About the service.

Autism Care Community Services (Yorkshire) provides a supported living service and personal care service to people aged 18 and over in their own homes. At the time of the inspection the services were supporting four people.

In December 2018, Lifeways Community Care (Halifax) became the corporate provider of Autism Care 2 Uk Limited and the location Autism Care Community Services (Yorkshire). At the time of inspection Lifeways Community Care (Halifax) were in the process of making changes to the service and embedding new provider practices within the service.

Not everyone using Autism Care Community Services (Yorkshire) receives regulated activity; CQC only inspects the service being received by people provided with ‘personal care’; help with tasks related to personal hygiene and eating. Where they do we also take into account any wider social care provided.

People’s experience of using this service.

The principles and values of Registering the Right Support and other best practice guidance ensure people with a learning disability and or autism who use a service can live as full a life as possible and achieve the best outcomes that include control, choice and independence. At this inspection the provider had ensure they were applied.

The outcomes for people using the service reflected the principles and values of Registering the Right Support. For example, people’s support focused on them having choice and control over the care and support they received and as many opportunities as possible to become more independent.

There was no registered manager in post at time of the inspection. Relatives and staff told us how there had been several managerial changes over the past four years which had led to inconsistencies within the service.

Staff recruitment and training records showed the appropriate checks had not always been undertaken before people started work and, some staff had not received training the provider deemed as mandatory. Staff had also not received regular supervision.

People received their care from a small consistent staff team who they had trusting relationships with. Relatives told us they were happy with the care and support being provided by the service.

People were supported to maintain and develop their independence. Staff treated people as individuals and respected their privacy and lifestyle choices.

The management team ensured people received a safe service with systems and processes in place which helped to minimise risks. Staff effectively reported any safeguarding matters. All incidents were critically analysed, lessons were learnt and used to improve practice.

People, their relatives and health and social care professionals were now actively involved in decisions being made about the care people received.

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 were receiving their medicines when they should. New systems had been introduced which followed national guidance for medication arrangements.

The management team were open and honest which enabled people to share their views and raise concerns. Relatives told us if they were worried about anything they would be comfortable to talk with a member of staff.

The management team monitored quality, acted quickly when change was required, sought people's views and planned ongoing improvements to the services.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection and update.

At the last inspection the service was rated requires improvement (published 10 May 2018). Although improvements were being made, the service remains rated requires improvement. This service has been rated requires improvement for the last two consecutive inspections.

Previous breaches.

Following the last inspection, we asked

Autism Care Community Services (Yorkshire) is based in Treeton, Rotherham. It provides care and support to people living with learning disabilities in their own homes. The service also has one ‘supported living’ setting. People’s care needs and housing requirements are provided under separate contractual agreements. CQC does not regulate premises used for supported living; this inspection looked at people’s personal care and support. At the time of the inspection the service was providing support packages to five people, some of whom lived in a supported living setting, in a shared house.

At the last inspection the service was rated Good. You can read the report from our last inspections, by selecting the 'all reports' link for ‘Autism Care Community Services (Yorkshire)’ on our website at www.cqc.org.uk.

This inspection took place on 9 and 12 February 2018 and was announced. We gave the service four days notice of the inspection site visit because it was possible that some of the people using the service might not have been able to consent to a home visit from an inspector, which meant that we had to provide time for any ‘best interests’ decisions to be made about this. We visited and observed staff supporting three of the people who used the service to gain an understanding of their lived experience, as people were not able to communicate with us by telephone.

At this inspection the service was rated Requires Improvement. We identified that there had been some concerns regarding staffing, identifying risk and staff support. The registered provider had not identified concerns in a timely way and, although at the time of the inspection the registered provider had identified and begun working on these areas, there were still improvements to be made and sustained.

This was a breach of Regulation 17 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.

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.

The service was being managed from some distance geographically and there had been a period when there was a lack of cohesion due to several changes of staff and managers. A new area manager who had been appointed. The area manager had responsibility for overseeing the service locally and the registered manager was visiting the service more regularly.

Issue with staff recruitment had been addressed to a large extent. However, providing unplanned staff cover remained a challenge, as the pool of staff was still quite small. Most of the relatives we spoke with said that on the whole, the longer term staff made sure their family member’s day to day care needs were met. However, some relatives told us the use of unfamiliar staff and agency workers had affected the quality of the care and support people had received.

