1-2 Prior's Court Cottages

1-2 Prior’s Court Cottages is a residential care home, also known as Dove Cottage. It provides accommodation and personal care for up to six autistic people, living with associated complex needs. The service provides a continuing education service to young adults aged from 18 to 25. At the time of the inspection there were six people living at the service. The service provides on-site educational and vocational services via a learning centre and other facilities based on individual assessments and needs.

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

We expect health and social care providers to guarantee people with a learning disability and autistic people respect, equality, dignity, choices and independence and good access to local communities that most people take for granted. ‘Right support, right care, right culture’ is the guidance CQC follows to make assessments and judgements about services supporting people with a learning disability and autistic people and providers must have regard to it.

Staff understood and effectively delivered care and support in accordance with the principles and values of Registering the Right Support and other best practice guidance. This ensured people who used the service lived as full a life as possible and achieved successful outcomes.

Right Support

People were kept safe from avoidable harm because staff knew them well and understood how to protect them from abuse. Staff had training on how to recognise and report abuse and knew how to apply it.

Staff focused on people’s strengths and promoted what they could do, so people experienced a fulfilling and meaningful everyday life.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice. Staff supported people to make decisions following best practice in decision-making and communicated with people in ways that met their needs.

Staff collaborated with people to plan for when they experienced periods of distress so that their freedoms were restricted only if there was no alternative. Staff made every attempt to avoid restraining people and did so only when de-escalation techniques had failed and when necessary to keep the person or others safe.

Staff supported people with their medicines in a way that promoted their independence and achieved the best possible health outcomes. Staff supported people to play an active role in maintaining their own health and wellbeing.

Right Care

Staff delivered person-centred, kind care, which protected and respected people’s privacy and dignity.

People’s support plans reflected their range of needs and promoted their wellbeing and enjoyment of life. Staff provided care to meet people’s needs and aspirations, focused on their quality of life, and followed best practice.

Staff and people worked together to assess risks people might face. Staff encouraged and enabled people to take positive risks and engage in activities to enrich the quality of their lives.

Right Culture

The ethos, values, attitudes and behaviours of the registered manager and staff ensured people led confident, inclusive and empowered lives.

People were supported by staff who understood best practice in relation to the wide range of strengths, impairments or sensitivities of autistic people. This meant people received compassionate and empowering care that was tailored to their individual needs.

Staff turnover was low, which supported people to receive consistent care from staff who knew them well and placed their wishes, needs and rights at the heart of everything they did.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection and update

The last rating for this service was good (report published 21June 2018).

Why we inspected

This inspection was prompted by a review of the information we held about this service.

Follow up

We will continue to monitor information we receive about the service, which will help inform when we next inspect.

At our last inspection we rated the service good. At this inspection we found the evidence continued to support the rating of good. There was no evidence or information from our inspection and ongoing monitoring that demonstrated serious risks or concerns. This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection.

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. (Registering the Right Support CQC policy). 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.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible. The policies and systems in the service supported this practice. People were treated with respect and their dignity was maximised in the way staff provided support.

People were kept as safe as possible because risks to people and staff were identified, assessed and appropriate steps taken to minimise them. Health and safety checks and servicing were carried out as required. The service had a robust recruitment system to ensure, as much as possible, that staff had the right approach and skills. People were supported by staff who were well trained and supported and who were additionally supported to develop their knowledge and skills. Staff understood the impact of their autism on each person and responded to their individual needs consistently. Where people needed support to manage their behaviours, this was delivered in planned, consistent ways which were kept under regular review. Staff had all been trained in a nationally recognised behaviour support technique.

Healthcare was very good and medical conditions were managed very well using appropriate technology where necessary to keep people safe. People’s transitions in and out of the service were extremely well planned and supported to try to give them the best chance of success.

People’s care was delivered according to detailed individual care plans which were subject to regular review. The views of relevant others were sought when reviewing people’s care needs. People had wide ranging opportunities for involvement in activities, holidays and supported employment. They continued to develop their skills through attending the on-site learning centre.

Each person’s communication preferences were recorded, understood and supported by the staff working with them. Communication aids were used effectively to enable people to be as involved in making decisions and choices as possible. People’s individual and diverse needs were met.

The provider and management exercised thorough governance over the service through a range of effective monitoring and audit systems.

Further information is in the detailed findings below.

People's care and support was clearly described within detailed care plans and supporting documents which were regularly reviewed. Appropriate support was sought from specialists including the speech and language team and psychologists. Parents gave us very positive feedback about the quality of care and support provided. One parent told us the staff were "very good at involving parents". Another parent said the staff sent them "DVD's and photos" of their son enjoying the activities provided.

Staff understood their role in safeguarding vulnerable adults. Staff had acted in accordance with the procedures in place to safeguard people.

Staff received a comprehensive induction and attended a planned programme of core training to equip them with the skills they needed. On-going support and staff development was provided through regular supervision and appraisal.

The provider had systems in place to monitor the effectiveness of 1-2 Prior's Court. The views of parents and staff were sought as part on monitoring and developing the service. Any complaints were responded to and addressed promptly. One parent told us "they always listen to what we say and make changes".

The 'continuing education' ethos was supported by the wide range of social and vocational opportunities made available to people in the home. Where people sometimes required support to manage their behaviour, this was provided by staff who had received recognised training in the approach used. All incidents were documented and analysed and parents were happy that they had been kept informed of these.

Parents felt the staff were competent and good at maintaining regular communication with them. They told us the staff and management were approachable and listened to their views. One parent told us the staff 'provided a varied range of activities and occupational opportunities'. Another parent said the staff do 'good work on communication and learning'.

A programme of staff training was provided, though we found some gaps in this. Staff supervision and appraisal had also not been regularly provided. The operation of the service was subject to regular management monitoring within and outside the home. Parents had opportunities to contribute their opinions about how the service operated.