Avebury House

We expect health and social care providers to guarantee people with a learning disability and autistic people respect, equality, dignity, choices and independence and good access to local communities that most people take for granted. ‘Right support, right care, right culture’ is the guidance CQC follows to make assessments and judgements about services supporting people with a learning disability and autistic people and providers must have regard to it. The provider did not know about this guidance but during the assessment, the registered manager began to read our guidance. We also found that of the three people with a learning disability, none were being supported in-line with CQC’s published best practice guidance. Some people who could not communicate verbally and who had a learning disability did not have recorded communication plans in place at the time of the inspection. Whilst some staff could explain informally what they felt their communication meant, people were at risk of not being understood because there was no clear guidance for all staff. During the assessment, the provider requested to add learning disabilities to their registration.

The provider had taken action to address all the shortfalls identified at the last inspection. The service now had effective systems to ensure people were supported by staff who were competent, skilled and experienced. The registered manager had spent considerable time looking at how to upgrade and personalise the environment and was passionate about people having access to a diverse range of activities including activities away from the home. Staff had received effective training to help them support people. There were now sufficient staff to meet people’s needs and the support hours commissioned by the local authority. Staffing levels enabled people to access their community.

People were supported to take their medicines safely. Incidents were clearly recorded and reviewed by managers to ensure any learning from incidents was implemented. The provider had successfully worked to reduce restrictions on people and improve their quality of life.

Most people had support plans which reflected their individual needs. The provider worked with health and social care professionals to ensure people had access to the care they needed. Staff said they could raise any concerns with the management team and were confident action would be taken as a result.

Records of decision-making processes where people did not have capacity to consent to their care and treatment were not always clear. While we saw a detailed MCA assessment and guidance document, which had been issued to all staff to provide a consistent framework and guide for undertaking and recording decision-making processes this had not been consistently applied for everyone. This meant it was not always clear how decisions about people’s care should be made. Information was provided for people in formats which were more accessible for them, and staff were skilled in people’s communication methods. Members of the management team demonstrated they had the skills, knowledge and experience to lead effectively. Governance systems were now effective in identifying shortfalls in the service and ensuring improvements were made.