This comprehensive inspection took place on 6 and 9 November 2018 and was unannounced. At our last comprehensive inspection in April 2016, we rated the service Good. However, at this inspection we found the service was not meeting legal requirements and areas of the service required improvement.
St Edwards Close is a residential care home for 12 people with autism. The service consists of two houses, the Willows and Conifers and can accommodate six people in each. In each house, there are single bedrooms and people have shared use of a lounge, activity room, kitchen and bathroom facilities. There is an enclosed garden and courtyard for people to access. There were 11 people using the service at the time of our inspection.
At the time of the provider’s registration, the care service had not been developed and designed in line with the values that underpin the Registering the Right Support and other best practice guidance. However, the service was continuing to develop their practice to meet this guidance and used other best practice to support people. They have applied the values under Registering the Right Support. 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 who joined the service in March 2018. 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 were not always protected from the risk of avoidable harm. Environment, equipment and fire safety checks had been regularly undertaken, however, hot water exceeded the maximum safe temperature and the provider was not complying with Health and Safety Executive (HSE) guidance about this.
People did not live in a well maintained environment as parts of the premises remained in need of redecoration or repair. The provider’s refurbishment plan took too long to deliver. Refurbishment of people’s bathroom facilities had not been completed and remained outstanding for over two years. This was highlighted at our last inspection in April 2016.
Other systems were used effectively to assess and monitor the quality of services that people received. Action plans were used to highlight any areas where improvements were required and these were monitored to ensure that changes were made.
The provider's recruitment and employment processes were robust and protected people from unsafe care. People received support from staff who knew them well, and had the skills to provide the care they required. Staff received the necessary training to fulfil their role and had ongoing support and supervision from the registered manager.
The provider’s training programme was designed to meet the needs of people using the service. Staff had the knowledge and skills they required to support people with autism. Training included supporting people who presented behaviours that could result in harming themselves or other people. This helped staff to manage situations in a consistent and positive way, and protect people's dignity and rights.
People continued to experience person-centred, flexible support. People's care needs were assessed, kept under review and they were fully involved in making decisions about their care and support. Assessments considered whether people had any needs in relation to their disability, sexuality, religion or culture. Staff understood and respected these needs.
People's care records recognised their rights and were person centred. People were supported to have 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.
Staff knew how to recognise and report any concerns they had about people’s care and welfare and how to protect them from abuse.
People had personalised support plans that reflected the care and support they needed. Plans identified any associated risks to their health and welfare. Where risks were identified, there was comprehensive guidance on the ways to keep people safe in their home and in the community.
People decided how they spent their time and staff supported their choices and independence. Pictorial aids were available for those who needed support with communication.
Staff encouraged people to participate in activities, pursue their interests and to maintain relationships with people important to them. Relatives and visitors were welcomed at the service.
People were supported to keep healthy and were encouraged to maintain a healthy lifestyle. Other professionals were involved when people became unwell or required additional services to ensure their healthcare needs were met.
The provider encouraged feedback from people who used the service, relatives, and staff and this was used to improve their experience at St Edward’s Close. People knew how to complain and told us they would do so if required. Procedures were in place to monitor, investigate and respond to complaints.
The service responded in an open and transparent way when things went wrong, so that lessons could be learnt and improvements made.
We found two breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see what action we told the provider to take at the back of the full version of this report.