Elysium Care Partnerships Limited - 1 Lichfield Lane

About the service

Elysium Care Partnerships Limited - 1 Lichfield Lane is a care home for up to 8 adults with learning disabilities and autistic people. The service is managed by Elysium Care Partnerships Limited, a national provider of health and social care services. At the time of our inspection 8 people were living at the service.

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

The service was not able to demonstrate how they were meeting some of the underpinning principles of Right support, right care, right culture.

Right Support: People's medicines were not always managed in a safe way. Systems for monitoring this had not always been implemented effectively. Decisions were made in people's best interests, but there were not always recorded assessments or agreements for some restrictions. The environment was clean, but improvements were needed to make sure it was always stimulating and interactive to meet people’s needs. Staff supported people to make choices and be independent where possible. People were supported to pursue their interests. Staff enabled people to access specialist health and social care support in the community. Staff supported people to play an active role in maintaining their own health and wellbeing.

Right Care: Staff knew people well and were able to provide support which met their cultural needs and reflected their interests. People received kind, compassionate care. Staff respected people's privacy and dignity. They understood and responded to their individual needs. Staff understood how to protect people from poor care and abuse. The service had enough skilled staff to meet people's needs and keep them safe. People could communicate with staff and who understood their individual ways of communicating. Interactions were positive and supportive. People were enabled to make choices and try a range of different activities to reflect their interests and help them develop skills. Staff supported people to take risks and provided care in the least restrictive way.

Right culture: People received good quality care and support and their views were considered when planning care to make sure they felt safe, comfortable and happy. Staff were trained and worked with others to provide personalised care. Staff felt well supported and able to speak up when things went wrong. Staff understood about best practice and had clear direction and guidance from managers.

For more information, please read the detailed findings section of this report. If you are reading this as a separate summary, the full report can be found on the Care Quality Commission (CQC) website at www.cqc.org.uk

Why we inspected

We undertook this inspection to assess that the service is applying the principles of Right support right care right culture.

Enforcement and Recommendations

We have identified breaches in relation to safe care and treatment at this inspection.

Please see the action we have told the provider to take at the end of this report.

Follow up

We will request an action plan from the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.

The home provides care and accommodation for up to eight people with learning disabilities. It is located in the Whitton area.

The home 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 and associated Regulations about how the service is run.

In December 2014, our inspection identified that the service was good in each area with an overall rating of good.

Due to people using the service having limited verbal communication relatives generally spoke on their behalf. Relatives told us that people really enjoyed living at Lichfield Lane and the way that staff treated and supported them. This was confirmed by the positive body language and displays of affection by people using the service towards staff throughout our visit.

People using the service were younger adults who had moved from residential schools, other care home placements or parental homes where their needs could no longer be fully met. Their move to Lichfield Lane had a hugely positive impact on their lives with progress being demonstrated by their personal achievements and opportunities to try new experiences. They were provided with choices from a lot of activities tailored to their individual interests and likes. Although people did not comment on their activities they enjoyed them very much with lots of smiling and laughter. The impact of this was that people enjoyed their activities and developed bonds and friendships.

The positive impact the home had on young people, since moving in was also demonstrated by a substantial reduction of incidents where people displayed anxiety or anger through aggressive behaviour. When aggressive behaviour did occur staff understood that this was an expression of people’s emotions, feelings and turned them into positives by calming the situation, finding out what was wrong and addressing it. They achieved this by having a thorough knowledge of each person living at the home and their likes and dislikes based on trial and error and growing positive bonds and relationships with them.

Relatives said that staff treated people’s safety as of great importance, whilst still recognising that people using the service must be enabled to try new experiences and take opportunities by taking acceptable risks. This was after having considered the benefit to people in relation to the risks involved and was reflected in the number of new experiences people had whilst maintaining those that they previously enjoyed. It meant people received a service that was individual to them and changed with them as their needs changed and skills and confidence developed, resulting in more fulfilling and enjoyable lives.

Staff enabled people to progress by adopting a very person centred approach that encouraged people to recognise and celebrate their achievements. This was by having a thorough knowledge of people’s individual communication and sensory needs and meeting them in a patient and measured way that enabled people to get their feelings and wishes across.

Each person had a comprehensive and individualised support plan that encompassed all aspects of their lives and included their social, leisure, educational and if appropriate, future work aspirational needs. This was reflected in the structured and spontaneous activities that people chose and enabled them to live their lives the way they wished. Great attention was also paid to people’s health and emotional needs with staff working in tandem with health care professionals in the community. People were protected from nutrition and hydration associated risks with balanced diets that also met their likes, dislikes and preferences. Relatives spoke positively about the choice and quality of food available. The depth of planning and co-operation and its impact was demonstrated by one person being enabled to return to live at Lichfield Lane and have a fulfilling and enjoyable lifestyle having undergone major heart surgery.

The home was well maintained, furnished, clean and enabled people to do as they pleased. It provided a safe environment for people to live and work in.

The staff we spoke with had received excellent training that was organisational based and service- and person-specific. The quality of the training was reflected in the excellent care practices staff demonstrated and followed throughout our visit. They were very knowledgeable about the field they worked in, had appropriate skills, knew people and their relatives well and understood people’s needs in great detail. This knowledge was used to provide care and support in a professional, friendly and supportive way, focussed on the needs and wishes of the individual.

Staff were enabled and supported to develop their skills and progress their careers. Individual skills were acknowledged, harnessed to further practice development and incorporated within the way the service worked. The service and organisation enabled staff at all levels of seniority to contribute effectively to developing people’s individual support as well as developing new ways of working and procedures. Staff feedback was very positive and enthusiastic about working at Lichfield Lane and the organisation as a whole. They felt their ideas were listened to, introduced and they were enabled and supported to develop their skills.

The quality assurance and monitoring systems were geared towards continuous improvement with staff constantly monitoring individual care and support, feedback from people using the service and reflection on how people’s lives could be improved and made more enjoyable. The records system was well thought through, clear and useable. Staff also recognised the importance of these records as a source of quality improvement and whilst they were very detailed this was not allowed to detract from the care and support people received.

The culture of the service, staff and organisation as a whole was open, transparent, progressive and committed to continuous improvement with care and support centred on the individual. People and their relatives felt valued as did staff who considered themselves as important representatives of the organisation. Relatives said the management team and organisation were approachable, responsive, encouraged feedback from people and consistently monitored and assessed the quality of the service provided. They and health care professionals told us that this was an outstanding service and organisation.

The National Autistic Society had accredited the organisation and recognised the person centred care and individualised support provided. It was also acknowledged that the organisation worked well with other stakeholders, seeking their opinions and checking if they were satisfied with the service provided.

We saw staff treated people with dignity, respect and involved them in decision making about what they would like to do. They were supported and encouraged to make their own decisions and choices, choosing activities they liked and ones that helped improve their life skills. Frequently these were one and the same as tasks were made fun.

The staff were friendly, skilled and supported by the organisation and management structure to meet peoples needs well. People were comfortable interacting with staff and spent a lot of time laughing and smiling.

The building was fit for purpose, well-maintained and equipped to meet the needs of people who use the service to a high level.

There was a robust complaints policy and procedure that was available in a part pictorial version to make it more accessible to people using the service.

The records, policies and procedures we saw were well kept easily accessible and up to date.