We inspected Trelawney House on the 6 July 2017, the inspection was unannounced. The service was last inspected in June 2017. At that time the service was found to be good in all areas.

Trelawney House provides care and accommodation for up to six people who have autistic spectrum disorders. The service is part of the Spectrum group who run several similar services throughout Cornwall, for people living on the autistic spectrum. At the time of the inspection six people were living at the service. The service was based in a large detached building set within its own gardens in a rural location. One person lived in a self-contained flat while the remaining five people shared a communal kitchen, two lounge areas, enclosed gardens and a bathroom. Each person’s room had en-suite toilet and shower facilities.

The service is required to have a registered manager and there was a registered manager in post at the time of this inspection.

Not everybody who lived at the service was able to communicate verbally however when asked everyone living at the service indicated that they were happy and cared for. Comments received from people and their relatives included, “I can have a joke with [the staff]” and “I am happy here. It is a nice place to live”. One Person’s relative told us, “The thing that comforts me the most is, I won’t be around for ever and I am confident they will look after [My relative]”.

Staff understood their role in protecting people from abuse and people told us they felt safe and would raise any concerns with the registered manager. Comments included; “I am safe. I would tell the [Registered manager] straight away if I was worried.” The service’s recruitment practices were robust and designed to ensure people’s safety.

There were appropriate systems in place to manage risks both within the service and the local community. The service supported and encouraged people to become more independent and recognised that this included some degree of risk taking. Staff were provided with detailed guidance on how to ensure people were safe and all incidents and accidents had been investigated.

The service was staffed safely. Staffing levels had been recently increased when a new person moved into the service. Our analysis of staff rota’s found that although there were two staff vacancies this had not impacted on the level of support people received. Staff told us, “The staffing is good here. Staffing is really good” and “usually a good staff rate here”.

People were supported to live varied and active lives. On the day of our inspection everybody left the service at some point during the day to engage in activities within the local community. This included attending a work placement, going for rural walks, shopping and attending a day centre. Staff said, “It’s a young adults house and it is very active. People go out all the time” and “I went to the pub with [Person’s name] last night”.

All new staff had received two weeks of formal induction training in accordance with the requirements of the care certificate. In addition, there were systems in place to ensure the training of existing staff was regularly updated. Staff told us, “The training is very good, they are really hot on it to be fair” and “All my training is up to date”.

Staff understood the requirements of the Mental Capacity Act 2005 and where people’s care plans were potentially restrictive necessary applications had been made to the local authority for their authorisation.

Care plans included details of people’s preferred methods of communication and guidance for staff on how to support people to make decision and choices. We observed that staff were able to communicate effectively with everyone and saw that staff provided support in accordance with people’s recorded preferences.

People’s care plans were detailed and provided staff with clear guidance on both how to meet people’s needs and their preference in relation to how support was prov

We inspected Trelawney House on the 12 June 2015, the inspection was unannounced. The service was last inspected in November 2013 we did not identify any concerns. The home is part of the Spectrum group. Trelawney house provides care and accommodation for up to six people who have autistic spectrum disorders. At the time of the inspection four people were living at the service.

The home has a registered manager in place. 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.

People were happy and relaxed on the day of the inspection. We saw people moving around the home as they wished, interacting with staff and smiling and laughing. Staff were attentive and available and did not restrain people or prevent them from going where they wished. Staff encouraged people to engage in meaningful activity and spoke with them in a friendly and respectful manner. Staff were knowledgeable about the people they supported and spoke of them with affection.

Care records were detailed and contained specific information to guide staff who were supporting people. One page profiles about each person were developed in a format which was more meaningful for people. This meant staff were able to use them as communication tools.

Incidents and accidents were recorded. These records were reviewed regularly by all significant parties in order that trends were recognised so that identified risks could be addressed with the aim of minimising them in the future.

Risk assessments were in place for day to day events such as using a vehicle and one off activities. Where activities were done regularly risk assessments were included in people’s care documentation. People had access to a range of activities. These were arranged according to people’s individual interests and preferences. Staff identified with people future goals and aspirations and worked with the person to achieve them.

The service adhered to the requirements of the Mental Capacity Act (2005) and the associated Deprivation of Liberty Safeguards.

Staff were well supported through a system of induction and training. Staff told us the training was thorough and gave them confidence to carry out their role effectively.

The staff team were supportive of each other and worked together to support people. Staffing levels met the present care needs of the people that lived at the service.

People knew how to raise concerns and make complaints.

There was an open and supportive culture at Trelawney house. Staff and people said the registered manager was approachable and available if they needed to discuss any concerns. Not all staff felt they were fully appreciated by the larger organisation or that the organisation had an

understanding of the day to day demands on them.

There was a robust system of quality assurance checks in place. People and their relatives were regularly consulted about how the home was run.

We spoke with two people who lived at Trelawney House and a relative. People told us they were happy living there and liked the staff. We observed how people interacted with staff on the day of our visit.

We spoke with the registered manager and two members of staff. They told us how they supported people to make decisions on a day to day basis.

We examined peoples care files and found they were detailed and well laid out.

We saw people had a choice of suitable and nutritious food.

Spectrum operated an effective recruitment procedure.

We spoke to four people who lived in the home they told us that they liked living at Trelawney House.

We observed staff interacting with people who used the service in a kind and calm manner. We saw that staff showed, through their actions, conversations and during discussions with us empathy and understanding towards the people they cared for.

We saw that people's privacy and dignity was respected by the way that staff assisted people with their personal care and knocked and waited for permission before entering their bedrooms.

We examined people’s care file and found the records were up to date and reviewed as the person's needs/wishes changed.

We found that people who used the service were involved in making day to day decisions and participated in tasks at home, such as cleaning and doing their laundry. The records showed that they went out frequently and saw healthcare professionals when they needed them.

Staff said they had received sufficient training and support to enable them to carry out their roles competently and felt there was sufficient staff on duty.

Systems for safeguarding people from abuse were in place. Legal safeguards, which protect people unable to make decisions about their own welfare, were understood by staff and used to protect people’s rights