Options Roxby House

Updated 24 August 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 was planned to check 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 3 and 4 July 2018 and was unannounced. The inspection team consisted of one adult social care inspector and an assistant adult social care inspector.

Before the inspection we reviewed information available to us about this service. The registered provider had completed a Provider Information Return (PIR). The PIR is a form that asks the registered provider to give some key information about the service, what the service does well and improvements they plan to make. We also reviewed safeguarding alerts; share your experience forms and notifications that had been sent to us. A notification is information about important events which the provider is required to send us by law.

We used the Short Observational Framework for Inspection(SOFI). SOFI is a way of observing care to help us understand the experience of people who were unable to speak with us.

We spoke with one person who used the service and eight relatives. We spoke with the registered manager, the training manager, two house managers, the PRICE (Protecting Rights in a Caring Environment) and three staff. We also spoke with two healthcare professionals following the inspection and consulted the local authority contracting and safeguarding teams.

We reviewed four people's care records and five staff personnel files. We also reviewed records relating to the management of medicines, complaints, staffing rota’s, minutes of meetings, complaints, accident and incidents, training and how the registered persons monitored the quality of the service.

Updated 24 August 2018

Roxby House is a care service providing accommodation and personalised support for up to 29 younger adults with autistic spectrum conditions, learning disabilities and complex needs, in the village of Roxby. Roxby House consists of four separate units. Each self- contained unit provides either individual or shared occupancy flats for between two to four people.

At our last inspection in June 2015 we rated the service outstanding. At this inspection we found the evidence continued to support the rating of outstanding. This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection.

Why the service is rated Outstanding.

Although the care service had not been developed and designed in line with the values that underpin the Registering the Right Support, in that it was registered to accommodate up to 29 people and would be considered a congregate setting, the service was registered prior to CQC implementing this guidance.

Other values such as, choice, promotion of independence and inclusion underpin the ethos of the service and what it continually strives to achieve for people. The service continues to support an extremely person-centred approach and people whose behaviour may have previously isolated them, have been fully supported by the service to develop new skills and successfully become involved in their local community and achieve extremely positive outcomes. People with learning disabilities and autism using the service can live as ordinary a life as any citizen

The service is committed to a continual and credible programme of training that encourages bespoke programmes for the development of academic, vocational, social and life skills, all designed to aid a move towards independent living. The organisation utilises their own innovative and robust evidence based models, clinical and best practices to support and enable people to achieve the best possible outcomes. People who have previously experienced failed placements elsewhere have been supported and enabled to move on to more supported living, after spending time at Roxby House.

We saw the provider was committed to personalising services and also followed the recommendations outlined in ‘Putting People First’(a shared vision in transforming adult social care to put people first through a radical reform of public services, enabling people to live their own lives as they wish, confident the services are of high quality, are safe and promote their own individual needs for independence, well-being and dignity) and the Autism Act (2009). The service is also accredited with the National Autistic society (NAS), which drives best practice to deliver outstanding care to people who used the service.

An outstanding feature of the service was the time invested developing innovative and flexible ways to support people to move forward and achieve their full potential and accommodate their changing needs. Positive risk taking was driven throughout the organisation to support people to lead fulfilling lives. A consistent team approach meant people were supported to try new things and experiences. Feedback from relatives included, “I can’t fault the place. It has changed all our lives for the better.” and “I thank my lucky stars every day that we found Roxby. It is the best thing that could ever have happened. [Name] has a life now.”

The registered manager demonstrated strong values, implemented good practice delivery throughout the service and led a committed staff team in delivering a person-centred approach. The service employed ‘life skills instructors’ to support people with daily needs and a ‘vocational life skills instructor’ for supervising and facilitating activities. These employees are referred to as 'staff' throughout the report.

Support for people was outstanding and enabled them maximum choice and control of their lives. Policies and systems used by the service supported this.

Thorough systems protected people from the risk of harm or abuse. People lived in a safe environment that met their specific needs. Robust recruitment systems ensured prospective staff were suitable to work with vulnerable people. Qualified and competent staff were employed and supervised. Their personal performance was checked annually. Everyone without exception, gave testimony to their extensive knowledge and skills. Staff understood systems in place to manage medicines.

Staff were compassionate and kind and went ‘above and beyond’ to ensure people received positive outcomes. Staff spoke consistently about the service being a good to place to work and support they received from the registered manager and colleagues. Extensive training was provided based on best practice and guidance.

People accessed health care professionals and the service worked in partnership with these agencies to raise their awareness of people’s needs and improve actions to support them effectively. People’s nutritional needs were well met. The service maintained strong links with the local community and regularly held ‘inclusive’ events to promote awareness and engagement.

Complaints were investigated and resolved to complainants’ satisfaction. Although no one needed end of life care at the time of inspection, systems were in place for when this time would come.

People who used the service and those who had an interest in their welfare and well-being were asked for their views about how the service was run and the care received. The registered manager used robust systems to continually monitor the quality of the service and had ongoing plans for improving the service people received.

Further information is in the detailed findings below.