About the service:

West Hill Place provides accommodation, care and support for up to six people with autism and learning disabilities. There were five people using the service at the time of the inspection.

The care service had 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.

People’s experience of using this service:

•The staff and the registered manager were passionate about providing people with support that met their individual needs, health, wellbeing, goals and aspirations. People were at the centre of their care and each person was treated as an individual. Care was bespoke and tailored to meet their exact needs. Staff were responsive to people’s changing needs and ensured they received the best care possible, challenging other professionals when required. People could take part in a range of activities and outings of their choosing.

• People’s independence was promoted. Each person was respected as an individual and their aspirations and wishes were followed. Staff helped people to gain independence at the pace that suited them, and consistently looked for opportunities for people to take part in the activity they wanted to.

•People felt safe within the service and staff understood safeguarding procedures.

• Administration and storage of medicines was safe.

• Risk assessments were in place to manage risks within people’s lives.

• Staff recruitment procedures ensured that appropriate pre-employment checks were carried out.

• Staffing support matched the level of assessed needs within the service during our inspection.

• Staff were trained to support people effectively.

• Staff were supervised well and felt confident in their roles.

• People were supported to have a varied diet.

• Healthcare needs were met. Staff and management supported people to access the healthcare they required, and made sure people received the appropriate care.

• People's consent was gained before any care was provided, and they were supported to have maximum choice and control of their lives.

• Staff and management treated people with kindness, dignity and respect and clearly understood the people using the service.

• People were supported in the least restrictive way possible.

• Care plans reflected people’s likes, dislikes and preferences and personality.

• People and their family were involved in their own care planning as much as was possible.

• A complaints system was in place.

• The service had a registered manager in place, and staff felt well supported by them.

• The registered manager was open and honest, and worked in partnership with outside agencies to improve people’s support when required

Rating at last inspection: Good (report published May 2016)

Why we inspected

This was a planned inspection based on the rating at the last inspection. The service remained rated good overall.

Follow up:

We will continue to monitor intelligence we receive about the service until we return to visit as per our re-inspection programme. If any concerning information is received we may inspect sooner.

We carried out an announced inspection on 9 March 2016. The service provides care and support to five people with learning disabilities and/or autistic spectrum conditions.

During our inspection in February 2015, the provider had not met three regulations. This was because people’s medicines had not always been managed safely and staff did not receive effective and up to date training. Additionally, the provider’s quality monitoring processes had not always been used effectively to drive improvements. Following the inspection, the provider had sent us an action plan telling us that they would make the required improvements by the end of June 2015. During this inspection, we found improvements had been made in all areas we had identified.

The service had 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.

People felt safe and there were systems in place to safeguard them from risk of possible harm.

People’s risk assessments had been updated so that staff had the information they needed to support people safely and minimise any risks. There had been significant improvements in how people’s medicines were being managed and systems had been put in place to ensure that new processes were consistently followed.

There had been improvements in the quality of training provided to staff so that they acquired the skills and knowledge necessary to support people appropriately. Staff received regular supervision and they had effective support from the manager and the senior support worker.

Staff understood their roles and responsibilities to seek people’s consent prior to care being provided and they acted in accordance with the requirements of the Mental Capacity Act 2005 (MCA).

People said that staff were caring and respectful, and they were supported well to maintain their health and wellbeing.

People’s needs had been assessed, and care plans took account of their individual needs, preferences, and choices. They enjoyed happy and fulfilled lives because they had been given opportunities to pursue their hobbies and interests.

The provider had a formal process for handling complaints. They regularly sought people’s feedback in order to improve the quality of the service.

There was significant improvement in how the service assessed and monitored the quality of the service they provided, with evidence that regular audits were being carried out.

We carried out this inspection on 16 February 2015 and it was unannounced.

West Hill Place provides accommodation and support for up to five people who have a learning disability or autistic spectrum condition. At the time of this inspection, there were five people living at the home.

The service has 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.

People were safe and the provider had guidance to enable the staff to safeguard people.

People’s medicines were not always managed safely.

People were supported to access other health and social care services to maintain their health and well-being. They were given a choice of food and drinks and where possible, supported to prepare their own meals.

People were supported to pursue their interests and hobbies and to maintain close relationships with their family members.

Information was available to people in a format they could understand and had access to an advocacy service.

There were sufficient staff to support people at all times and there were robust recruitment processes in place.

The staff did not receive effective training so that they supported people well and safely.

The staff understood and complied with the requirements of the Mental Capacity Act 2005 (MCA) and the associated Deprivation of Liberty Safeguards. They were caring and respected people’s privacy and dignity.

The provider had a formal system for handling complaints. They encouraged people to contribute to the development of the service. However, their quality monitoring processes were not always used effectively to drive improvements.

We identified some breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2010, which corresponds to breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. This was in respect of how medicines were being managed, and ineffective staff training and quality monitoring processes. You can see what action we told the provider to take at the back of the full version of the report.