Walnuts Care

Updated 24 July 2018

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection checked whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

This comprehensive inspection took place on 9 May 2018 and was announced. The provider was given 48 hours' notice because we needed to be sure that someone would be in the office to assist us with our inspection. The inspection was carried out by one inspector, an assistant inspector and an expert-by-experience. An expert-by-experience is a person who has personal experience of using or caring for someone who uses this type of care service.

We visited the office location on 9 May 2018 to see the management team, office staff; and to review care records and policies and procedures. On the day of our inspection young people who used the service were invited to visit us to have a chat about the care and support they received. This took place at the office location where there was a sensory room and activities for people to take part in. Parents either accompanied their family member or dropped in throughout the day to talk with us as well.

Before the inspection, we asked the provider to complete a Provider Information return (PIR). This is a form that asks the provider to give some key information about the service, what the service does well and improvements they plan to make. We reviewed the completed PIR and considered this when we made our judgements.

We checked the information we held about the service including statutory notifications. A notification is information about important events, which the provider is required to send us by law. We also contacted the health and social care commissioners who help place and monitor the care of people using the service.

During this inspection, we spoke with five young people who used the service and five relatives. We also spoke with seven staff that included the registered manager and director, the operations manager and four care and support staff.

We reviewed the care records of five people that used the service. These included their care plans, health and medication records, risk assessments and daily care records. We also looked at the recruitment records for four members of staff to see how the provider operated their recruitment procedures. Other records we examined related to the management of the service and included staff rotas, training and supervision records, quality audits and service user feedback.

Updated 24 July 2018

At the last comprehensive inspection on 4 February 2016 the service was rated Good.

At this announced inspection on 9 May 2018 we found the service remained Good in Safe, Effective and Responsive. The service had progressed to Outstanding in Caring and Well-led giving it an overall rating of Outstanding.

Walnuts Care provides a range of support services for families and young people living with Autism. Services include respite care, support with social activities and daily living skills. At the time of our visit there were 70 people using the service. Walnuts Care Ltd. (WCL) was set-up in association with The Walnuts School, a community, residential Special School in Milton Keynes for young people on the Autistic Spectrum, to provide care and support for younger adults once they leave school, in addition to respite for children.

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.

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.

People and relatives told us that they were supported by very kind, caring and compassionate staff that often went the extra mile to provide them with exceptional care. People were at the heart of the service, which was organised to suit their individual needs and aspirations. There were exceptional relationships between people, their families and members of staff. Relatives told us about the positive impact the service had on their lives and how things had changed for the better. Each person was treated as an individual and as a result, their care was tailored to meet their exact needs. People were supported to use a range of personalised communication methods and staff ensured communication was not a barrier to people achieving their goals and aspirations. Staff and relatives told us that people were supported to use their individual communication methods and tools to help reduce anxiety and have greater control about their care and lifestyle.

There was an extremely positive culture within the service and the management team provided strong leadership and led by example. The registered manager and the operational manager had clear visions, values and enthusiasm about how they wished the service to be provided and these values were shared with the whole staff team. Staff had clearly adopted the same ethos and enthusiasm and this showed in the way they spoke about people. Individualised care was central to the service's philosophy and staff demonstrated they understood and practiced this by talking to us about how they met people's care and support needs.

People continued to receive safe care. Staff had been provided with safeguarding training to enable them to recognise signs and symptoms of abuse and how to report them. There were risk management plans in place to protect and promote people’s safety. Staffing numbers were appropriate to keep people safe and the registered provider followed thorough recruitment procedures to ensure staff employed were suitable for their role. There were systems in place to ensure people were protected from the spread of infections. People’s medicines were managed safely and in line with best practice guidelines. If any accidents or incidents occurred lessons were learnt and action taken to reduce risk in future.

People’s needs and choices were assessed and their care provided in line with best practice that met their diverse needs. There were sufficient numbers of staff, with the correct skill mix to support people with their care. Staff received an induction process when they first commenced work at the service and in addition received on-going training to ensure they were able to provide care based on current practice when supporting people.

People received enough to eat and drink and staff gave support when required. People were supported to access health appointments when required to make sure they received continuing healthcare that met their needs. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible. The policies and systems in the service supported this practice.

Care plans provided staff with detailed information and guidance about people's likes, dislikes, preferences and guidance from any professionals involved in their care. People and their relatives were involved in planning all aspects of their care and support and were able to make changes to how their care was provided. Records were regularly reviewed to ensure care met people's current needs. This helped to provide staff with up to date information about how each person’s support was to be delivered.

People, relatives and staff knew how to raise concerns and make a complaint if they needed to and there was a complaints procedure in place to enable people to raise complaints about the service.

The management and leadership within the service had a clear structure and the management team were knowledgeable about people's needs and key issues and challenges within the service. Staff felt supported and valued. There were systems in place to monitor the quality of the care provided and to ensure the values, aims and objectives of the service were met. The registered provider was aware of their responsibility to report events that occurred within the service to the Care Quality Commission (CQC) and external agencies.