This inspection took place on 01 March 2016. This inspection was announced. 48 hours’ notice of the inspection was given because people needed to prepare for unfamiliar visitors due to their autism needs and to reduce any possible anxiety this may cause.This location is registered to provide accommodation and personal care to a maximum of seven people with adults with complex needs within the autistic spectrum. Seven people lived at the service at the time of our inspection. Some people could communicate using words and short sentences. Some people had non-verbal communication skills. We talked directly with people and used observations to better understand people's needs.
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 2008 and associated regulations about how the service is run.
Some new staff had not yet attended relevant training and other staff required refresher training in some areas. The training system in place was not sufficiently robust to ensure that staff training needs were fully met. We have made a recommendation about training.
The provider had consulted people to obtain their feedback to develop and improve the service.
We have made a recommendation that the provider reviews the formal consultation process.
Staff responded to people’s individual needs and support people to meet their individual goals and aspirations. However one person required additional support to ensure their person-centred needs to move on from the service were met.
We made a recommendation that the provider works proactively with people and their funding authority to help people move on from the service.
Some records were not available on the day of the inspection, some records were not securely stored and other records required were not in place.
There were audit processes in place to monitor the quality of the service and promote continuous service improvements. However, audits were not sufficiently robust. Shortfalls we found had not been identified as part of the provider’s audit process. There was no service improvement plan in place to determine how the service would continuously develop and improve.
Staffing levels were adequate and were flexibly deployed to ensure people received appropriate support at all times to meet their individual needs.
Staff we spoke with understood how to protect people from abuse and harm. Staff knew how to recognise signs of abuse and how to raise an alert if they had any concerns.
Risk assessments were centred on the needs of the individual. Each risk assessment included clear control measures to reduce identified risks and guidance for staff to follow to make sure people were protected from harm.
Accidents and incidents were recorded and monitored to identify how the risks of reoccurrence could be reduced. There were safe recruitment procedures in place which included the checking of references.
Medicines were stored and administered safely and correctly. Staff were trained in the safe administration of medicines.
The Care Quality Commission (CQC) is required by law to monitor the operation of Deprivation of Liberty Safeguards (DoLS) which applies to care homes. DoLS assessments were not required at the time of our inspection to ensure people were lawfully deprived of their liberty.
People’s needs and personal preferences had been assessed. People’s care plans had been regularly reviewed to ensure they were up-to-date and met people’s individual preferences and needs.
Staff supported people to have meals that met their needs and choices. Staff knew about and provided for people’s dietary preferences and needs.
Staff communicated effectively with people, responded to their needs promptly, and treated people with kindness and respect. People’s privacy was respected and people were assisted in a way that respected their dignity. The registered manager demonstrated a high level of knowledge about people and their individual autism needs. They supported people with kindness and compassion.
People were promptly referred to health care professionals when needed. Personal records included people’s individual plans of care, life history, likes and dislikes. The staff promoted people’s independence and encouraged people to do as much as possible for themselves.
Staff responded to people’s individual needs and support people to meet their individual goals and aspirations.
People were provided with accessible information about how to make a complaint and received staff support to make their views and wishes known.
There was an open culture that put people at the centre of their care and support. The registered manager demonstrated a high level of commitment to meeting the needs of people at the service. They knew people well and had positive relationships with people and staff.
Staff held a clear set of values based on respect for people, ensuring people could make choices and have support to be as independent as possible.