The inspection took place on 28 and 29 January 2016 and was unannounced. There was a registered manager in post. 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.
The service provides accommodation and personal care for up to 16 younger people with learning disabilities or autistic spectrum disorder. Fourteen people were living in the three houses provided by the service at the time of our inspection.
Support workers understood their responsibilities to protect people from harm and were encouraged and supported to raise concerns under the provider’s safeguarding and whistleblowing policies. The registered manager assessed risks to people’s health and welfare and people’s care plans included the actions support workers should take to minimise the risks.
There were enough suitably skilled and experienced support workers on duty to meet people’s care and social needs. The registered manager checked support workers suitability to provide care and support during the recruitment process.
The registered manager regularly checked that the premises were suitable for people’s needs and properly maintained, to minimise risks to people’s safety. People’s medicines were managed, stored and administered safely.
People’s needs were met effectively because support workers received appropriate training and support. Support workers read people’s care plans and observed experienced support workers until they knew people well and understood their needs and abilities. Support workers were encouraged to reflect on their practice and to develop their skills and knowledge.
The registered manager understood their responsibility to comply with the requirements of the Mental Capacity Act 2005 (MCA) and Deprivation of Liberty Safeguards (DoLS). People were only deprived of their liberty under the authority of the local supervisory body. For people with complex needs, their families and other health professionals were involved in making decisions in their best interests.
Risks to people’s nutrition were minimised because staff knew about people’s individual dietary requirements and preferences. People made their own choices about their food and were supported to maintain a balanced diet.
People were cared for by kind and compassionate staff who knew them well. Staff knew about people’s individual preferences for care and their likes and dislikes. Staff ensured people obtained advice and support from other health professionals to maintain and improve their health and when their health needs changed.
Support workers were attentive to people’s feelings and behaviours and understood how to reassure them. People were supported to feel empowered, to develop their independence and to maintain relationships with those people were important to them.
People and their representatives were involved finding creative ways to enable people to live as full a life as possible Care was planned to meet people’s individual needs and abilities and care plans were regularly reviewed.
People told us support workers were kind and respected their choices. People were encouraged to give feedback at care plan review meetings, to ensure improvements in the quality of the service focused on people’s needs. Support workers were guided and supported in their practice by a management team they respected.
The provider’s quality monitoring system included regular reviews of people’s care plans and checks on the premises, equipment, medicines management and staff’s practice. The focus of the service was to ensure people enjoyed the best possible outcomes and lived the lives they wanted to live.
The provider’s plans to improve the quality of the service included improving staff retention, redecoration and refurbishment in accordance with people’s personal tastes and seeking out opportunities for people to be more involved in their community.