A single inspector carried out this inspection. The focus of the inspection was to answer five key questions; is the service safe, effective, caring, responsive and well-led?The Wirral Autistic Society (WAS) locations and premises contained limited records, apart from the care files for the people living at any particular location. The bulk of the files relating to such things were kept in the headquarters of WAS at Oak House. In light of this, we visited the headquarters of WAS at Oak House on 16 June 2014. We sampled records and files for each of the locations in order to fairly appraise them. We looked at 17 staff files and various other audits and records. Some of the records were kept as paper records, others were computerised.
Nelson's Croft was home to eight people who used the service. The service comprised a pair of large, older semi-detached buildings which were accessible to each other by a lockable door on the ground floor. Each of the semi's had bedrooms and communal facilities for people. The two buildings were operated as one service and shared many activities together.
We talked with one person who used the service although their communication was limited. We observed them and other people who had returned after a day out at various activities. They appeared to be well supported by the staff member on duty. They were excited about their day but settled to become relaxed and content.
We also talked with four members of staff on duty as well as the registered manager for the home. We looked at various records including three care plans. We had seen other records relating to Nelsons Croft at Oak House.
Below is a summary of what we found. The summary describes what people using the service and the staff told us, what we observed and the records we looked at. If you want to see the evidence that supports our summary please read the full report.
Is the service safe?
There were enough staff on duty to meet the needs of the people living at the home and a member of the management team was available or on call in case of emergencies.
Staff had been appropriately and properly recruited, ensuring that Criminal Records (CRB) or Disclosure and Barring Scheme (DBS) records had been checked. Staff had been trained in safeguarding principles and procedures and the people living in the home had been given information in easy read format to help them raise a concern if they were worried about anything. The home had a safeguarding policy which was regularly monitored.
The home had a friendly and sociable feel. Appropriate risk assessments had been carried out and action plans put into place for safe practice.
CQC monitors the operation of the Deprivation of Liberty Safeguards which applies to care homes. Proper policies and procedures were in place. Relevant staff had been trained to understand when an application should be made, and how to submit one.
Is the service effective?
It was clear from what we saw and from speaking with staff that they understood people's care and support needs and that they knew them well. We spoke with one person using the service who nodded 'yes' when asked if they liked living at Nelson's Croft.
Staff had received training to meet the needs of the people living at the home. One staff member said, "The training is excellent'.
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Is the service caring?
People were supported by kind and attentive staff. We saw that workers were patient and gave encouragement when supporting people. We saw that people were able to do things at their own pace and were not rushed. People and their families had been involved in the creation of their care plans and continued to be involved throughout their stay in the home. We noted that peoples preferences about, for example, activities, room layouts or clothing choices, were respected by the staff. The people who used the service were supported, where necessary, to make these choices and decisions.
Is the service responsive?
People's needs had been assessed before they moved into the home and frequently re assessed whilst they lived there. They had key workers who related to them specifically, but they were also happy with other team members and spoke well of them. Records confirmed that people's preferences, interests, aspirations and diverse needs had been recorded. Care and support had been provided that met their needs and wishes. Other professionals, such as speech and language therapists and the organisation's own 'Autism Practice' department, were involved in peoples care when necessary.
People had access to activities that were important to them and had been supported to maintain relationships with their friends and relatives. All of the people we saw appeared happy and content in the home and were supported well by staff.
Is the service well-led?
The home had a registered manager in post which indicated that the person had undergone the relevant checks. This meant that they were of good character, were physically and mentally fit and has the necessary qualifications, skills and experience.
The staff we spoke with and the registered manager had a good understanding of the ethos of the organisation. Quality assurance processes were in place. People, staff and other professionals had been asked for their feedback on the service. This also confirmed that respondents were listened to and as a result, some changes had been made. The home completed various other audits throughout the year, which contributed to an annual audit. An action plan had been produced to address any areas of concern raised through all of the audit and feedback processes.
The provider had a number of homes and they all same systems and IT package for much of its record keeping and policies. The provider had a centralised administration office at the head office. The manager was able to demonstrate effective knowledge of this and showed us that they had acted according to policy regarding such things as recruitment,safeguarding procedures and CQC notifications.
You can see our judgements on the front page of this report.