Alderwood LLA Irchester is a ‘care home’ for six people with autism. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection. Alderwood LLA Irchester accommodates people in one adapted residential house that is located on a residential street. The care service has been developed and designed in line with the values that underpin the Registering the Right Support and other best practice guidance. These values include choice, promotion of independence and inclusion. People with learning disabilities and autism using the service can live as ordinary a life as any citizen.

This inspection took place on 3 January 2018 and was unannounced.

At the time of our inspection the provider confirmed they were providing care to six people.

At the last inspection in October 2015, the service was rated Good. At this inspection we found that the service was now outstanding.

People were supported to work towards and complete major achievements in their lives. The service had continued to strengthen their positive links with resource centres for people with a learning disability, local leisure facilities, health and wellbeing providers, and employers who offered work placements. The service was flexible and adapted to people's changing needs and desires, enabling positive outcomes for all concerned. People felt a part of their community, and were able to take pride in their achievements.

Professionals involved in people’s care confirmed that the service was focused on individuals needs and the service had been able to meet people’s high level of needs where other services had failed. Staff had gone the extra mile to ensure that a people received the medical treatment that they needed and they had taken innovative steps in complying with the accessible information standard.

The provider was involved with the development of a national initiative to try and prevent the over medication of people with learning disabilities, autism or both and this ethos was firmly embedded within the service. The provider continued to be awarded by external bodies for educating the wider community about positive approaches to autism, and for the on-going investment into the strong development within their staff team.

The service had a consistently high level of engagement with relatives of people that used the service. Feedback from relatives was extremely positive and commented on the unique nature of the service, and how their own lives had been improved as well as their relative using the service.

Staff were well supported by the registered manager and senior management team. The registered manager had a clear vision for the service and its development. Staff were passionate and dedicated to their roles and had belief in the ethos of the support they received, and that of the provider in general. Staff at all levels had a strong belief that they were providing the best possible care for people, and were confident and empowered in their roles because of the strong leadership and management across the company. Staff were innovative in their approach to support, and were enthusiastic about supporting people to overcome life’s hurdles.

There was a registered manager in post. 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.

Staff had an understanding of abuse and the safeguarding procedures that should be followed to report abuse. Safeguarding procedures were followed accurately and alerts made when required. Detailed risk assessments and behaviour management plans were in place to manage all risks with

Alderwood LLA Ltd Irchester provides accommodation and personal care and support for up to six people with a learning disability and autistic spectrum disorder. Before admission, the provider, along with people and their family, considered people’s needs and abilities to ensure that they were placed in the service that was best for them. Once there, staff promoted people’s independence and provided truly individualised, person centred care. On the day of our inspection there were six people living in the service.

The inspection took place on 8 October 2015.

The service had 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.

We found a really positive, caring and progressive atmosphere within the service. People were at the heart of the service and all aspects of care had been centred on them and their needs. There was lots of laughter and good humour, with kind and trusting relationships evident between staff and people. People were involved in the planning of their care and told us they felt included in discussions, being able to have their say at each step of the way. Staff were passionate about their work and driven by a desire to provide high quality care. They were flexible and adaptable, ensuring that people participated in their own care and achieved their full potential, helping them to lead a meaningful life, doing things that were important to them. The provider philosophy was that people should be able to access the best of everything in life and have ample opportunities to achieve their goals.

People had been supported to develop life skills and gain independence, using individually created development programmes. The support for this was provided by a highly skilled staff group, who shared a strong person centred ethos and were dedicated to helping people lead a fulfilled and enriched live. People and their relatives expressed their delight at the progress they had made since coming to the service, which was often way beyond the level of achievement they had previously hoped for. Staff used innovative ways to support people to move forward, adapting when their needs changed. They had a strong understanding of people’s interests and hobbies and accessed a wide range of activities that were tailored to people’s individual needs. People were actively supported to integrate within the local community, using local facilities to avoid social isolation. To facilitate this, the service had developed links with local colleges, libraries and local employers offering work experience.

