Creative Support - Ulverston Autism Service

We assessed the service against ‘Right support, right care, right culture.’ This guidance supported judgements about whether the provider guaranteed people with a learning disability and autistic people respect, equality, dignity, choice, independence, and access to local communities that most people take for granted. We found the service had demonstrated a clear understanding of this guidance and had met the requirements of these principles to an exceptional level.

People were supported to be safe and protected from avoidable harm. The providers safety policies and procedures were understood and followed by the registered manager and staff team. As a member of the Restraint Reduction Network, a network of independent organisations that aim to reduce reliance on restrictive practices in care setting. The provider and their complex care team had analysed data from safety incidents and developed strategies which were more person-centred, and dignified, in response to people. They and the registered manager worked with the staff team to embed the new strategies. There had been a significant improvement in the number and intensity of safety events people experienced when they felt distressed. There had been a reduction in the need to use restrictive interventions.

People’s medicines were managed safely. There was a minimal use of medicines prescribed to be used when required for people who felt distressed.

Staff had been recruited safely and had received robust person-centred induction training. Staff were supported to continually develop their skills and knowledge. There were enough staff to support people safely both inside the home and out in the local community. The environment was spacious, and people had access to their own secure gardens and outside space.

The property was safely maintained, however some bathrooms needed to be refurbished, and the heating system was not reliable. The provider had agreed a solution with the landlord.

People’s needs had been holistically assessed, and effective care plans had been developed. Care plans reflected best practice guidance and included the involvement of other professionals and representatives. Care plans had been reviewed and updated regularly. Staff found the care plans detailed and informative. Staff were required to read care plans to ensure they understood how best to provide support and to communicate with people.

The staff team worked effectively together and with other agencies and families. Staff praised the quality of the team work in the home. There were regular handover meetings and staff meetings which helped staff keep each other up to date and share ideas.

People were supported to live healthier lives and achieve optimum health. Health Action Plans (HAP) included enough detail about people’s health needs and treatments to ensure staff could monitor their health effectively. We found evidence of people’s health and wellbeing had improved as a result of this monitoring.

People had been involved in decision making in all areas of their life. This included in mental capacity and best interest decision making procedures. The provider went to exceptional lengths to understand what was important for the person in relation to each decision. All people living in the home had representation from an advocate or a court appointed deputy.

The provider, registered manager and staff team were exceptionally caring. The policies and procedures helped ensure people were respected and supported as unique individuals with a range of skills, qualities and preferences. People were supported respectfully, and their dignity was upheld and promoted by staff. Staff went to exceptional lengths to maximise people’s independence, choice and control. People’s flats were individualised and reflected their preferences. For some people this meant having minimal furniture or low stimulus environments. Staff understood how to respond to people and minimise stress.

Staff told us they felt cared for, valued and respected at work. The provider had a broad range of services to support staff. This included an assistance programme, an award scheme and a health and wellbeing app.

People received an exceptionally person-centred service. The provider and staff team ensured people were at the centre of their care and treatment. Care plans were holistic; they included input and guidance from a broad range of sources. Staffing was as consistent as possible to ensure continuity and predictability for people who found this important. Communication with families and other professionals was well maintained. A relative told us “They are good at communicating with me and involving me.”

People were supported to communicate their views and preferences to maximise their involvement with staff who were skilled in the different ways people expressed themselves and how to respond. The provider had ensured information about all aspects of people’s daily lives and the service was available in accessible formats. These were tailored to peoples’ preferences. This also contributed to people being supported to access and enjoy community activities and accept health interventions, including surgery.

The provider ensured people had been represented equitably. Not everyone’s relatives were able to visit, to ensure people were represented the provider had a system in place which ensured people were visited by managers from other homes in the group to complete robust audits of people’s care experiences.

There was a clear value-based, positive culture in the home which fully embraced the principles of Right Support, Right Care, Right Culture. The providers policies and procedures had been followed and fully embedded by the registered manager. Staff praised the registered manager and leaders and found them to be open, approachable and very supportive. Staff felt valued and respected at work. We could see how staff also reflected these qualities in their understanding and support of the people living in the home. People were empowered to speak up and express their views. The provider responded to any points raised fully. The management team had effective oversight of the quality of care, care records and the environment. Issues with the building had been raised with the landlord promptly and a solution to some difficulties had been identified. The management team also had good oversight of staff and people’s wellbeing.

There was evidence the management team and staff were committed to continuous learning and development. We saw significant improvements in people’s quality of life and access to their local communities and services because of the support from the providers’ complex care team.