We found the following examples of good practice.
The home had prominent and clear infection prevention control (IPC) signs with helpful information and best practice guidance.
The home was clean, hygienic and well ventilated.
Staff were seen to be correctly wearing personal protective equipment (PPE). The home was accessing regular testing for both staff and residents.
This comprehensive inspection was unannounced, which meant those associated with the home did not know we were coming. It took place on 14 August 2018.
At the last inspection in June 2016 the service was rated overall as good. You can read the report from our last inspections, by selecting the 'all reports' link for ‘Autism Plus - Rusholme’ on our website at www.cqc.org.uk.
At this inspection we found the evidence continued to support the rating of good. This inspection report is written in a shorter format because our rating of the service has not changed since our last inspection.
The home 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 2008 and associated Regulations about how the service is run.
People continued to feel safe. Staff understood their roles and responsibilities to safeguard people from the risk of harm and risks to people were assessed and monitored regularly. The service provided specialist care for people who at times, present behaviour that might challenge others. Everyone we spoke with, including external professionals, said the service was effective and provided individualised care.
Staffing levels ensured that people's care and support needs continued to be met safely and the staff recruitment processes in place had been reviewed and improved. Staff recruited had the right values and skills to work with people who used the service. Risks continued to be assessed and recorded by staff to protect people. Accidents and incidents were monitored and evaluated so the service could learn lessons from past events and make improvements where necessary. The registered provider had formal systems in place to monitor or review that infection prevention and control was effective.
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. People continued to receive their medicines in a safe manner and received good healthcare support. People received a nutritious and balanced diet and their dietary needs and choices were met. Staff received the training they needed to deliver a high standard of care and support. They told us that they received very good quality training that was relevant to their work.
Staff were caring and kind. Staff respected people’s privacy and dignity and promoted their independence. Staff were committed to providing care that was centred on people’s individual needs. There continued to be a strong, person centred culture in the care and support team. Person centred means that care is tailored to meet the needs and aspirations of each person, as an individual. It ensures the person is at the centre of everything the service does with and for them. This means that staff take account of the person’s individual wishes and needs; their life circumstances and their choices.
Care and support plans provided detailed information about people so staff knew how they wished to be cared for in a personalised way. People were at the forefront of the service and encouraged to develop and maintain their independence. A varied range of activities were on offer for people to participate in if they wished. There was an emphasis on getting out into the local community. People were encouraged and supported to pursue their interests and hobbies. People were listened to and treated fairly if they complained about the service.
The registered provider continued to effectively monitor and audit the quality and safety of the service. The service had a culture which encouraged communication and learning. The health and social care staff we spoke with praised the quality of the service. People, their representatives and the staff were encouraged to provide feedback about the service and this was used to drive improvement. Staff told us they worked as part of a team and that Rusholme was a good place to work.
Autism Plus - Rusholme is a care home for younger adults with learning disabilities or autistic spectrum disorder. The home has a communal lounge, dining room, sensory room and multi-purpose rooms for art therapy and other activities. People who used the service have their own bedroom and en-suite bathroom. The home can accommodate two people. At the time of our visit one person was living at Rusholme.
The home 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 2008 and associated Regulations about how the service is run.
There was a strong person centred and caring culture in the care and support team. (Person centred means that care is tailored to meet the needs and aspirations of each person, as an individual.) The vision of the service was shared by the management team and staff.
Staff told us they worked as part of a team that was a good place to work and staff were committed to providing care that was centred on people’s individual needs. Staff received the training they needed to deliver a high standard of care. They told us that they received a lot of good quality training that was relevant to their job.
Everyone we spoke with including external professionals said people received individualised care. They said the service provided specialist care for people who at times presented behaviour that may challenge others.
There were systems in place to manage risks, safeguarding matters and medication and this made sure people were kept safe. Where people displayed behaviour that was challenging the training and guidance given to staff helped them to manage situations in a consistent and positive way which protected people’s dignity and rights.
People received care and support that was responsive to their needs. Care plans provided detailed information about people so staff knew exactly how they wished to be cared for in a personalised way. People were at the fore front of the service and encouraged to develop and maintain their independence. A wide and varied range of activities was on offer for people to participate in if they wished. Regular outings were also organised and people were encouraged to pursue their interests and hobbies.
CQC is required by law to monitor the operation of the Mental Capacity Act (MCA) 2005 Deprivation of Liberty Safeguards (DoLS), and to report on what we find. The members of the management team and nurses we spoke with had a full and up to date understanding of the Mental Capacity Act (MCA) 2005 and Deprivation of Liberty Safeguards (DoLS). These safeguards protect the rights of adults by ensuring that if there are restrictions on their freedom and liberty these are assessed by appropriately trained professionals. We found that appropriate DoLS applications had been made, and staff were acting in accordance with DoLS authorisations.
We saw that staff recruited had the right values, and skills to work with people who used the service. Where any issues regarding safety were identified in the recruitment process appropriate safeguards had been put in place. Staff rotas showed that the staffing levels remained at the levels required to make sure all peoples needs were met and helped to keep people safe.
Systems were in place which continuously assessed and monitored the quality of the service, including obtaining feedback from people who used the service and their relatives. Records showed that systems for recording and managing complaints, safeguarding concerns and incidents and accidents were managed well and that management took steps to learn from such events and put measures in place which meant lessons were learnt and they were less likely to happen again.