Archived: Hilltop

Hilltop accommodates up to seven people with severe autism. They are non verbal and need high levels of support. They live in a two storey house. There were seven people using the service at the time of this inspection.

At the last inspection in September 2015 the service was rated Good.

At this inspection we found the service remained Good.

Why the service is rated Good:

People were supported to have maximum choice and control of their lives. A high emphasis was put on using technology to help people’s understanding and reduce people’s anxieties. This widened their opportunities and helped to promote their health because they had been able to access health care which was previously too stressful for them. The service worked closely with health and social care professionals toward achieving good outcomes for people. The provider organisation also ensured experts in the field of autism were available as a staff resource.

People’s safety was maintained through adequate staffing levels, which included the use of agency staff, recruitment practice, safe medicines management, premises and adequate infection control. Individual risks were understood and innovative methods used to reduce risk with as little negative effect on the person as possible.

Staff promoted people’s dignity and privacy because they were able to pre-empt situations where this might be compromised. Through listening to people’s views, using person specific communication methods and a strong staff commitment to the people in their care, the service was centred on each individual. Care plans were very detailed and reviewed with the person, staff who support the person, external professionals and family members. Staff had the time and resources to identify best practise and use this to people’s benefit.

The premises was maintained in a safe way and people had a variety of spaces available for their use.

Staff induction and on-going training ensured staff were effective in their role. Staff received a high level of support and regular supervision of their work. Staff were very happy with the level of training they received.

People’s legal rights were understood and upheld. People were safeguarded from abuse and harm.

The service was well-led through the example of the registered manager who ran a well organised service. People’s views were sought and every opportunity taken to improve the service. Audits and checks were carried out in-house and through the provider so any problem could be identified and rectified.

The registered manager understood and met their legal responsibilities.

We saw that staff had an appropriate manner. We saw staff approached people respectfully, were unhurried, supportive and patient at all times and worked in person centred ways. For example, knocking on doors before entering private rooms. Throughout the visit, we saw that people were engaged in various activities of their own choosing.

Staff showed us various picture boards and photos that were used with people who did not use speech to communicate.

We saw everyone looked happy and relaxed. We saw that people were going out on chosen activities during our visit. We saw that these activities were recorded in care records as things they enjoyed doing.

There were systems in place to monitor the quality of support people received. We viewed audits, questionnaires and complaint records.

Staff told us they used a variety of communication methods to support people to make choices. These included speech, signs and symbols, pictures and objects of reference. This enabled people to make choices in line with their abilities.

The manager gave evidence that physical and mental health was monitored and appropriate professionals were involved to make sure that people received the correct treatment and support. .

Medication was administered by staff who had received training in this area and had had their competence assessed by a more senior member of staff.

Staff were generally happy in their role and felt well supported by more senior staff. The provider may find it useful to note that more than one member of staff said they worked long shifts, up to 14 hours, without any official break. Staff said that although they appreciated that this provided continuity for the people who lived at the home, it was extremely tiring and could be stressful for staff.

There were systems in place to monitor the quality of care and ensure the safety of people who lived at the home. These included regular audits, satisfaction questionnaires and risk assessments.