well supported by a strong and positive management structure within the provider organisation. The culture within the service was open, optimistic and uplifting; staff were proud to work for the service and wanted it to be the best it could. Staff and the registered manager were exceptionally well motivated and committed to their work; they faced up to challenges and used these to improve things. They had strong values and a shared vision, and strived to give people positive care experiences and provide high quality care.

Staff attended regular meetings, which gave them an opportunity to share ideas, and exchange information about possible areas for improvements to the registered manager. Ideas for change were welcomed by the registered manager and provider, and used to drive improvements and make positive changes for people. Quality monitoring systems and processes were used robustly to make positive changes, drive future improvement and identify where action needed to be taken. All staff told us they wanted standards of care to remain high and so used the outcome of audit checks and questionnaires to enable them to provide excellent quality care.

People felt secure in the service and we observed they were calm and relaxed in the presence of staff. Staff had a positive approach towards keeping people safe and demonstrated a strong awareness of what constituted abuse. They understood the relevant safeguarding procedures to be followed in reporting potential abuse. Staff were committed to managing fluctuating risk factors for people and had a good understanding of how to support them when they became anxious or distressed. Potential risks to people had been identified, and detailed plans implemented to enable them to live as safely and independently as possible.

Robust recruitment checks took place in order to establish that staff were safe to work with people before they commenced employment. There were sufficient numbers of staff available to meet people’s care and support needs and to enable them to do the things they enjoyed. People received their medication as prescribed. Safe systems and processes were in place to protect people from the risks associated with medication.

Staff received regular training, based upon best practice in autism, which provided them with the knowledge and skills to meet people’s needs in a person centred manner. They were well supported by the registered manager and senior management team in respect of supervision and appraisal which enabled them to remain motivated and responsive to people’s individual needs.

Staff sought people’s consent before they provided care and support. Where people were unable to make certain decisions about their care, the legal requirements of the Mental Capacity Act 2005 and the Deprivation of Liberty Safeguards (DoLS) were followed. Where people had restrictions placed upon them, staff ensured people’s rights to receive care that met their needs was protected, and that any care and treatment was provided in the least restrictive way.

People were supported to access suitable amounts of good quality, nutritious food. A variety of meal options were available for people, which included specific health and cultural dietary requirements. We found people were encouraged and supported to participate in meal preparation as part of developing their life skills. Referrals to health and social care professionals were made when appropriate to maintain people’s health and well-being. Staff worked closely with other professionals to ensure people’s needs were fully met.

People had been supported to develop life skills and gain independence, using individually created development programmes. The support for this was provided by a highly skilled staff group, who shared a strong person centred ethos and were dedicated to helping people lead a fulfilled and enriched live. People and their relatives expressed their delight at the progress they had made since coming to the service, which was often far beyond the level of achievement they had previously hoped for. Staff used innovative ways to support people to move forward, adapting when their needs changed. They had a strong understanding of people’s interests and hobbies and accessed a wide range of activities that were tailored to people’s individual needs. People were actively supported to integrate within the local community, using local facilities to avoid social isolation. To facilitate this, the service had developed links with local colleges, libraries and local employers offering work experience.

Inspection carried out on 15 April 2014

During a routine inspection

We considered all the evidence we had gathered under the outcomes we inspected during our inspection at Alderwood Hayway. We used the information to answer the five questions we always ask.

� Is the service safe?

� Is the service effective?

� Is the service caring?

� Is the service responsive to people's needs?

� Is the service well led?

This is a summary of what we found:

Is the service safe?

We found that the staffing ratio facilitated people to participate in activities of their choice, both within the home and the community. We found evidence to suggest they enjoyed a good quality of life. One person told us, �I like it here; staff are kind to me and I get to do things that I like.� We found that people were protected from potential abuse because staff understood their role in safeguarding the people they supported and staff ratios enabled them to effectively attend to people's support needs.

Individual care plans and associated risk assessments were updated regularly and generally contained detail to guide staff and ensure that people were protected from harm.

We found that there was a system in place to make sure that manager and staff learnt from events, including accidents and incidents, complaints and concerns. This meant that the risk of harm to people was reduced and that lessons were learnt from mistakes and areas of concern.

Is the service effective?

We observed staff talking with and assisting people with the person's privacy and dignity in mind. This demonstrated staff's awareness of people's individual support needs. This was further reinforced in our conversations with staff, which emphasised their knowledge and understanding of people�s specific needs. It also reflected the support plans we viewed on the day.

Within the care files we saw that people or their families, where appropriate, had been involved with, and agreed with the particular care needs that had been identified for them. People had their needs assessed prior to admission and again on a regular basis. We found staff had a good understanding of what people�s care needs were and when they had changed.

Is the service caring?

We found that people were happy with the care and support they received. One person said, "Staff are kind." We observed that people were offered support at a level which encouraged independence and assured their individual needs were met. Staff were helpful and confident in their approach to people and interacted appropriately with them. We noted that people were encouraged to express their views about the quality of care in the home and were involved in planning their care, making decisions about their support and treatment, and how they spent their time.

Is the service responsive to people's needs?

We found that people received person- centred care and support from appropriate people, when required. We noted that people's wishes were respected by care staff and taken into account when making best interest decisions and planning care and support. Records supported that the service engaged effectively with other professionals in ensuring that all areas of health and well-being were maintained.

Is the service well - led?

We found that the provider monitored the quality of the service provided to people and acted upon the feedback they were given. This showed that the service had an effective management structure and was responsive to concerns, making efforts to drive on-going improvement.

Inspection carried out on 25 July 2013

During a routine inspection

Some of the people who lived at the home communicated by using an individual communication method. We spoke to both people living in the home, but were unable to ascertain what one person felt about their experiences in the home. We took the opportunity and observed people�s daily routines and interactions with others from a distance.

The person we spoke with was very complimentary about the home and staff and stated, �I get the right support and can go out with my friends.� He also said �the staff were very supportive� and that his care plan was �clear�.

We looked at outcome areas covering people�s consent to receiving care in the home, how the staff are organised to assist in delivering that care. We looked at the composition of care plans, how people are assisted with their diet and medication. We also looked at the general safety around the home, and found the home was compliant in all of these areas.

Inspection carried out on 14 December 2012

During a routine inspection

We spoke with one person who lived at Alderwood LLA Limited Hayway. They told us, �I have a really good life here� and went on to say saying they received they received �all round great support.� We saw that people appeared calm and relaxed with staff and that staff had a good knowledge of people's care needs.

Alderwood LLA Limited Hayway was registered for treatment of disease, disorder or injury as well as accommodation for persons who require personal care. As the Alderwood LLA Limited Hayway is a care home without nursing this regulated activity was not being provided. We discussed this with the nominated individual who stated they would apply to amend the registration. This inspection did not include treatment of disease, disorder or injury.

Inspection carried out on 14 February 2012

During a routine inspection

There were two people living in the home when we visited on 14 February 2012. We spoke with both people who use the service and two members of staff to ask for their comments and views about the service. Both people who uses the service told us that they were happy living in the home. One person explained that he had worked hard to be able to move to the home and was very glad that he had.