Elysium Care Partnerships Limited - 13 Alexandra Gardens

Updated 22 August 2019

The inspection

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Care Act 2014.

Inspection team

This inspection was carried out by one inspector.

Service and service type

Elysium Care Partnerships Limited - 13 Alexandra Gardens is a ‘care home’. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

The service had a manager registered with the Care Quality Commission. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.

Notice of inspection

This inspection was unannounced and took place on 29 and 30 May 2019.

What we did before the inspection

We reviewed information we had received about the service since the last inspection. We sought feedback from the local authority and professionals who work with the service. We used the information the provider sent us in the provider information return. This is information providers are required to send us with key information about their service, what they do well, and improvements they plan to make. This information helps support our inspections. We used all of this information to plan our inspection.

During the inspection-

We spoke with three people who used the service about their experience of the care provided. We spoke with six members of staff including the registered manager and senior care workers. We also spoke with two healthcare professionals and a speech and language therapist who was employed by the provider.

We reviewed a range of records. This included five people’s care records and medicines records. We looked at four staff files in relation to recruitment and staff supervision. A variety of records relating to the management of the service, including policies and procedures were reviewed.

After the inspection

We spoke with three relatives and two healthcare professionals.

Updated 22 August 2019

About the service

Elysium Care Partnerships Limited - 13 Alexandra Gardens is a care home for people with learning disabilities or autistic spectrum disorder. The service has 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 service was a large home in a residential area, bigger than most domestic style properties for eight people with four self-contained flats joined to it by a communal court yard. It was registered for the support of up to 12 people. 12 people were using the service at the time of the inspection. This is a larger care service than current best practice guidance. However, the size of the service having a negative impact on people was mitigated by the building design fitting into the residential area and the other large domestic homes of a similar size. There were deliberately no identifying signs, cameras, industrial bins or anything else outside to indicate it was a care home. Staff were also discouraged from wearing anything that suggested they were care staff when coming and going with people.

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

The provider had a strong ethos and culture of delivering quality care and support to people. Their systems to monitor, manage and improve service delivery and to improve the care and support provided to people were highly effective. People using the service and staff reported the strong commitment of the registered manager to the service. They were always available and they actively listened and promoted an open and transparent work environment. There were regular meetings where information was shared with staff and people who used the service and concerns were discussed. The registered manager liaised with other professionals to share best practice and develop the team’s skills and knowledge.

The provider identified and mitigated risks to support people to remain safe. They did this in a way that was meaningful and enabling to the person. One person was supported to create their own ‘rules’ to manage risks around their behaviours, so that they took ownership for their own safety with a primary focus on promoting their independence.

Incidents and accidents were managed through a process where staff, including a behaviour analyst and speech and language therapist, could reflect upon the incident, analyse it, learn from it and put in preventative measures to minimise risks and behaviours that challenged and thereby improved the quality of people’s lives. This approach led to the number of incidents for one person dropping from up to 83 incidents in a month, to months without any incidents.

The provider and staff had a very good understanding of each person’s behaviour and the factors that could impact on this. For example, there was a recognition that the environment could impact on the way a person behaved and the provider went over and above to tailor the environment to suit people’s needs.

Staff were very skilled at using a wide range of methods to communicate with people as part of the provider’s ‘total communication’ approach. This ensured people had access to the right means of communication for them to make their needs known and so that staff could communicate with them. For example, the provider used ‘now and next boards’ (a visual aid of pictures that showed what activity is happening now and what will happen next) to help prepare people for what was going to happen next on a day to day basis. The various initiatives of supporting people to understand information, played a significant role in supporting people to make decisions and to be involved in their care.

The staff liaised with various healthcare professionals to identify the optimal ways of supporting people with their healthcare needs and to lead healthier lives. We saw an example where one person lost weight and started to benefit from improved health outcomes through a review of their medicines and support from staff to change to a healthier lifestyle

The provider demonstrated an exceptionally strong social care model approach to care and person-centred culture by making people their primary focus and not just addressing their physical needs.

There was an exceptionally varied range of activities that was tailored to the people using the service. For example, people took part in community projects, went on holidays, and used interactive light system games to help them to communicate and improve skills such as problem solving and dexterity.

The provider used person-centred care planning to make sure people received the care they needed and took account of people’s sensory and communication profiles and positive behaviour plans. They recognised all these areas had an impact on people’s behaviour and needed to be addressed as a whole.

Staff undertook reflective practice around the care provided to people, to review if the care provided was appropriate to meet people’s needs and to reflect on what else could have been done.

The service is accredited and is part of a number of local and national initiatives and organisations and has an impact not only locally and regionally but also nationally in terms of the national guidance they have contributed to, for example their contribution to the Skills for Care guidance.

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; the policies and systems in the service supported this practice.

The service applied the principles and values of Registering the Right Support and other best practice guidance. This ensured 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.

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 outstanding (published18 November 2016).

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.