Autism and Aspergers Care Services Ltd

The service has been developed and designed in line with the principles and values that underpin Registering the Right Support and other best practice guidance. This ensures that people who use the service can live as full a life as possible and achieve the best possible outcomes. The principles reflect the need for people with learning disabilities and/or autism to live meaningful lives that include control, choice, and independence. People using the service receive planned and co-ordinated person-centred support that is appropriate and inclusive for them.

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

The service applied the principles and values of Registering the Right Support and other best practice guidance. People's support focused on them having as many opportunities as possible for them to gain new skills and become more independent. They were encouraged to take part in daily living tasks with support from staff in areas such as laundry, cleaning, cooking and hoovering.

People received support from staff who knew them very well as individuals. Staff turnover was low, and a relative and professionals who provided feedback told us this was due to consistency in the staff team. People’s care and support needs were assessed and reviewed regularly. This enabled people to receive care that was person-centred and reflected their needs and choices.

People were supported to maintain their own interests. Staff supported people to take part in choosing activities to meet their individual needs and wishes. Two people loved to attend a fitness/dancing class and another person was supported to maintain their religious beliefs. Staff ensured people had regular opportunities to use cafes and restaurants and the organisations ‘Trip club’ ensured people had regular outings to places of interest to them.

People were protected from the risks of harm, abuse or discrimination because staff knew what actions to take if they identified concerns. The home was clean and tidy throughout. There were enough staff working to provide the support people needed, at times of their choice. Recruitment procedures ensured only suitable staff worked at the service.

The registered manager had very good oversight of the service. Quality assurance systems were comprehensive and ensured all aspects of the running of the home were examined regularly, records were kept up to date and any actions resulting from audits were addressed swiftly.

Staff understood the risks associated with the people they supported. Risk assessments provided further guidance for staff about individual and environmental risks. People were supported to receive their medicines safely.

Staff received training that helped them to deliver the care and support people needed. This included specialist training in autism and positive behavioural support to meet people’s complex needs. They attended regular supervision meetings and told us they were very well supported by the registered manager. A staff member told us the registered manager, “Knows the way we work. We can turn to her if we have a problem.”

People's health and well-being needs were met. Where appropriate, staff supported people to attend health appointments, such as the GP or dentist and appointments for specialist advice. People’s nutritional needs were assessed. They ate a wide range of healthy, freshly cooked meals, drinks and snacks each day.

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. There was a detailed complaint procedure, and this was displayed so anyone wanting to raise a concern could do so.

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

Rating at last inspection

The last rating for this service was Good. (Published 4 February 2017).

The overall rating for the service has remained Good. This is based on the findings at this inspection.

Why we inspected

This was a planned inspection based on the previous rating.

Follow up:

We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.

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 a legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

We carried out a previous inspection of this service on 24 October 2013. The service met all the regulations we inspected.

Staff were trained in how to protect people from abuse. The registered manager and staff understood their responsibilities in relation to safeguarding vulnerable adults from abuse. Staff knew how to recognise signs of abuse and the procedures to follow should they need to report concerns.

People were protected from risks relating to their health, medicines, nutrition and hydration and behaviours. Staff assessed and managed individual risks to people whilst supporting them to be as independent as possible. The registered manager monitored and reviewed accidents and incidents and had put plans in place to minimise the risk of recurrence.

There were robust recruitment procedures in place to ensure only staff of good character were employed by the service. Staff underwent checks before they started working at the service to ensure they were suitable to work with people. There were enough staff to support people safely.

Staff supported people to take their medicines safely. Medicines were stored and managed appropriately. Staff were trained in the safe administration of medicines and maintained accurate records.

Staff had the skills and knowledge they required to undertake their role. Staff received relevant training as well as regular supervision and appraisal to support them in their role. Staff supported people through positive behavioural support which contributed to them experiencing fewer incidents of behaviour which challenged the service.

Staff understood their role in relation to the Mental Capacity Act 2005 and Deprivation of Liberty Safeguard (DoLS) and ensured they put their knowledge into practice. People consented to care and treatment.

Staff treated people with respect and showed them kindness and compassion. Staff knew each person well and understood how to meet their support needs. The service had a welcoming, happy and friendly atmosphere. Staff and people interacted with humour which showed people felt comfortable in their presence. Staff were positive about working with people who identified as gay, lesbian, bisexual or transgendered.

People were supported with their nutritional needs and encouraged to adopt healthy lifestyle choices. People were able to make choices about what they wanted to eat and encouraged to help prepare meals where they were able.

People, relatives, staff and healthcare professionals were asked for their views about the service. The registered manager used their feedback to improve the quality of care. People were provided with information about how to make a complaint.

Care plans contained assessments of people's individual needs and the support they required. Staff reviewed care plans on a regular basis and when changes to a person’s needs were identified. People received care and support as planned and as they wished. People accessed health and social care professionals for support with their care and health needs.

People and staff described the registered manager as approachable and open to ideas and feedback. An open culture put people at the centre of care and support.

The registered manager carried out audits and checks to develop the quality and safety of the care and support people received. The service worked in partnership with healthcare professionals to ensure people received the support they needed.

We found that care and support provided was person centred and focused on promoting people's independence. We saw that staff listened to people and responded to people in a kind and respectful way. We found that staff were supported and were given opportunities to develop their skills. We examined the systems and processes in place for the safe management of medicines and found these to be effective. We found that there was an effective complaints system available.

People were given support to make choices and decisions for themselves wherever they could do so, and staff clearly understood each person’s way of communicating their needs, wishes and choices.

We looked at compliments received from relatives. Comments included " Thank you for all your support it is appreciated.”

The provider had systems in place to identify, assess and manage risks and to ensure that care was delivered effectively and to people's satisfaction.