This inspection took place on 9 December 2014 and was unannounced.
The service provides accommodation, support and personal care for three younger adults with moderate to severe autism and communication difficulties. Each person received continuous one to one support from staff and needed to be supervised whenever they went out. The service promoted a culture of learning and individuality. They wanted to equip people with skills for life regardless of whether they remained within the service or eventually moved on.
The service 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.
Because of people’s language difficulties we were only able to have limited discussions with them. We relied mainly on our observations of care and our conversations with people’s relatives and staff to understand their experiences.
People’s relatives were full of praise for the way staff cared for their relatives. They told us the service was exceptional. A parent said “It feels like (their relative) is part of a loving and generous family, everyone goes the extra mile, all of the time, every day. The staff are exceptional people and deliver exceptional care”.
People had individualised communication plans to help them to express themselves better. Staff used a variety of communication techniques tailored to each person’s needs; including sign language, pictures and symbols. Staff assisted people to express both their physical and emotional needs and preferences. People pointed at pictures and symbols to show us they felt happy and safe.
We were told of numerous examples of people being supported to develop life skills and independence, way beyond the level of attainment their families had expected or hoped for. We also observed similar examples of staff providing exceptionally personalised care and support. They encouraged people at every opportunity to be as independent as they were able to be. Staff supported people exceptionally well but only to the extent needed. This helped maintain and develop people’s independence and increased people’s self-esteem and confidence. A relative said “Staff are delightful, caring and compassionate. There’s lots of fun and happiness”.
The service employed a behavioural therapist, who specialised in autism, to provide service specific training for staff. This enabled the small dedicated team of staff to provide a highly effective, caring and uniquely individualised service that reflected current best practices. There were sufficient numbers of suitably trained staff to keep people safe and meet their individual needs. They used nationally recognised tools to monitor people’s attainment and progression toward achieving their maximum capabilities. The service was accredited by the National Autistic Society. To achieve accreditation the service had to demonstrate and maintain high standards of care for people living with an autistic spectrum disorder.
With people’s consent, most relatives opted to receive weekly reports on their family member’s activities and progress. Relatives were always made very welcome and they were encouraged to visit people as often as they wished. Staff also supported people to visit their families on a regular basis according to the wishes of people and their relatives.
People were supported to integrate within the local community and to avoid social isolation. To facilitate this, the service had developed strong links with local colleges, specialist schools, resource centres, libraries and local employers offering work experience.
People were supported to maintain good health. The service employed nutritionists to help promote healthy eating and varied diets. There were close working relationships with local health and social care professionals. Professionals visited the home or staff supported people to attend appointments according to people’s individual needs and preferences.