Alan Atchison - 2 David's Close

Updated 5 March 2021

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008.

As part of CQC’s response to care homes with outbreaks of coronavirus, we are conducting reviews to ensure that the Infection Prevention and Control practice was safe and the service was compliant with IPC measures. This was a targeted inspection looking at the IPC practices the provider has in place.

This inspection took place on 03 February 2021 and was unannounced.

Updated 5 March 2021

Alan Atchison – 2 David’s Close is a residential care home providing personal care to 10 adults with autism, physical and learning disabilities at the time of the inspection. The service can support up to 11 people in one adapted building.

The service had been running for many years prior to the Registering the Right Support best practice guidance. The registered manager told us on the second day of inspection they had become aware of this guidance after our first inspection day. However, we saw the service had been developed and designed in line with the principles and values that underpin Registering the Right Support and other best practice guidance. This ensures that people who use the service can live as full a life as possible and achieve the best possible outcomes. The principles reflect the need for people with learning disabilities and/or autism to live meaningful lives that include control, choice, and independence. People using the service receive planned and co-ordinated person-centred support that is appropriate and inclusive for them.

The Secretary of State has asked the Care Quality Commission (CQC) to conduct a thematic review and to make recommendations about the use of restrictive interventions in settings that provide care for people with or who might have mental health problems, learning disabilities and/or autism. Thematic reviews look in-depth at specific issues concerning quality of care across the health and social care sectors. They expand our understanding of both good and poor practice and of the potential drivers of improvement.

As part of thematic review, we carried out a survey with a senior support worker, in the registered manager’s absence at this inspection. This considered whether the service used any restrictive intervention practices (restraint, seclusion and segregation) when supporting people.

The service did support people effectively in line with positive behaviour support principles. Staff told us they were trained to support people using positive behaviour support during their autism awareness training.

People’s experience of using this service and what we found

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests.

Although the registered manager at this inspection was not aware of the guidance of Registering the Right Support, the service applied the principles and values of Registering the Right Support and other best practice guidance. These ensure that people who use the service can live as full a life as possible and achieve the best possible outcomes that include control, choice and independence.

We have made a recommendation about keeping up to date with best practice guidance.

People's support focused on them having as many opportunities as possible for them to gain new skills and become more independent.

The support and care provided by staff at the service made people feel safe. Staff understood their duty to report any concerns they had about poor care and potential harm to people. Staff had information available to them to refer to on how to monitor and reduce people’s individual risks. Staff worked in conjunction with guidance from external health care professionals such as the speech and language therapist team and a hospital consultant to help support and maintain people’s well-being.

Staffing levels were looked at and determined to make sure they met the needs of the people using the service. This included support for people who required one-to-one or two-to-one support within the community. Trained staff safely managed people’s medicines.

Records showed that not all staff had completed their mandatory training, including a new staff member. Staff told us they had supervisions and a yearly competency check to monitor their skills and knowledge.

We have made a recommendation that staff’s training be completed by a set timeframe to make sure staff are competent and confident to deliver effective care and support.

People were supported to maintain their independence where appropriate. Staff promoted people’s food and drink intake. Staff respected people’s privacy and dignity. Staff knew the people they supported well. People had developed caring relationships with staff who understood their individual and sometimes complex care and support needs and wishes.

People told us staff were kind. People’s personal information was kept confidential in the service’s office. People, where possible, and their relatives or an advocate service were involved in discussions and reviews of their, or their family member’s, care. There had been no complaints recorded. A guide on how to complain was available in a pictorial easy read format. This helped aid people’s understanding.

Staff felt supported by the registered manager and other staff colleagues. Audits were carried out to monitor the service and address any improvements required.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection

The last rating for this service was good (published 2 May 2017).

Why we inspected

This was a planned inspection based on the previous rating.

Follow up

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