Options Applegate House

Updated 28 July 2017

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection checked whether the registered 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 inspection took place on 23 and 27 June 2017. We gave notice of the inspection the day before so the service could ensure someone was available at the service to assist with the inspection. The inspection team consisted of two adult social care inspectors on the first day of the inspection and one on the second day.

Before the inspection, we asked the registered provider to complete a Provider Information Return (PIR). This 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 received the completed PIR within the timescale given. We requested information from professionals involved in the service.

During the inspection we observed how staff interacted with people who used the service. We spoke with three of the six people who used the service, the registered manager, the deputy manager, two care staff an advocate and a relative. Following the inspection we spoke with a further two relatives and received comments from two health and social care professionals.

We looked at three care files which belonged to people who used the service. Other important documentation relating to the six people who used the service such as their Medication Administration Records (MARs) were also looked at.

We looked at how the service used the Mental Capacity Act 2005 to ensure when people were assessed as lacking capacity to make their own decisions, best interest meetings were held in order to make important decisions on their behalf.

We also checked a selection of documentation relating to the management and running of the service. These included three staff recruitment files, training records, the staff rotas, minutes of meetings with staff, records of complaints, accident and incident records and quality assurance audits.

Updated 28 July 2017

Applegate House is a care service providing accommodation and personalised support for up to six younger adults with autistic spectrum conditions, learning disabilities and complex needs, based in the local community of Barton-upon-Humber.

It is an autism specific transitional service where life-long learning can be developed further, including social and domestic skills, along with community and leisure facility access. Based on the philosophy of the organisation, ‘Fitting a service around you, not fitting you within a service,’ flexible staffing and personalised programmes enabled and promoted people to live as independently as possible. This philosophy was embraced by the staff team and drove staff practice in their delivery of care.

Accommodation is provided in six self-contained flats each with a bedroom, en-suite bathroom, kitchen/diner and lounge.

At the last inspection, the service was rated Outstanding.

At this inspection we found the service remained Outstanding.

We saw the provider was committed to personalising the services they provided and also to following 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 that 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 was accredited with the National Autistic Society (NAS), which drove best practice to deliver outstanding care to people who used the service.

There was a strong person-centred culture apparent within the service. Person centred means care is tailored to meet the needs and aspirations of each individual. Positive risk taking was driven throughout the organisation, balancing the potential benefits and risks choosing particular actions over others, in order to support people to lead fulfilling lives in as ordinary a way as possible. In delivering this consistent approach people were supported to try new things and make positive changes in their lives. The provider, the registered manager and the staff team all had an excellent understanding of positive risk management and supported people that had previously challenged services to reach their full potential.

An outstanding feature of the service was the time invested developing the service to accommodate the changing needs of the people who used the service, using innovative and flexible ways to move people forward. The registered provider was seen to constantly adapt and strive to ensure people were able to achieve their full potential.

The registered manager demonstrated strong values and a desire to continue to learn about and implement best practice throughout the service and also shared their skills to support other registered providers to develop their services.

We found personalised programmes and flexible staffing arrangements enabled people to learn to live fulfilled and meaningful lives. Staff knew people well and were skilled at ensuring people were safe whist encouraging them to stretch their potential and achieve as much independence as possible. Care plans had been developed to provide guidance for staff to support in the positive management of behaviours that may challenge the service and others. This was based on least restrictive practice guidance to support people safety.

Robust systems were in place to protect people from the risk of harm or abuse. People who used the service were supported by staff who understood the importance of protecting them from harm. Staff had received training in how to identify abuse and report this to the appropriate authorities. Staff were recruited in a safe way and all checks were in place before they started work. The staff had received an induction and essential training at the beginning of their employment and we saw this had been followed by periodic refresher training to update their knowledge and skills. People were supported by sufficient numbers of staff.

People who used the service were supported to access health care professionals when needed and were supported to have maximum choice and control over their lives.We looked at how the service used the Mental Capacity Act 2005 to ensure when people were assessed as lacking capacity to make their own decisions, best interest meetings were held in order to make important decisions on their behalf.

The service developed and maintained strong links with external organisations and within the local community. Complaints were investigated and resolved wherever possible to the complainant’s satisfaction.

People who used the service, and those who had an interest in their welfare and wellbeing, were asked for their views about how the service was run and the care they received. Regular audits were carried out to ensure the service was safe and well run.

Further information is in the detailed findings below.