Elysium Care Partnerships Limited - School House

At our last inspection we rated the service outstanding. At this inspection we found the evidence continued to support the rating of outstanding and there was no evidence or information from our inspection and ongoing monitoring that demonstrated serious risks or concerns. This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection.

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At this inspection we found the service remained Outstanding in the key questions is the service caring, responsive and well-led. We also found the service has improved and is now rated Outstanding in safe. This was because we found the provider continued to drive improvement, particularly in relation to the service being safe.

The service had a registered manager in post. A registered manager is a person who has registered with the CQC to manage the service. Like registered providers, they are 'registered persons'. Registered persons have a legal responsibility for meeting the requirements in the Health and Social Care Act and associated Regulations about how the service is run.

We received extremely positive feedback about the standard of care provided at School House from relative’s and a healthcare professional. We also observed staff delivering kind, caring and compassionate support throughout our three-day inspection.

People continued to be protected against the risk of avoidable harm and abuse, as the provider had devised comprehensive and robust risk management plans in conjunction with behavioural specialists. Extensive analysis of people’s behaviours and early positive interventions ensured the number of incidents had significantly decreased whilst increasing people’s quality of life.

The provider had arrangements to ensure only suitable staff were employed, and sufficient numbers of staff were deployed in School House to keep people safe.

Regular health and safety checks carried out by qualified professionals ensured the environment was safe. People continued to be protected against the risk of fire, as the provider had robust process in place. The service had an embedded culture of ensuring the risks of cross contamination were minimised, through robust infection control measures in place.

The service had effective systems in place to ensure people continued to receive their medicines safely and in-line with good practice. Robust medicines audits ensured issues identified were acted on swiftly, minimising the impact on people.

Staff continued to receive on-going training to enhance their skills and knowledge. Personalised training was available to staff to ensure people received effective support. Staff reflected on their working practice through regular one-to-one meetings with the registered manager. Goals set for the coming months were achievable and enhanced staff’s role.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice. The service used imaginative ways to ensure people’s consent to care and treatment was sought prior to delivery.

People continued to be supported to maintain meaningful relationships with people that mattered to them. Relatives spoke positively about the support they received, and told us they were welcomed into the service and could visit as and when they wished.

People’s dietary needs and preferences were considered and catered for. People continued to be supported to access healthcare professional services to maintain and monitor their health and well-being. The service used imaginative ways to ensure people could access these services safely.

The service continued to support people’s religious and cultural needs in the way people wished. Staff members ensured people were treated equally and their diversity was respected and encouraged. The service continued to use imaginative ways to encourage people to develop their independence and enhance their life skills.

Relatives confirmed staff treated people exceptionally well, ensuring they were respectful, compassionate and caring. Observations throughout the three-day inspection confirmed what relatives told us. The atmosphere within the School House was warm, welcoming and inclusive.

People continued to receive exceptional care and support that was responsive to their individual needs. Care plans were person-centred, up-to-date and regularly reviewed. Assessments were regularly analysed to ensure they reflected people’s changing needs and support provided was responsive.

Ways of communicating with people were tailored to their specific needs. Innovative practices ensured people could communicate their needs and wishes in line with the accessible information standards.

The service had appropriate arrangements in place to manage and learn from complaints and concerns. Relatives confirmed they were confident the registered manager would deal with any complaints in a timely manner.

The registered manager had significant oversight of the service. Robust audits ensured all issues identified were acted on in a timely manner. People’s views were continually sought through regular questionnaires, general discussions and meetings. The registered manager placed great importance on partnership working to continually drive improvements.

Further information is in the detailed findings below.

London Care Partnership- School House provides care and accommodation for up to ten people with learning disabilities. It is located in Sunbury on Thames in Surrey. At the time of the inspection the home was fully occupied.

The service had 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 and associated Regulations about how the service is run.

The service was well led with strong values and a vision to involve people as much as possible and continually improve people’s experience. The service aimed to follow evidence based best practice in the care of people with autism. They adopted approaches reflected in a significant body of authoritative guidance. Having achieved recognition from the National Autistic Society (NAS) for creating an autism friendly environment, in 2016 the service was awarded NAS Autism Accreditation and proceeded to attain Investors in People Silver standard; surpassing both the standard and bronze awards on the first assessment.

The organisation was committed to continuous improvement. The Quality Action Group was created to facilitate diffusion of good practice that had been achieved through the autism accreditation process. This meant the service was committed to providing effective support, which was person centred and rooted in an appreciation of current knowledge and understanding of autism.

The service was described by people, their relatives, healthcare professionals, and professionals from the local authority in complimentary terms in respect of leadership, person centred care, partnership working and compassion.

Throughout this inspection we saw outstanding examples of person-centred care, which were informed by current knowledge and understanding of autism. The care needs of people had been fully assessed and documented before they started receiving care. With a dedicated Positive Behaviour Support Team, staff were supported to carry out assessments to identify people's support needs and care plans were developed outlining how these needs were to be met. We observed people received consistent, outstanding personalised care and support.

Staff understood how to support people with dignity.. People looked well-groomed and cared for and dressed appropriately. Staff spoke with people in a respectful way, giving people time to understand and respond. Where people requested personal care, staff responded discreetly and sensitively. The service had also adopted assistive technologies to allow for unobtrusive monitoring. The premises were also purpose built to meet the needs of people; bedrooms had ensuite facilities and this ensured people’s privacy.

The registered provider recognised the importance of learning and development for staff and in 2013 opened its own management training academy. Throughout the inspection all staff were keen to tell us how the management developed staff who worked at the service. We saw 80% of all team leaders and managers were promoted from within the organisation. This showed the service aimed for excellence in facilitating learning opportunities so that staff could provide the very best of care to people.

All staff had attended training on the requirements of the Mental Capacity Act 2005 within the last 12 months. Staff were extremely knowledgeable and were aware of their obligations with respect to people's choices and consent. Staff told us that people and their families were involved in discussions about their care. Records showed clear decision-making processes, mental capacity assessments and best interests meetings.

People receiving care were safe. Their risks had been assessed and well managed. There were procedures in place for monitoring and managing risks to people. When there were changes in the level of risk, the risk management strategies changed to reflect this. There were appropriate procedures in place to help ensure people were protected from all forms of abuse. Staff had received training on how to identify abuse and understood procedures for safeguarding people.

People were protected from the risks associated with the recruitment of new staff. The service followed safe recruitment practices. People were safe because staffing levels were assessed and monitored to ensure they were sufficient to meet people's identified needs at all times.