This announced inspection took place on 16 and 17 August 2016. Autism Plus is a supported living and community outreach service. It provides support for people with learning disabilities and autistic spectrum disorder living in the community. The service supports most people on a 24 hour basis. Some people lived in single occupancy houses and others in shared, supported living houses. At the time of the inspection 19 people were using the service. The service was last inspected in October 2013 and no concerns were identified at that time. A registered manager was employed to manage the service. 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. There were team leaders employed to help make sure the service ran smoothly.
People, their relatives and staff were very positive about the organisation, the management team and the support people received.
Staff described the management team to be very open, supportive and approachable. Staff talked about their jobs in a very positive way. The registered manager and nominated individual demonstrated a strong ethos of personalised support and empowerment, which was communicated to staff, and it was clear that the staff shared this vision.
People were supported to live active lives based on their wishes. Relatives felt that people valued their relationships with staff and placed trust in them. Staff also prioritised building strong relationships with people’s families in order to help understand people better. People’s care plans included detailed information about how they wanted to be supported and were updated whenever their needs changed.
People were encouraged to develop new skills and further their level of independence. Action plans and steps were created to make sure people received all the support and advice they needed to do this, at a pace that suited them.
People received care from a staff team who were trained to meet their needs and who cared deeply for their wellbeing. Regular activities were carried out to assess any gaps in staff knowledge and resources put in place to improve knowledge in these areas. Staff members were encouraged to develop professionally and used their increased knowledge to the benefit of the people they supported.
Staff were recruited safely and detailed information was collected about people’s likes and dislikes to help make sure staff’s skill suited the person they supported. People were empowered to be in control of who supported them. If people showed they didn’t get on with a particular staff member, this was respected and the staff member did not support them anymore.
People were supported by staff who had an in depth understanding of how to keep them safe. Staff were skilled in using personalised communication methods to understand people’s needs and wishes; and respected people’s decisions. New technology was embraced in order to gather detailed information to support people to be safe.
Staff had undertaken training on safeguarding adults from abuse, and put their knowledge into practice. Where staff had raised alerts the service managed the concerns promptly and when appropriate, conducted thorough investigations to protect people. Any learning was shared to improve future practice.
Risk assessments and guidance were put in place to help make sure staff knew how to keep people safe and healthy. People’s individual preferences were taken into account to help make sure any measures put in place suited them and were successful.
People knew how to raise concerns and make complaints. People and their relatives who had raised concerns confirmed they had been dealt with promptly and satisfactorily. Staff understood how to manage risks to people’s health and supported them to develop and reach their full potential. Staff had sufficient guidance on positive management of behaviours that may challenge the service and others which protected people’s dignity and rights.
The registered manager carried out regular supervision sessions and appraisals. Staff felt well supported and understood their roles and responsibilities to ensure they delivered people’s support in an effective manner.
The service actively sought people’s views about the service and listened and acted on their ideas. One relative commented, “A brilliant, responsive and caring organisation, I can't thank them enough.”
Staff treated people with dignity and respect and provided their care and support in a caring and compassionate way. Care plans contained thorough and well documented assessments of people’s individual needs and the support they required. People received their care and support as planned and as they wished.
People were supported with their nutritional needs and encouraged to adopt healthy lifestyle choices. Staff supported people to have access to the healthcare services they required for advice, treatment and support.
People continued to acquire new skills and gain confidence in living their lives as independently as possible. People took part in activities they enjoyed and were encouraged to try new things based on their individual interests, hobbies, preferences and abilities.
There were effective quality assurance systems in place. Action was taken to address areas where practice could be enhanced, and as a result, changes had been made to help make sure the service moved forward and continually improved.
The registered manager monitored incidents and accidents and put plans in place to prevent recurrence.
Staff understood how to protect people from possible harm. There were sufficient numbers of appropriately skilled staff on duty meet people's needs. Staff managed and administered people’s medicines safely.