A single inspector carried out this inspection. The focus of the inspection was to answer five key questions; is the service safe, effective, caring, responsive and well-led? The summary describes what people using the service and the staff told us, what we observed and the records we looked at. All those who lived at the home were young males aged between 18 and 25 years who had complex needs including autism and/or a learning disability. Some people were not able to verbally communicate, others choose not to speak and others could verbally express themselves clearly, but were not always able to answer our questions about the care they received. After the inspection we telephoned seven family members or the professional people who offered support to people. Two other family members also called the Care Quality Commission to speak to us about the care their family member received. We looked at the care records of five people, spoke with four people, seven family members and six members of staff.
Below is a summary of what we found.
Is the service safe?
Care plans had details of people's needs and how these were to be met. These plans were regularly reviewed with the person using the service. Risk assessments relating to the care and support being provided were regularly reviewed to ensure people's individual needs were being met safely. People were supported to take their medicines in a safe way.
Staff told us that their policy was not to physically restrain people using the service. Instead they used techniques to diffuse situations, and had learnt ways to do this in challenging behaviour training.
Staff had undertaken training on the Mental Capacity Act 2005 but not on the recent changes to the Deprivation of Liberty Safeguards. But staff understood how this could impact on the people they cared for.
Is the service effective?
The home is one of several within the same group and since the home opened in July 2013 there had been two managers and families that we spoke with told us about the high turnover of staff and that there could be poor communication between staff. They told us about several incidents where messages had not been passed on to their family member and where incidents relating to the person using the service had not been passed on to them. They felt this lack of communication was because of the frequent changes to the staff team.
We saw that eight staff were new to the organisation and were still within their probationary period and had not completed all of the training available.
Is the service caring?
We observed that staff did not knock on people's door before entering and on two occasions we saw that people were still in bed. We observed and families that we spoke with also mentioned times when they had observed staff telling people what to do and not engaging with them positively.
Care plans we viewed detailed people's individual preferences, so that staff knew people's individual wishes. Risk assessments were included for all aspects of a person's daily life, including the activities they do, being out in the community and travelling. These included triggers to watch for that may upset a person, things to avoid and what to do if an incident occurs.
Is the service responsive?
People's needs were reassessed on a regular basis and we saw the service responded to any changing needs. People had access to other services and to professionals who worked with the provider and staff for the benefit of people who used the service.
We saw that each person had an activity plan and the staff explained that these were developed based upon the interests and support needs of the individual. During our visit we observed staff supporting people to access different activities including going out to have breakfast in the local caf', a shopping trip to the supermarket, a visit to the cinema and accompanying another person to play pool.
Is the service well-led?
The home employed a manager who knew their staff and people well.
The manager told us about the audits that they conducted and showed us the recorded evidence to support them. Health and safety checks included fire drills, ensuring window restrictors were in place and working and first aid boxes were correctly stocked and contents within date. Other areas that were audited were staffing levels, staff rotas and training and supervision. Care and activity plans were also monitored. We saw that the manager's monthly audits for medication were up to date.
The manager told us that as the home had been open for less than a year they had not sent out satisfaction surveys to families or to professionals who work with people who use the service but this process would be starting soon.
In this report the name of a registered manager Gregory Ernest John Anstead appears who was not in post and not managing the regulatory activities at this location at the time of the inspection. Their name appears because they were still a Registered Manager on our register at the time.