This comprehensive inspection took place on 29 and 30 September 2016 and was announced. We announced the inspection because people living at Helen House attended day services and other activities and staff accompanied them. We wanted to be sure there would be someone there.

Helen House is part of a wide range of services provided by the registered charity Wirral Autistic Society. The house is on the Raby Hall campus alongside other Wirral Autistic Society services. Helen House is registered to provide accommodation and personal care for up to 20 people. At the time of this inspection there were 15 people living at the service. Three of the 15 people lived in an annex building consisting of three separate flats.

The service is located on the Raby Hall site and is a distinct and separate building from the others.

Helen House is owned and staffed by the provider, Wirral Autistic Society (WAS), which now has the ‘working name’ of Autism Together. The service is still registered as being provided by WAS. Also nearby this building were other WAS homes and a home farm centre and day services for the people living on the site.

The home required 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 looked at information the Care Quality Commission (CQC) had received about the service including notifications received from the registered manager. We checked that we had received these in a timely manner. We also looked at safeguarding referrals, complaints and any other information from members of the public.

The home was furnished in a homely way which was according to people’s taste, especially in their own rooms. We observed the people in the home on the days of our inspection. However, we were unable to speak with the people as most had limited verbal communication. We spoke with the relatives of the six people who used the service. They gave us their views on the service and about the care provided to their family members. People appeared happy and comfortable with their surroundings and with staff.

We saw that people received sufficient quantities of food and drink and had a choice in the meals that they received.

Medication procedures were followed and the medication stored tallied with the records.

The provider had complied with the Mental Capacity Act 2005 and Deprivation of Liberty Safeguards and its associated codes of practice in the delivery of care. We found that the staff had followed the requirements and principles of the Mental Capacity Act 2005 (MCA). Staff we spoke with had an understanding of what their role was and what their obligations where in order to maintain people’s rights.

We found that the care plans and risk assessment monthly review records were all up to date in the files looked at and there was updated information that reflected the changes of people’s health.

The home used safe systems for recruiting new staff. These included using Disclosure and Barring Service (DBS) checks. New staff had an induction programme in place that included training them to ensure they were competent in their role at the home. Staff told us they did feel supported by the team leaders, deputy team leaders and the registered manager.

The staffing levels were seen to be appropriate to support people and meet their needs and the staff we spoke with considered there were adequate staff on duty.

Accidents and incidents were recorded and monitored to ensure that appropriate action was taken to prevent further incidents. Staff knew what to do if any difficulties arose whilst supporting somebody, or if an accident happened.

We looked at records relating to the safety of the premises and its equipment, which wer

We looked at satisfaction questionnaires for people who used the service and their families. These showed a high overall satisfaction rating and comments made included: “very dedicated staff”, “good autism practice”, “exceptionally pleased with the care and attention of our daughter”, and “I was impressed by the level of care he is receiving”.

Care plans were detailed and comprehensive. They showed that people’s support needs were met and risks to the person’s health and safety were identified and measures put in place to minimise risks.

The premises were comfortable and well maintained. Records showed that regular health and safety checks were carried out.

Most of the people who used the service required one to one input from staff to keep them safe and to support them to access vocational and social activities. There were enough qualified and experienced staff to provide the support that people required.

People were given information about how to make a complaint and the manager responded appropriately to complaints and concerns and kept good records.

On the day of our visit, the majority of people who used the service were out at day centres or other activities. We spoke with four relatives of people who used the service and who all had regular contact with them. All the people we spoke with were very happy with the care and support provided and praised the staff. One relative told us “we think Helen House is an excellent service and the quality of care is very high and gets better all the time.” We looked at satisfaction questionnaires for people who used the service and saw these were positive.

All the relatives we spoke with told us they were part of the care planning process. One relative told us “we are invited to meetings all the time and are constantly sent information about our son and kept updated.”

We found that Helen House had safeguarding measures in place and that staff were trained to identify and act if there were any safeguarding issues. One relative we spoke with said “I have peace of mind and I feel my son is very safe there.”

We found that staff received regular training and supervisions to make sure they could support people who used the service.

We found that Helen House had systems in place for monitoring quality assurance. Relatives told us they were aware of how to make a complaint but knew they could always talk to the manager or staff if they had any concerns. Relatives told us they did not have any concerns about the care people received.

When we visited Helen House on 24 August 2011 there were 18 people living there. The people living at the home have restricted verbal communication so the service manager provided telephone numbers for family members of a number of residents and confirmed with them that they would be agreeable to speaking with us. We spoke with four people who were all parents of people living at the home and who all have regular contact with them.

Comments from relatives included:

We are very happy at the moment. There were a lot of changes about 18 months ago and we felt that these were done too quickly and were unsettling at the time.

The quality of care has improved tremendously in the last six months.

Our relative spends the weekends at home with us and we are aware that he is happy and would know if anything was wrong.

Helen House is my life-line. I trust them implicitly.

My relative has been at Helen House for more than 20 years and is really very happy. We have never had to make any complaints.

They know him well and are like his family.

He likes being out in the fresh air.

My relative spent time in hospital a few years ago and the staff from WAS were so supportive. I can’t thank them enough.

I am extremely happy with the way that my relative has been supported through the move to her new home. The family were involved in every step of the process.

For the first time I feel that I can switch off and stop worrying.

I feel very confident in their professionalism.

We also spoke with a social worker who was involved in supporting a new service user during her move to Helen House. She said that she was very impressed with the way the transition was handled. The process was completely ‘client focused’ and as a result, the person has settled in very well. They have followed the support plans that were developed at the hospital she came from. All staff were well prepared and all the reports are good. The environment was clean and orderly and suits the person’s needs well.