Autism & Aspergers Support Ltd

Updated 14 February 2018

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection checked whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

The inspection took place on 6 December 2017 and was announced.

We gave the service 48 hours’ notice of the inspection visit because it was small and the registered manager often supported staff or provided care. People living at Latimer Road often accessed the community with the support of staff or the registered manager. We needed to be sure that they would be in and that our visit would not disrupt the lives of people there more than necessary.

Autism and Asperger’s (Latimer Road) is a ‘care home’. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

The care service was 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. The service was small, homely and intimate and therefore allowed more personalised support. Its location also supported these principles by being close to shops, other amenities and public transport links that reduced risks of social isolation and strengthened links with the local community.

Two inspectors were present on the day of the inspection. Before the inspection, we checked the information held regarding the service and provider. This included previous inspection reports and any statutory notifications sent to us by the registered manager. A notification is information about important events which the service is required to send to us by law. We also reviewed the Provider Information report. This is a form that asks the provider to give some key information about the service, what they do well and improvements they plan to make.

On the day of inspection we spoke with two people who used the service about their day to day experiences. We spoke with three staff and the registered manager. We spent time reviewing records, which included two care plans, two staff files, two medication administration records, staff rotas and training records. Other documentation that related to the management of the service such as policies and procedures, complaints, compliments, accidents and incidents were viewed. We also ‘pathway tracked’ the care for people living at the service. This is where we check that the care detailed in individual plans matches the experience of the person receiving care.

Following the inspection we spoke with two relatives and two health professionals who had continued involvement with people living at Latimer Road.

Updated 14 February 2018

The provider Autism and Asperger’s Support Ltd operate three care homes in Eastbourne. We inspected their Latimer Road location which provides accommodation and personal care for up to three people; however at the time of inspection, only two people were living there. The building is situated over three floors and which are accessed by a stair-case. There is a communal lounge, dining room and kitchen as well as a shower room and a bath room. There are also toilet facilities located close to people’s bedrooms. One person’s bedroom had been arranged as a flat with a separate lounge. There were also outside spaces that were accessed by people regularly.

At the previous inspection in 2016, the service was rated as ‘Requires Improvement’ overall. This was due to some insufficient recording regarding the administration of medicines, no registered manager at the premises and a lack of audit protocols. This meant that there was not clear oversight of the service and the people accessing it. It was evident from this inspection that drastic improvement had been made to areas identified previously.

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.

People were safe. Staff had a thorough understanding of how to protect people against harm and there were suitable levels of staff available to ensure people’s needs could be met at any time. The provider had listened to what made people feel anxious and found innovative ways to support them to feel safe at home and when using local amenities. People had a range of individualised risk assessments to support them to maintain their independence and safety. These were developed and regularly reviewed by people and staff who supported them.

Medicines were managed in such a way that people received them safely. Medicines documentation was clear and people had their own medicine cabinets in their bedrooms to encourage maximum independence and control. One person now managed their medicines independently as a result of support, with the encouragement of staff and involvement of the local pharmacy.

The registered manager and staff had a thorough understanding of the Mental Capacity Act 2005 and how to promote choice in decision making. People at Latimer Road were independent and able to make decisions about their care and safety. Regardless of this, the registered manager and staff understood their responsibilities under the Deprivation of Liberty Safeguards (DoLS); these provide legal safeguards for people who may be deprived of their liberty for their own safety. Staff had sought support from health professionals to enable people to make decisions about their own health and wellbeing.

Staff felt well supported due to regular supervision, annual appraisals and a robust induction programme, which developed their understanding of people and their routines. Staff also received a wide range of specialised training to ensure they could support people safely and carry out their roles effectively.

People were supported to maintain their health and were referred for specialist advice as required. Yearly Health Calendar’s meant people could write down when they had appointments and manage their own health. There were clear guidelines in how to support people when accessing different health professionals such as the GP, Dentist or Chiropodist. People were also involved in writing their own emergency plans that could be taken to the hospital if they needed to be admitted.

People, relative’s and health professionals considered the caring nature of the service to be of the highest standard. We saw this not only through observations of people and staff together but through the positive impact living at Latimer road had on people. Relative’s told us how staff had “saved” their relative in times of crisis and that without them, life would be “bleak.” People’s independence was continually focused on; people managed their medicines, managed their own budget and used their locality independently which had increased their confidence and made them feel “very proud.” We were also told how the service had supported a person to quit smoking and how this had made a huge impact on their health.

Each person had a clear and detailed care plan tailored to their individual needs. These highlighted specific support needs, particularly involving anxiety and how to support the person to manage these. The provider has introduced protocols such as ‘Emotional support’ sessions and Social stories; these allowed people to write down what made them anxious and what things could help them feel calmer. These protocols aided in reducing anxiety and people and staff told us how this had had a positive impact on their lives.

Each person developed and reviewed their own timetable of activities. These were reflective of people’s hobbies and interest’s but also incorporated goals that people had set for themselves. People developed their social skills by interacting with peers regularly and were also supported to plan trips to visit relative’s that did not live locally.

The registered manager and owners were highly praised for their support and people, staff and relative’s felt they were extremely open and approachable. Staff felt a part of an open and empowering culture where they were respected as individuals and as part of a team. Relative’s had the utmost confidence in management and always felt welcomed and kept up to date with how people were.

The registered manager had developed robust systems to ensure that all documentation was reviewed regularly and only contained up to date and relevant information. Quality audits were completed monthly and included checks on the building, people and staff’s welfare. People and staff had regular meetings where they were given updates on the service and the opportunity to voice any concerns. The registered manager looked for ways to continually improve the quality of the service.

Further information is in the detailed findings below.