104 Church Road is a two storey semi-detached property situated in Bebington. It is one of the premises managed by the Autism Together to provide support to adults with an autistic spectrum condition and an associated learning disability.

At the last inspection, the service was rated Good. At this inspection we found the service remained good.

People told us they were well cared for and felt safe living at the home. The registered manager had systems in place to record safeguarding concerns, accidents and incidents and take appropriate action when required.

Recruitment checks were carried out to ensure suitable people were employed to work at the home. Our observations and discussions with staff and people who lived at the home confirmed sufficient staff were on duty.

The registered manager understood the requirements of the Mental Capacity Act 2005 (MCA) and the Deprivation of Liberty Safeguards (DoLS). We found that the appropriate Deprivation of Liberty Safeguard (DoLS) applications had been submitted to the Local Authority in relation to people’s care.

Risk assessments had been developed to minimise the potential risk of harm to people who lived at the home. These had been kept under review and were relevant to the care and support people required.

Care plans were in place detailing how people wished to be supported. People who received support or where appropriate their relatives were involved in decisions and consented to their care.

Staff responsible for assisting people with their medicines had received training to ensure they had the competency and skills required.

People had access to sufficient quantities of nutritious food and drink and were given suitable menu choices at each mealtime, these options had been chosen by the people who lived at 104 Church Road.

We found people had access to healthcare professionals and their healthcare needs were met.

We found that staff were well trained and supported. They were able to demonstrate skill and competency in their knowledge about autism and the support people required.

People who used the service and their relatives knew how to raise a concern or to make a complaint. The complaints procedure was available and people said they were encouraged to raise concerns.

The registered manager used a variety of methods to assess and monitor the quality of the service including staff and resident meetings to seek the views of people about the quality of care being provided.

On the day of our inspection, one person had gone on holiday leaving only one other person at the home. We spoke to them and their relative and they told us they were happy with the home. The relative we spoke with described the home as “marvellous.”

We looked at the people's care records and found they provided clear guidelines for the staff to enable them to support the people in their care. The relative told us they were part of the care planning process and they attended annual care review meetings. We found the home supported people to access other health care professionals.

We found there were enough suitably skilled staff to look after people who lived at the home.

We found that the home managed medicines appropriately and had systems in place to ensure the secure storage and safe administration of medicines.

We saw the home was of a suitable design and layout for the needs of the people at the home and that it was warm, clean and secure.

We visited 104 Church Road and spoke with the registered manager, both of the people who lived at the home, one of their relatives and a member of staff. Communication was limited but both people were able to talk to us with support from the registered manager and the staff. They were able to tell us that they felt safe and were happy living at 104 Church Road. One person said "I like the manager. He helps me with my stuff".

The member of staff we spoke with knew and understood the care needs of the people who lived at the home and was familiar with the things they liked and disliked. They knew about any risks that needed to be considered and they were able to describe how those risks were managed. This meant that care and support for the people who lived at 104 Church Road was delivered according to their requirements and risks were managed accordingly.

The people who lived at 104 Church Road were encouraged to live as independently as possible. They went to community vocational services and work placements. People were able to make choices and change decisions. One person said "Sometimes I don't like what's going on and so I change it".

We looked at the care records of both people who lived at the home. They were organised, clear and up to date. One person said they were included in the planning of their care and a relative said "I am always in touch about my relative's care - relationships with staff and managers are good".

Limited information was obtained from the people using the service due to communication difficulties. However, staff interacted with the people using the service in a warm and friendly way and the people using the service were clearly comfortable in their company. One of the people using the service said they liked living at the home and explained how staff support her with daily tasks. She said, "I like living here, the staff are good and help me with lots of things. We go out together and do things in the house." One person said they are always treated well. She said, "The staff are nice, no one has every been bad to me. I like the staff a lot."

The relatives of the people using the service said they were very happy with the standard of care provided. One person said, “I have watched my relative come on tremendously over the years. The staff couldn't look after her any better.” Another person said, “I am extremely happy with the way my relative is being looked after. I am always invited to the care plan reviews and staff I keep me informed about any issues or concerns.” Both relatives commented on the kind and caring nature of the staff team. One person said, “The staff are wonderful.” Another person said, “The staff are lovely.” Relatives commented on how well the home is managed. One person said, “The manager is very good, she communicates well and runs a good home.” Another person said, “The service is very good and the calibre of the workers employed is excellent.”

This inspection took place on 8,15 and 16 October 2014.

48 hours’ notice of the inspection was given because the service is small and the registered manager was often out of the office. The people who used the service were also often at day services or supported employment. We needed to be sure that they would be in. We visited the service on 08 October and contacted peoples’ relatives and other professionals involved in their care, on 15 and 16 October.

Wirral Autistic Society (WAS) and the service, 104 Church Road offer individualised life skills training, activities and supported employment for people with autism and support for their families.

104 Church Road is a semi-detached house which provides residential care for two people who have autistic spectrum conditions and/or learning disabilities. The two people who lived there occupied a bedroom each and shared communal facilities including the bathroom, kitchen, lounge and dining room. It was staffed full time with at least one staff member and one staff member was always present overnight in the sleep-in room. This room also doubled as an office. On week days, the people who lived at the home engaged in day care and employment activities and travelled to these in a vehicle owned by WAS. People also got out and about with staff at weekends and they used either public transport or a staff or WAS vehicle. There was always at least one member of staff with people to support those outings, apart from visits where relatives picked up their family member from the house.

The home had a registered manager. A registered manager is a person who has registered with the CQC, 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 and associated Regulations about how the service is run.

The staff we observed and spoke with clearly understood the needs of the people they were supporting and were skilled and trained to provide support to them. The care was based on national and local best practice. At the time of our visit, the service was accredited and validated under such national bodies as the National Autistic Society which researched the condition and provide information, support and services. They were also a member of the Autism Partnership which scientifically researches and validates new treatments and practices.

The people who used the service told us they were happy there. People were able to use their skills and interests to occupy themselves as they chose. They had individual and personal plans of care, training and support. They engaged in the day to day running of their home and were supported by a group of caring and skilled staff. Their relationships with the staff who we saw with them were friendly and trusting.

We found that the staff were knowledgeable and caring and had been recruited safely and appropriately. The home was clean, bright and had been recently redecorated and people’s rooms had been personalised to their choice. The home maintained good and comprehensive records about the people and their needs as well as about audits and checks which had been done periodically. The people and their relatives were happy and said they felt confident they would be safe. Professionals told us the standard of care was very good and the service was forward thinking and used current best practice.

The registered manager assessed and monitored the quality of care consistently. The provider encouraged feedback from people who lived at 104 Church Road, staff who worked there, relatives and professionals involved in the care of the people. They used the information to make improvements to the service.