Archived: Hoffmann Foundation for Autism - 11 Pear Close

11 Pear Close is a care home registered for six people with autistic spectrum conditions situated in Kingsbury. At the time of our inspection there were five people living there .The people who used the service had significant support needs including cognitive and communication impairments and behaviours considered challenging.

There was 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.

Family members that we spoke with told us that they considered that their relatives were safe at the home. We saw that people were comfortable and familiar with the staff supporting them.

People who lived at the home were protected from the risk of abuse. Staff members had received training in safeguarding, and were able to demonstrate their role in ensuring that people were safe and that concerns were reported appropriately.

Medicines at the service were well managed. People’s medicines were managed and given to them appropriately and records of medicines were well maintained.

We saw that staff at the home supported people in a caring and respectful way, and responded promptly to meet their needs and requests. There were enough staff members on duty to meet the needs of the people using the service.

We were satisfied that staff who worked at the home received regular relevant training and were knowledgeable about their roles and responsibilities. Appropriate checks took place as part of the recruitment process to ensure that staff were suitable for the work that they would be undertaking. All staff members received regular supervision from a manager, and those whom we spoke with told us that they felt well supported.

The home was meeting the requirements of The Mental Capacity Act 2005 (MCA). Information about capacity was included in people’s care plans. Applications for Deprivation of Liberty Safeguards (DoLS) authorisations had been made to the relevant local authority to ensure that people who were unable to make decisions were not inappropriately restricted. Staff members had received training in MCA and DoLS, and those we spoke with were able to describe their roles and responsibilities in relation to supporting people who lacked capacity to make decisions.

People’s nutritional needs were well met. Meals provided were varied and met guidance provided in people’s care plans. Alternatives were offered where required, and drinks and snacks were offered to people throughout the day.

People’s care plans and risk assessments were person centred and provided detailed guidance for staff around meeting people’s needs. These had been updated regularly and reflected any changes in people’s care and support needs.

The home provided a range of activities for people to participate in throughout the week. Staff members supported people to participate in these activities. People’s cultural and religious needs were supported by the service and detailed information about these was contained in people’s care plans.

A complaints procedure was in place and this was available in an easy to read format. The home’s complaints log showed that complaints had been addressed, although a family member told us that concerns that they had not always received a response in relation to concerns that they had raised.

The care documentation that we saw showed that people’s health needs were regularly reviewed. The home's records showed that there was regular liaison with health professionals to ensure that people received the support that they needed.

There were effective systems in place in relation to review and monitoring of the quality of support provided at the home. Regular monitoring had taken place, and action plans had been put in place and addressed where there were concerns. Policies and procedures were up to date.

The registered manager told us that the home would be closing during the coming months and people would be moving to a supported living service managed by the provider. The family members that we spoke with confirmed that they had been consulted about this.

During the inspection we spoke with all the people who used the service. People had varied communication needs. They communicated with us by making gestures, facial expressions and sounds. Two people spoke a few words. We spent time observing care in the lounge and used the short observational framework (SOFI), which is a specific way of observing care to help us understand the experience of people who could not talk to us. We also spoke with four care staff, the registered manager and two relatives of people who used the service.

Below is a summary of what we found. The summary describes what people using the service, their relatives and the staff told us, what we observed and the records we looked at.

If you want to see evidence that supports our summary please read the full report.

This is a summary of what we found:

Is the service safe?

People who used the service were unable to tell us whether they felt safe. However, we spent a significant part of the inspection observing people and staff. We found that people who used the service showed signs of well being and approached staff without hesitation. Staff respected people's rights and dignity. Relatives of people who used the service told us that people were 'looked after well' and seemed to be 'happy.'

Safeguarding procedures were robust. Staff understood their role in safeguarding people whom they supported and understood the whistleblowing policy.

The service had systems in place to identify assess and manage risks related to health welfare and safety of people who used the service.

The Care Quality Commission monitors arrangements related to the Deprivation of Liberty Safeguards (DoLS), which applies to care homes. Staff had received training with regard to DoLS. The registered manager told us that no applications for deprivation of liberty had needed to be submitted. However, we saw people living in the home needed continuous supervision and control and staff told us that due to risk to their safety people were not free to leave without staff or family members' accompanying them. This may mean that deprivation of liberty authorisations were required. The registered manager agreed that she would contact the local authority with regard to this issue.

People's care and support needs were taken into account when senior staff made decisions about the qualifications, skills and experience of staff required. Relatives of people who used the service expressed confidence in the care staff and management staff and told us that they generally thought staff were skilled, kind and competent.

There were systems in place to make sure that the manager and staff learned from events such as accidents and incidents.

Furnishings were of good quality. We noted that there was a banister located on only one side of the stairway, which could mean that people were not as safe as they could be when ascending and descending the stairs .

Is the service effective?

People's health and care needs were assessed. People were central to their plan of care and support. It was clear from our observations and from speaking with staff that they had a good understanding of people's care and support needs and knew them well. Staff had received training to meet the needs of the people living in the home.

Staff, family members, healthcare and social care professionals were involved in decisions about people's care. People's care plans were reviewed regularly.

Is the service caring?

We saw that people were supported by kind attentive staff. We saw that care staff were patient and praised and encouraged people who used the service. People were provided with choices. People made decisions about what to eat and do. These decisions were respected by staff. People who used the service were able to do things at their own pace and were not rushed. People's privacy and dignity were respected.

People's preferences, interests, aspirations and diverse needs had been included in their care plans. The registered manager and care staff were aware of each person's individual needs and worked as a team with others including people's relatives to provide the support people needed.

Is the service responsive?

People's progress was monitored closely. Written notes about people's behaviour, mood, health and care were completed by staff during each shift. Monthly reports completed by staff included reviews of each person's needs. People completed a range of activities in and outside the service.

Relatives and significant others of people who used the service completed an annual satisfaction survey. Relative's of people told us that they felt staff listened to them and responded appropriately to feedback about the service provided to people. The organisation assisted people with significant communication needs to provide feedback about the service.

Is the service well-led?

Staff had a good understanding of the ethos of the home and quality assurance processes. Systems were in place to monitor the quality and the safety of the service provided to people.

The service worked well with other agencies and services to make sure people received their care and support in a joined up way. People's health, safety and welfare were protected as they received the advice and treatment that they needed from a range of health and social care professionals.

Staff meetings took place regularly. Care staff confirmed that their views about the service were taken into account. Staff were clear about their roles and responsibilities. Staff training and supervision records showed that staff received appropriate training and support.

One relative who spoke with us by phone informed us that people had been treated with respect and dignity and the care provided was of a good standard. We tried to contact three other relatives and three care managers but they were not available to comment on the service.

Care records indicated that the needs of people had been carefully monitored and attended to. The care records contained appropriate assessments, care plans and reviews. Details of appointments with healthcare professionals were recorded.

There were suitable arrangements in place to manage medicines. This ensured that people were protected against the risks associated with medicines.

The premises were clean and tidy. Safety inspections of the portable appliances, gas and electrical installations had been carried out. Fire safety arrangements were in place.

The home had a development plan and suitable arrangements for monitoring the quality of care provided.