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Inspection carried out on 11 March 2020

During a routine inspection

About the service

Charlotte House is an adapted residential building which delivers personal care and support for up to five people who have autism and associated conditions. At the time of inspection the service was supporting five people.

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

People received care and support that was safe. People were protected from avoidable harm and abuse. The provider undertook appropriate recruitment checks on staff prior to their employment. People's medicines were managed in a safe way. There were safe systems in place to help ensure people received their medicines as prescribed. Staff received training on infection control and were provided with personal protective equipment such as disposable aprons and gloves.

People received care and support that was effective and based on detailed assessments and care plans which reflected their physical, mental and social needs. The service worked with other agencies to achieve good outcomes for people. People were supported to access appropriate healthcare services to ensure these needs were met. 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; however, the systems in the service did not always support this practice. We have made a recommendation that the provider reviews their systems to ensure they are working within the principles of the Mental Capacity Act 2005.

The outcomes for people using the service reflected the principles and values of Registering the Right Support by promoting choice and control, independence and inclusion. People's support focused on them having as many opportunities as possible for them to gain new skills and become more independent.

There were caring relationships between people and staff. Staff were aware of and supported people's emotional needs. Staff respected and promoted people's privacy, dignity and independence, and encouraged people to be as independent as possible.

People received personalised care that was responsive to their needs. People were provided with information in a way they could understand which helped them make decisions about their care. There were effective systems in place to deal appropriately with complaints.

People were at the heart of the service. The registered manager and staff were passionate and continuously strived to achieve good, positive outcomes for people. Systems were operated effectively to maintain the quality and safety of the service.

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

Rating at last inspection and update

The last rating for this service was requires improvement (published 13 March 2019).

At our last inspection we found breaches of the regulations in relation to medicines management and governance. The provider completed an action plan after the last inspection to tell us what they would do and by when to improve.

At this inspection we found the provider had made improvements and was no longer in breach of regulations.

Why we inspected

We carried out this inspection to follow up on action we told the provider to take at the last inspection.

Recommendations

We have made a recommendation in relation to

Inspection carried out on 20 February 2019

During a routine inspection

About the service:

Charlotte House is a residential care home which is registered to support up to five people between the ages of 19 to 25 years old who are severely affected by autism. At the time of our inspection there were five people living at the service.

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. 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

Overview of findings:

¿Staff were not regularly assessed as competent to administer medicines in line with clinical guidance and best practice.

¿Staff had not always attended training that the provider deemed as mandatory.

¿ Audits had not always been undertaken. Those that had, did not always identify gaps or highlight trends, themes or lessons learnt.

¿People were happy living at the service. People were observed smiling and positively interacting with the staff supporting them.

¿Staff supported people to have a meaningful life and encouraged them to be independent.

¿People received care that was designed to meet their individual needs and preferences.

¿Recruitment processes were in place to make sure, as far as possible, that people were protected from staff being employed who were not suitable.

¿People who lacked capacity were supported to have maximum choice and control of their lives. Policies and systems supported them in the least restrictive way possible.

¿The registered manager and home manager demonstrated a commitment to providing person centred care for people.

¿Staff felt the management was supportive and approachable. Staff were happy in their role which had a positive effect on people's wellbeing.

Rating at last inspection:

This was the first inspection of the service since it was added to the provider's registration on 28 February 2018. Therefore, the service was not previously rated.

Why we inspected:

This was a planned comprehensive inspection in line with our aim to carry out the first inspection of a service within six to twelve months of the date of registration.

Enforcement:

Full information about CQC’s regulatory response to the more serious concerns found in inspections and appeals is added to reports after any representations and appeals have been concluded.

Follow up:

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