23 Oak Avenue

The service is a care home. It is a specialist service for autistic people and people with a learning disability. It provides support for people who may display distressed behaviours. There were 2 people using the service at the time of the inspection.

People lived in a bungalow which was suitable for their mobility needs. People had their own shower room and toilet facilities and shared a kitchen and lounge. This helped create a familiar home environment where staff can support people in a more personal and flexible way. People had access to the garden where seating was provided.

People can only be deprived of their liberty to receive care and treatment with appropriate legal authority. In care homes, this can be done through a procedure called the Deprivation of Liberty Safeguards (DoLS), which is part of the Mental Capacity Act 2005 (MCA). We checked whether the service was working within the principles of the MCA and how they managed DoLS within the service. We found that staff and management worked within the MCA. DoLS authorisations were appropriately applied for and overseen. People were not subject to unlawful or excessive restrictions they had choice, control and freedom over their lives.

We assessed the service against ‘Right support, right care, right culture’ guidance to make judgements about whether the provider guaranteed people with a learning disability and autistic people respect, equality, dignity, choices, independence and good access to local communities that most people take for granted.

There was a new owner of the organisation. Staff told us this had resulted in some changes to their working practices, but the level of care and support of people received, remained the same. They said they were fully supported through the change process.

The management team told us the new provider had made improvements to the governance and oversight of the service through the introduction of new recording systems. They said they could access important information more quickly which helped them to identify and continuously monitor any patterns, trends or concerns. Regular audits and quality checks, together with feedback from people, relatives and staff, was used to identify and make improvements to the service. There was a positive learning culture whereby information was shared effectively by the staff team. We identified that there were some shortfalls in the management and storage of one medicine. The provider took immediate remedial steps and added this to their service improvement plan for effective monitoring.

Staff, relatives and visitors were complimentary about the way the service was managed. Comments included, “The home manager is responsive and staff are caring”; “He is very good manager. He is caring and committed”; and “The managers are there for us. They are brilliant. The shift leaders good too.”

The practice of positive behavioural support (PBS) had been established throughout the service. Positive behavioural support is an evidence-based, nationally recognised model of care. It is seen as the best way of supporting people who display or are at risk of displaying distressed behaviours which may cause harm to themselves or others. Staff were knowledgeable about the actions they should take to reduce the risk of distress and harm to people and others.

Each person had a person-centered support plan that set out what was most important to the person, such as their needs, preferences, routines and goals. Goals reflected changes in people’s health and mobility and focused on people enjoying quality of life. We observed that people went out, listened to music and enjoyed spending time in staff’s company. People’s health, wellbeing, distressed behaviours and participation in the community was reviewed every 6 months to effectively monitor if people were indeed achieving quality of life. Based on this in-depth analysis changes were made to people’s care and support, and further interventions and actions were identified.

Staff had opportunities for learning, development and reflective practice. New staff said they were welcomed by the staff team and always felt able to ask for help and support if they needed it. They were enough regular staff provided to ensure people had consistent, effective and safe support. Staff knew how to identify, report and escalate concerns. They were assured the registered manager would act on any concerns they raised.

Staff knew how to keep people safe, and this was confirmed by visitors to the service. Comments included, “Staff are confident and effective in redirecting the residents away from hazards and encouraging calming if required.” Staff had a good understanding of risks to people’s health and care. They could describe individual risks and the support people needed to minimise them.

There were regular checks of the environment to ensure it continued to be a safe environment for people, staff and visitors. This included visual checks and ongoing maintenance of equipment and services.