This inspection was carried out on 16 November 2015 by one inspector and an expert by experience. It was an announced inspection. Forty-eight hours’ notice of the inspection was given to ensure that the people we needed to speak to were available. Some of the people we spoke with were able to express themselves verbally. Others used specific communication methods such as signing and Makaton to converse with us. Elysium Supported Living Limited is registered to provide personal care and supported living to younger adults who have a learning or physical disability, autistic spectrum disorder, mental health needs, or other conditions such as sensory impairment. The ethos of the service is to enable people to gain and maintain skills to achieve independent living. People are supported in the community, in their family home, or in shared houses. The Care Quality Commission inspects the care and support the service provides to people but does not inspect the accommodation they live in.
There was a 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.
Staff were trained in how to protect people from abuse and harm. They were aware of the procedures to follow in case of abuse or suspicion of abuse, whistle blowing and bullying.
Risk assessments were centred on the needs of the individual. They included clear measures to reduce identified risks and guidance for staff to follow to make sure people were protected from harm. Accidents and incidents were recorded and monitored to identify how risks of re-occurrence could be reduced.
There were enough qualified, skilled and experienced staff to meet people's needs. Staffing levels were calculated according to people’s changing needs and ensured continuity of one to one support. Thorough recruitment practice was followed to ensure staff were suitable for their role.
Staff were trained in the safe administration of medicines. Records relevant to the administration of medicines or the supervision of medicines were monitored. This ensured they were accurately kept and medicines were administered to people and taken by people safely according to their individual needs.
Staff knew each person well and understood how to meet their support needs. Each person’s needs and personal preferences had been assessed before care was provided and were continually reviewed. This ensured that the staff could provide care in a way that met people’s particular needs and wishes.
Staff had completed the training they needed to support people in a safe way. They had the opportunity to receive further training specific to the needs of the people they supported. All members of care staff received regular one to one supervision sessions to ensure they were supported while they carried out their role. They received an annual appraisal of their performance and training needs.
All care staff and management were trained in the principles of the Mental Capacity Act 2005 (MCA) and were knowledgeable about the requirements of the legislation. People’s mental capacity was assessed and meetings were held in their best interest when appropriate.
Staff sought and obtained people’s consent before they provided support. When people declined or changed their mind, their wishes were respected.
Staff supported people when they planned their individual menus and ensured people made informed choices that promoted their health. Staff knew about people’s dietary preferences and restrictions.
The staff used creative ways to make sure that people had inclusive methods of communication. People told us that staff communicated effectively with them, responded to their needs promptly and treated them with kindness and respect. People were satisfied with how their support was delivered. Clear information about the service, the management, the facilities, and how to complain was provided to people. Information was available in a format that met people’s needs.
People were referred to health care professionals when needed and in a timely way. Personal records included people’s individual plans of support, likes and dislikes and preferred activities.
The registered manager and the staff’s approach promoted an environment where people could affirm themselves and excel. They promoted people’s independence, encouraged them to do as much as possible for themselves and to make their own decisions. Comments from relatives included, “The support workers motivate my son to try out new things and keep on learning”.
People’s privacy was respected and people were assisted in a way that respected their dignity and individuality. Staff took account of people’s psychological wellbeing.
People’s individual assessments and support plans were reviewed regularly with their participation or their representatives’ involvement. A relative told us, “We are definitely involved.” People’s support plans were updated when their needs changed to make sure they received the support they needed.
The provider took account of people’s complaints, comments and suggestions. People’s views were sought and acted upon. The provider sent questionnaires regularly to people, their legal representatives and staff. The results were analysed and action was taken in response to people’s views.
Staff told us they felt valued and supported under the manager’s leadership. There was honesty and transparency from management when mistakes occurred. The manager notified the Care Quality Commission of any significant events that affected people or the service. Comprehensive quality assurance audits were carried out to identify how the service could improve and action was taken to implement improvements.