Clayton Brook House

Clayton Brook House is a 'care home' which is registered to provide care and accommodation for up to seven adults with autism. The care service had been developed and designed in line with the values that underpin the CQC policy 'Registering the Right Support' and other best practice guidance. People in care homes receive accommodation and nursing care as a single package under one contractual agreement. CQC regulates both the premises and the care provided and both were looked at during this inspection. Nursing care is not provided at Clayton Brook House. At the time of our inspection 6 people were using the service.

The service was managed by a registered manager. 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.

At our last inspection in May 2017 the service was rated Requires Improvement. This was because the provider had failed to ensure refresher training and supervision for staff and there were insufficient complaints processes. Recommendations were also made on improving medicine management processes. At this inspection we found sufficient action had been completed to make improvements.

During this inspection we found there were no breaches of the regulations of the Health and Social Care Act (Regulated Activities) Regulations 2014. At this inspection we found the evidence to support the overall rating of Good. However, we have made recommendations about infection prevention and induction training for managers.

We found there were management and leadership arrangements in place to support the effective day to day running of the service. The registered manager had made a number of improvements and the provider was monitoring the service.

Staff recruitment procedures had improved. Robust processes were in place to make sure all appropriate checks were carried out before staff started working at the service.

There were enough staff available to provide care and support; we found staffing arrangements were kept under review.

Relatives told us they felt people were safe at the service. Staff had received training on supporting people safely and on abuse and protection matters. They had also received training on positively responding to people's behaviours. Staff were aware of the signs and indicators of abuse and they knew what to if they had any concerns.

Risks to people's well-being were being assessed and managed. We did find a lack individual risk assessments in responses to specific needs; however the registered manager took action to rectify this matter. Systems were in place to maintain a safe environment for people who used the service and others.

Arrangements were in place to gather information on people's backgrounds, their needs, abilities and preferences before they used the service.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible. Policies and processes at the service supported this practice.

We found people were effectively and sensitively supported with their healthcare needs and medical appointments. Changes in people's health and well-being were monitored and responded to. People had been supported to increase their awareness of their wellbeing and health care needs.

We observed positive and respectful interactions between people using the service and staff. Relatives made positive comments about the staff team, describing them as compassionate, tolerant and friendly.

Staff expressed a practical awareness of promoting people's dignity, rights and choices. People were supported to engage in meaningful activities at the service and in the community. Beneficial relationships with relatives and other people were supported.

People's individual dietary needs, likes and dislikes were known and catered for. Arrangements were in place to help make sure people were offered a balanced diet and healthy eating was encouraged.

Each person had detailed care records, describing their individual needs, preferences and routines. This provided clear guidance for staff on how to provide support. People's needs and choices were kept under review and changes responded to.

People had communication profiles with plans in place, to highlight ways of sharing their feelings, needs and preferences.

There were processes in place for dealing with complaints. There were procedures to manage, investigate and respond to people's complaints and concerns.

There were systems in place to consult with people who used the service and staff, to assess and monitor the quality of their experiences. Various checks on quality and safety were completed regularly.

The five questions we ask about services and what we found