Ashcroft provides accommodation with personal care for up to 3 people. The home specialises in providing a service to young adults who have moderate to severe autism and communication difficulties. The home is staffed 24 hours a day.

At the time of the inspection there were 3 people living at the home.

At the last inspection, the service was rated Outstanding.

At this inspection we found the service remained Outstanding.

Why the service is rated Outstanding

The staff team were exceptional in how they supported and enabled people to reach their full potential. They used innovative and creative ways to help people communicate, to learn new skills and overcome situations which had caused increased anxieties. People had flourished since moving to the home and the staff team had ensured people experienced a smooth and positive transition when they moved to the home from children’s services.

People are supported to have maximum choice and control of their lives and staff support them in the least restrictive way possible; the policies and systems in the service support this practice.

The service was very well led by a registered manager who was committed to enabling people to live their lives to the full and to provide a safe and enabling environment which people called their home. The registered manager was passionate about supporting the staff team to develop their skills and knowledge so they could provide people with the best care and support possible. The registered manager and provider continually monitored the quality of the service and made improvements where needed.

People continued to receive safe care. Risks were well managed which meant people had control over their lives in a safe way. People were supported by adequate numbers of staff who had the skills and knowledge to meet their needs. Staff knew how to protect people from the risk of harm and abuse.

The home continued to provide a caring service to people. A relative told us “I am extremely happy with the level of care [name of person] receives at Ashcroft and he has been very happy there for several years now.” The registered manager said “All of Ashcroft’s achievements are because of the strong caring team here and the positive attitude towards caring, developing and supporting the housemates.”

People received care which was responsive to their needs and preferences. People had been involved in planning and reviewing the care they received and we found care plans were reflective of people’s needs and preferences. Staff used proactive strategies to support people at times of anxiety and to reduce the risk of behaviours escalating.

Further information is in the detailed findings below.

This inspection took place on 9 December 2014 and was unannounced.

The service provides accommodation, support and personal care for three younger adults with moderate to severe autism and communication difficulties. Each person received continuous one to one support from staff and needed to be supervised whenever they went out. The service promoted a culture of learning and individuality. They wanted to equip people with skills for life regardless of whether they remained within the service or eventually moved on.

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.

Because of people’s language difficulties we were only able to have limited discussions with them. We relied mainly on our observations of care and our conversations with people’s relatives and staff to understand their experiences.

People’s relatives were full of praise for the way staff cared for their relatives. They told us the service was exceptional. A parent said “It feels like (their relative) is part of a loving and generous family, everyone goes the extra mile, all of the time, every day. The staff are exceptional people and deliver exceptional care”.

People had individualised communication plans to help them to express themselves better. Staff used a variety of communication techniques tailored to each person’s needs; including sign language, pictures and symbols. Staff assisted people to express both their physical and emotional needs and preferences. People pointed at pictures and symbols to show us they felt happy and safe.

We were told of numerous examples of people being supported to develop life skills and independence, way beyond the level of attainment their families had expected or hoped for. We also observed similar examples of staff providing exceptionally personalised care and support. They encouraged people at every opportunity to be as independent as they were able to be. Staff supported people exceptionally well but only to the extent needed. This helped maintain and develop people’s independence and increased people’s self-esteem and confidence. A relative said “Staff are delightful, caring and compassionate. There’s lots of fun and happiness”.

The service employed a behavioural therapist, who specialised in autism, to provide service specific training for staff. This enabled the small dedicated team of staff to provide a highly effective, caring and uniquely individualised service that reflected current best practices. There were sufficient numbers of suitably trained staff to keep people safe and meet their individual needs. They used nationally recognised tools to monitor people’s attainment and progression toward achieving their maximum capabilities. The service was accredited by the National Autistic Society. To achieve accreditation the service had to demonstrate and maintain high standards of care for people living with an autistic spectrum disorder.

With people’s consent, most relatives opted to receive weekly reports on their family member’s activities and progress. Relatives were always made very welcome and they were encouraged to visit people as often as they wished. Staff also supported people to visit their families on a regular basis according to the wishes of people and their relatives.

People were supported to integrate within the local community and to avoid social isolation. To facilitate this, the service had developed strong links with local colleges, specialist schools, resource centres, libraries and local employers offering work experience.

People were supported to maintain good health. The service employed nutritionists to help promote healthy eating and varied diets. There were close working relationships with local health and social care professionals. Professionals visited the home or staff supported people to attend appointments according to people’s individual needs and preferences.

We spoke with one person who received and a service at Ashcroft. They told us that they were happy with the care and support they received.

We observed staff interacting with the person who used the service and were of the view that they dealt with the person with dignity and respect.

We saw records of best interests meetings which meant there were clear procedures in place for making decisions for people without capacity.

We saw care records which had very thorough assessments and care plans which showed us that peoples individual needs were being well met at Ashcroft.

We saw the medication procedures which were very well maintained and audited. This meant that procedures were in place to ensure that medication was safely administered.

We spoke with staff and the manager and saw staff rotas which showed that there were sufficient staff on duty who were skilled and competent to meet the needs of the people who lived at Ashcroft.

We saw quality monitoring systems which collated information to ensure that the service was being well run and was able to meet the needs of all the people who lived at Ashcroft.