Petunia Grove - Macclesfield

The service is a care home. It is a specialist service for autistic people and people with a learning disability. There were 4 people using the service at the time of the inspection. People lived in a 4 bedroomed house within a residential setting. They had their own bedroom, with an en-suite shower and toilet, a shared a kitchen, dining room and lounge, with access to a garden.

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 most people take for granted. We found the service was meeting these requirements.

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 provider was working within the principles of the MCA and how they managed DoLS within the service. Managers and staff worked within the MCA and demonstrated exceptionally strong practice in this area, they ensured people’s human rights were protected. Staff had focused on ensuring people were not subject to unlawful or excessive restrictions they had choice, control and freedom over their lives.

People were supported by enough staff who had the skills and knowledge to support them safely. There was a consistent and familiar staff team who had built effective and trusting relationships with people. Certain staff had worked at the service for several years.

The provider recruited staff safely and ensured they had suitable opportunities for learning, development, and reflective practice. Specific training had been carried out in relation to people’s support needs, including responding to health emergencies. Staff told us, “The training is top notch” and “I think the training is brilliant, we’re very up to date with the training.”

Staff knew how to keep people safe; they assessed risks and took actions to mitigate risks where required. People participated in this process. However, we found an aspect of a person’s care plan could be strengthened, which the registered manager addressed immediately.

The registered manager promoted an open culture, with a focus on learning. For example, any incidents or medication errors were seen as an opportunity to learn and develop. A staff member said, “We’re encouraged, if we see something that’s not right, to raise a concern or raise with safeguarding.”

There were effective systems in place to safeguard people from abuse. Staff told us the registered manager would act on any concerns they raised. A staff member said, “We have a clear process, and I would feel able to report any concerns.”

Medicines were administered safely and there were systems in place to ensure the environment was safe. The environment was homely and well maintained. People were involved in making choices around re-decoration and new furniture. Staff enabled people to take part in some of the home’s safety checks.

Staff were knowledgeable about the actions they should take to reduce the risk of distress and harm to people and others. There had been minimal incidents or accidents at the service. Staff understood and followed positive behavioural support approaches and understood how to de-escalate situations and supported people effectively.

Each person had a person-centered care plan, which staff kept up to date and included essential information such as people’s needs, preferences, typical day and goals.

People’s care was regularly reviewed to ensure they continued to be supported effectively. People and their relatives were fully involved in these reviews. For example, one person chaired their own review, using a presentation they’d devised with the support from staff.

Care plans included information about people’s health needs, as well as guidance from health professionals. For example, staff supported a person with physiotherapy exercises. Staff understood and monitored people’s health needs, they ensured people had regular health checks and access to other supported as needed.

Staff were positive about the management of the service. They told us they felt well supported and the registered manager was approachable. Comments included. “It’s brilliant here, really supportive” and “I do love it.” There was an effective and collaborative team, who worked and communicated well together. A relative told us, “They are good at what they do and very accommodating.”

The provider ensured staff undertook regular audits and quality checks to monitor the quality and safety of the service. The registered manager had good oversight of the service and clearly understood the needs of the people supported. They demonstrated commitment to providing quality care to people.

The provider had a positive learning culture whereby information was shared across the organisation. People were encouraged to give feedback and could be involved in the development of the service. For example, through co-production, people could be elected to a ‘people’s council’ by their peers. There were other initiates the provider was developing.