Autumn Leaf House is a 'care home'. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.Autumn Leaf House provides care and accommodation for up to eight people with a diagnosis of a learning disability or autistic spectrum disorder. There were two people living in the home at the time of our visit.
The care service has been developed and designed in line with the values that underpin the 'Registering the Right Support' and other best practice guidance. These values include choice, promotion of independence and inclusion. People with learning disabilities and autism using the service can live as ordinary a life as any citizen.
The service was last inspected on 24 August 2017 when we found the provider was not meeting the required standards. We identified three breaches in the legal requirements and regulations associated with the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. We asked the provider to take action to ensure people’s care and treatment was provided in a safe way and to take action to mitigate risks. Also, systems to continually assess and monitor the service provided to people needed to be improved.
The provider’s action plan informed us the required actions would be completed by the end of February 2018. We checked during this inspection and found sufficient action had been taken in response to the breaches in regulations.
A registered manager was in post. They had started working at the home in January 2018 and registering with us in July 2018. 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’s relatives felt people were safe at Autumn Leaf House and told us the consistency of staff had begun to improve. The provider's recruitment procedures minimised risks to people's safety and we saw enough staff were on duty to keep people safe during our visit. Since our last inspection further management and staff changes had occurred. Some new staff members had recently been recruited and they were due to start working at the home shortly after our visit.
Staff understood the risks associated with people's care and how these were to be managed. Staff were trained to use techniques to support people remain calm when they were feeling anxious.
Procedures were in place to protect people from harm. Staff and the registered manager understood their responsibilities to keep people safe. Staff had received training in 'safeguarding adults' to protect people from harm and described to us the signs which might indicate someone was at risk.
People’s relatives felt overall, staff had the skills to provide the care and support peopled required. New staff received effective support when they started working at the home. Staff completed the on-going training they needed to be effective in their roles.
People received their medicines when they needed them. However, some areas of medicines management required improvement because staff did not always follow the provider’s medication policy. Action was being taken to address this. Some systems and processes to assess monitor and improve the quality and safety of the service continued not to always be effective. Action was being taken to address this.
Staff understood the provider’s emergency procedures and the actions they needed to take in the event of an emergency. Checks took place to ensure the environment and the equipment in use was safe for people and staff to use.
People received effective care and support from health professionals. Staff had a good understanding of people's dietary needs and people were involved in choosing their own meals. People’s relatives confirmed people got enough to eat and drink.
People's needs were met by the design of the building. The home was clean and well maintained. Staff understood their responsibilities in relation to infection control which protected people from the risks of infection.
Overall, relatives told us the staff were caring. Staff knew the people they supported well. There was a calm atmosphere at the home and we saw people confidently approached staff when they needed assistance.
People received care that was responsive to their needs and personalised to their preferences. Each person had their needs assessed before they moved into the home and people planned and reviewed their care in partnership with the staff. People had opportunities to participate in activities that they enjoyed.
The provider was working within the principles of the Mental Capacity Act 2005. Staff had received MCA training and demonstrated they understood the principles of the Act and why restrictions were in place.
The provider's complaints policy was accessible to people and people’s relatives knew how to make a complaint and felt comfortable doing so. The registered manager used complaints as an opportunity to drive continuous improvement in the home.
Staff enjoyed working at the home and felt more supported by their managers since our last inspection. Staff had regular supervision of their work and attended team meetings which gave them the opportunity to discuss any issues of concern and ideas for improvement.
The quality of care had improved at the home but occupancy at the home was low. The changes made needed to be sustained over a longer period of time to be fully embedded in to the organisation.