Options Watermill Lodge

Updated 9 March 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.

The inspection took place on 25 and 29 January 2018 and was unannounced on the first day. We gave the provider 48 hours’ notice of the second day because the service supports a small number of people and we needed to ensure people and staff were available to carry out the inspection.

The inspection team consisted of one adult social care inspector and an expert by experience that made telephone calls to two relatives and five professionals on the second day of the inspection. An expert by experience is a person who has personal experience of using or caring for someone who uses this type of care service. The expert by experience attending this inspection had been caring for an adult with a learning disability and autism.

Prior to the inspection, we reviewed information available to us about the service. This included information we received from outside agencies and statutory notifications since the last inspection. Notifications are when providers send us information about certain changes, events or incidents that occur within the service. We sought feedback from the commissioners of the service prior to our visit. The provider completed a provider information return (PIR) prior to this inspection. This is a form that asks the provider to give some key information about the service, what the service does well and improvements they plan to make. We used all of this information to plan our inspection.

During the inspection, we observed how staff interacted with people who used the service. 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, the registered manager, the deputy manager, a house manager and two support staff.

The care files for two people who used the service were looked at and we reviewed how the service used the Mental Capacity Act 2005. Other documents we looked at included documents relating to the management and running of the service. These were three staff recruitment and supervision records, the staff rota, menus, minutes of meetings, quality assurance audits and maintenance and equipment records. We also reviewed records of complaints, accidents and incidents and Medication administration documents.

Updated 9 March 2018

Options Autism (2) Limited Options Watermill Lodge is a ‘care home’. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection. Watermill Lodge is registered to provide accommodation and personal care for up to four younger adults with a learning disability, autistic spectrum disorder and associated complex needs. Many of the people the service supports had previously challenged traditional services and require bespoke and flexible support packages. There were four people living at the service at the time of our inspection.

The care service has been developed and designed in line with the values that underpin the Registering the Right Support and other best practice guidance. These values include choice, promotion of independence and inclusion. People with a learning disability and/or autism using the service can live as ordinary life as any other citizen.

At the last inspection, the service was rated Outstanding. At this inspection, we found the service remained Outstanding.

The service has built on their previous success and sustained the outstanding model of care and was committed to personalising the services they provided and 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 a 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.

The strong person-centred culture apparent at our previous inspection continued to be a driving force in delivering a consistent approach to support and enabled people to try new things and to make positive changes in their lives. The provider, the registered manager and staff team all had an excellent understanding of positive risk taking and positive behaviour support strategies (PBS) were in place to support people that have previously challenged services, to reach their full potential. Personalised programmes and flexible staffing arrangements continued to enable people to live meaningful and fulfilled lives. Positive risk taking was driven throughout the organisation, balancing the potential benefits and risks of choosing particular actions over others, in order to support people to lead as ordinary a way of life as possible.

Staff had a clear understanding of systems in place to manage medicines, safeguarding matters and behaviours that are challenging to others. People’s medicines were managed so that they received them safely. A robust recruitment and selection process was in place which ensured prospective new staff had the right skills and are suitable to work with people using the service.

Staff were compassionate, kind and caring and had developed good relationships with people using the service. People were seen to be comfortable in the presence of staff and relatives and professionals confirmed staff looked after people very well. People benefited from staff having exceptional skills around understanding each person’s needs and aspirations. This included an excellent understanding of sensory impairment and how to support people to be as independent as possible in all areas of their life, through positive communication. Information was available in each person’s preferred format including policies and procedures such as activity programmes and complaints.

People continued to be supported to access health care professionals when required and supported to have maximum control over their lives and staff supported them in the least restrictive way possible; policies and procedures supported this practice. Menus were planned with input from people, based on their personal preferences and choice.

Staff told us they enjoyed working at the service and felt supported by the registered manager. Quality assurance systems were in place and regularly carried out by both the provider and registered manager. Feedback was sought from people who used the service, staff and relatives, this information was analysed, and action plans produced when needed. The provider continues to work in partnership with other organisations and has taken part in good practice initiatives, designed to further develop the service and support other providers to develop their services.

Further information is in the detailed findings below