The service was led by a dedicated and passionate registered manager, who was well supported by a strong and positive management structure within the provider organisation. The culture within the service was open, optimistic and encouraging; staff were proud to work for the service and wanted it to be the best it could. Staff and the registered manager were extremely well motivated and committed to their work; they faced up to challenges and used these to improve things. They had strong values and a shared vision, and strived to give people positive care experiences and provide high quality care.

Staff attended regular meetings, which gave them an opportunity to share ideas, and exchange information about possible areas for improvements to the registered manager. Ideas for change were welcomed by the registered manager and provider, and used to drive improvements and make positive changes for people. Quality monitoring systems and processes were used robustly to make positive changes, drive future improvement and identify where action needed to be taken. All staff told us they wanted standards of care to remain high and so used the outcome of audit checks and questionnaires to enable them to provide excellent quality care.

People felt secure in the service and we observed they were calm and relaxed in the presence of staff. Staff had a positive approach towards keeping people safe and demonstrated a strong awareness of what constituted abuse. They understood the relevant safeguarding procedures to be followed in reporting potential abuse. Staff were committed to managing fluctuating risk factors for people and had a good understanding of how to support them when they became anxious or distressed. Potential risks to people had been identified, and detailed plans implemented to enable them to live as safely and independently as possible.

Robust recruitment checks took place in order to establish that staff were safe to work with people before they commenced employment. There were sufficient numbers of staff available to meet people’s care and support needs and to enable them to do the things they enjoyed. People received their medication as prescribed. Safe systems and processes were in place to protect people from the risks associated with medication.

Staff received regular training, based upon best practice in autism, which provided them with the knowledge and skills to meet people’s needs in a person centred manner. They were well supported by the registered manager and senior management team in respect of supervision and appraisal which enabled them to remain motivated and responsive to people’s individual needs.

Staff sought people’s consent before they provided care and support. Where people were unable to make certain decisions about their care, the legal requirements of the Mental Capacity Act 2005 and the Deprivation of Liberty Safeguards (DoLS) were followed. Where people had restrictions placed upon them, staff ensured people’s rights to receive care that met their needs was protected, and that any care and treatment was provided in the least restrictive way.

People were supported to access suitable amounts of good quality, nutritious food. A variety of meal options were available for people, which included specific health and cultural dietary requirements. We found people were encouraged and supported to participate in meal preparation as part of developing their life skills. Referrals to health and social care professionals were made when appropriate to maintain people’s health and well-being. Staff worked closely with other professionals to ensure people’s needs were fully met.

Because many people who live at Alderwood Irchester have a cognitive disability or communication difficulties, we were unable to ask all the people directly about their experiences. We did spend time observing people and saw that they appeared relaxed and interacted with staff members in a positive way and some were occupied with activities.

We looked at outcome areas covering people’s consent to receiving care in the home and how the staff are organised to assist in delivering people’s care. We looked at the composition of care plans and how people are assisted with their diet and medication. We also looked at the general safety around the home and staff recruitment. We found all these areas to be well detailed and compliant.

We met all of the people who used the service and carried out general observations of their care and treatment. We saw that people had the full supervision and support of one or two staff, and the staff were knowledgeable of the individual needs of the people they supported.

We found that people had a daily programme of educational, social and leisure activities throughout the day. We saw one person engaged in completing a complex jigsaw puzzle, another person was spending time in a quiet room with visual and tactile sensory objects in use. The staff told us the person found looking and touching the objects helped them to relax.

One person told us they had recently got a bike, we heard them talking with staff about how they were looking forward to going on a bike ride and visiting a local country park. We saw another person being supported by staff to prepare their own lunch. The people who used the service appeared relaxed and happy and it was evident they got enjoyment from the activities they were engaged in.

We observed that staff worked at a relaxed pace and were heard to speak with people who used the service politely and respectfully. From the observations we made during our visit, we saw that the individuality of the people using the service was valued and promoted regardless of their mental or physical abilities.

There were five people living in the home when we visited on 14 February 2012. We spoke with two people who use the service and three members of staff to ask for their comments and views about the service. Two people who use the service, with the help of their support staff, told us that they were happy living in the home.