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Inspection carried out on 23 November 2017

During a routine inspection

The inspection took place on 23 and 27 November 2017 and was unannounced. At the last inspection on 23 February and 3 March 2015 the service was rated Good. At this inspection the service was rated overall good.

Wargrave house (LEAP) is purpose-built residential accommodation on the site of Wargrave school and college. The service accommodates up to 6 young adults between the ages of 19 and 25 years who are living with autism and attend the college that is also run by the registered provider. On the day of our inspection there were five people staying at the service. Each person stayed for between one and four days each week.

There was a registered manager at the service at the time of our inspection. 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 of the Health and Social Care Act 2008 and associated Regulations about how the service is run.

The Care Quality Commission is required by law to monitor the operation of the Mental Capacity Act (MCA) 2005 and to report on what we found. At our last inspection we found the registered provider was not fully following the requirements of the MCA. At this inspection records showed the registered provider had ensured all appropriate documentation was in place that included capacity assessments. The registered provider had policies and guidance available to staff in relation to the MCA. Staff demonstrated an understanding of this and had all completed training.

Systems in place for the recruitment of staff were robust and this ensured that only suitable staff were employed to work with the vulnerable people supported. Records showed that all staff had completed an induction at the start of their employment and also undertaken shadow shifts. All staff had completed mandatory training as well as additional training specific to their role. Staff were supported by the management team through regular supervision and team meetings. This meant that people were supported by staff that had the right skills and knowledge for the role.

The registered provider had safeguarding policies and procedures in place. Staff had all received training and demonstrated a good understanding of this topic.

A thorough assessment of people's needs was completed prior to them accessing the service. Individual care plans and risk assessments were in place and included 'What is important' and 'My health passport' documents. People and their chosen relative's had participated in the preparation of their person centred care plans.

People knew the staff that supported them by name and had developed positive relationships. Staff treated people with kindness and were caring in their manner.

People undertook activities of their choice. Feed back was sought from people on each day of their stay at the service. Annual feedback questionnaires were sent to relatives and positive feedback had been received.

Dietary needs were fully assessed and clear guidance and documentation was in place for the management of this. Relatives told us people's dietary needs were met.

The registered provider had documents available in accessible formats that included easy read and pictorial.

There was a clear complaints policy and procedure in place that was accessible to all people and their relatives.

The registered provider had up to date policies and procedures in place that were reviewed regularly.

Inspection carried out on 25 February and 3 March 2015

During a routine inspection

This was an announced inspection, carried out over two days. We inspected the service on 25 February and 3 March 2015. We gave the service a week’s notice of our inspection. We did this due to the needs of the young people who live in the service. A photograph of the inspector and their name was sent to the service so that they could make sure that the young people were aware that an inspection was being undertaken.

Wargrave House LEAP) is a purpose built service on the site of Wargrave House school and specialist college. Young people attending the college live in LEAP during the term time of their college education. The service can accommodate up to six young adults between the ages of 19 and 25 years who are living with autism.

During this inspection we only looked at the care provided to young people and their families who used the residential service. Although the school/college supply the service with support, notably some therapy, administration and medical support, we only inspected these aspects in relation to the personal care support provided to Wargrave House LEAP.

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.

We saw in one instance that support given by staff did not comply with the Mental Capacity Act 2005. A decision had been made on behalf of a young person without obtaining valid consent or determining whether it was in their best interests.

Staff demonstrated a clear understanding of the individual needs of the young people and support was provided with kindness and compassion. Young people and their families told us they were happy with the support they received and were complimentary about the staff and the managers.

Staff were appropriately recruited, trained and skilled in providing support in a safe environment that met young people’s individual needs and promoted their independence. All staff received a thorough induction when they started work and fully understood their roles, responsibilities, the values and philosophy of the service. The staff had completed extensive training to make sure that the support they provided to the young people was safe, effective and met their needs.

Throughout our inspection we saw examples of support that helped make the service a place where people felt included and consulted. Young people and their families were involved in the planning of their care and were treated with dignity and respect.

The registered manager and the provider assessed and monitored the quality of care continuously. The provider encouraged feedback from young people and families, which they used to make improvements to the service.

Inspection carried out on 3 October 2013

During a routine inspection

People living in the service had a variety of needs making verbal communication difficult for them at times. We used a variety of methods in order to determine the support people received. This included discussions with staff and observations of staff interaction with people living in the service.

We also contacted three families for their input and opinions as to the service delivery. Families told us they are kept involved and they were �very happy� with the support their relatives received. They told us staff were �really skilled �at making sure that they met their relative�s needs. They told us they could not �fault� the service. One relative told us �No one could possibly provide anything anywhere near as good. They could not look after [name of person] any better they are so good [name of person] has developed a lot of skills.�

The service had opportunities to promote the independence of people using the service and involve them in the care that they received. People were supported to develop independence skills by the use of care, medical and support plans. Support plans were written in a picture format to assist in meeting the needs of people.

The building was adapted to meet the needs of people living in the service and was decorated in a domestic manner. There were signs and notices in picture format on doors as an example, that helped people who lived in the service maintain their independence.

Inspection carried out on 19, 28 February 2013

During a routine inspection

We saw that people were treated with dignity and their views respected. Staff gave people the time to respond and supported them to undertake daily activities in a manner that maintained their personal rights. We observed that staff communicated effectively with the people they supported and demonstrated an understanding of their individual needs.

People�s relatives were very enthusiastic about the support being provided. They told us that the home was �brilliant� and �absolutely flawless�. They told us that they were kept completely up to date with information about care and medical needs. One relative informed us of the extra efforts the staff and manager had made when their relative was unwell. Relatives also told us that they were sure that their relatives were safe. Another told us �there are a lot of staff so they are always able to keep an eye on as to what�s going on and know where they are. Often there is one member of staff to each person. I know that they have been out and about even if that�s just to the shops and I am assured that staff know what to do. Safety seems to always be of paramount concern�.

We saw that people were supported and encouraged to have their say about the quality of the service. Records and discussions showed that people�s views were listened to and actioned to influence the quality of the service.