Systems were in place to safeguard people from abuse and staff we spoke with knew how to recognise and report abuse. Risks associated with people’s care needs and lifestyles were identified and plans were in place to minimise the risks. Medicines were managed safely and administered as prescribed.

We found that overall, staff were trained and had the skills they required to carry out their role. People received a healthy diet which they had been involved in choosing. People were supported to live healthy lifestyles and had access to relevant healthcare professionals when needed. People were supported to have choice and control in their lives and staff supported them in the least restrictive way possible.

People were treated with kindness and care. When we visited people in the supported living settings we saw staff interacting with them in a caring and positive way

The inspection took place on 19 May 2016 and was announced. We gave the service 48 hours’ notice in line with our current methodology about inspecting domiciliary care agencies. The service was last inspected in May 2015 and although no breaches were identified, the service was rated as ‘requires improvement.’

Autism Care (UK) 2 Limited is based in Treeton Rotherham and is known as Rother Heights. The service provides personal care to people living in their own homes in North and South Yorkshire. At the time of our inspection there were five people using the service.

The service had a registered manager in post at the time of our inspection. 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. The provider had appointed a manager and they were in the early stages of applying to be registered with the Care Quality Commission. The registered manager had recently been promoted to area manager within the company. The manager’s post had been filled but the person had not yet registered with the Care Quality Commission.

The provider had a policy to protect people from abuse. Staff had received training in this area and were knowledgeable about how to recognise and respond to abuse.

People received their medicines in a safe manner. We looked at records in relation to medicine and spoke with the management team. We found each person had a medication administration record (MAR) in place. Staff who were responsible for administering medicines were appropriately trained.

Risks associated with people’s care had been identified and action had been taken to reduce the risk from occurring.

We spoke with relatives of people who used the service and staff and found there were enough staff around to ensure people’s needs were met. Staff told us they worked well as a team and were able to respond to people’s needs.

We looked at records in relation to training and spoke with the manager. The manager showed us where training had been arranged and booked to ensure staff were up to date with training in accordance with their company policy.

People were supported to make decisions about their care and their choice was respected. Care plans included information about people’s likes and dislikes.

People received a nutritious and balanced diet. Snacks and drinks were offered throughout the day. We spoke with the cook who was knowledgeable about the different dietary requirements people had, and provided meals to suit their needs and tastes.

People were supported to maintain good health, have access to healthcare services and received on going healthcare support.

We spoke with relatives and staff and found people received support from staff that were caring, kind and were passionate about person centred care.

We looked at some support plans belonging to people who used the service and found they were person centred and included the person’s current needs.

People were supported to engage in social activities and interests of their own choice. This was agreed on a weekly basis and a timetable drawn up to ensure activities took place.

The provider had a complaints procedure which was also available in an easy read format. Relatives we spoke with told us they had never had to complain, but felt the manager would resolve any issues they brought to their attention.

We saw audits took place to ensure policies and procedures were being followed, and actions were identified where improvements were required.

We spoke with relatives of people who used the service and they felt they were involved in the development of the service and were able to contribute ideas.

The inspection took place 13 May 2015 and was announced. Our last scheduled inspection at this service took place in January 2014 when no breaches of legal requirements were identified.

Autism Care UK’s community service is located at Treeton in Rotherham and is known as Rother Heights. It can provide personal care to people living in the community. The service supports people in South and North Yorkshire.

The service had a registered manager in post at the time of our inspection. 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 were two service managers who had day to day responsibilities for each area. The service managers reported to the registered manager.

We spoke with staff who had a clear understanding of safeguarding adults and what action they would take if they suspected abuse. One care worker said, “I know the people I support and would notice if something was wrong.” Another care worker said, “I would report anything of this nature to my manager straight away.”

Care and support was planned and delivered in a way that ensured people were safe. The support plans we looked at included risk assessments which identified any risk associated with

people’s care. We saw risk assessments had been devised to help minimise and monitor the risk.

We spoke with staff and people who used the service and we found there were enough staff with the right skills, knowledge and experience to meet people’s needs.

The registered manager showed us a training matrix for the South and North Yorkshire service. The provider’s information stated that some training was completed on an annual basis. However, some training had not been completed within these timeframes.

We found the service to be meeting the requirements of the Mental Capacity Act and Deprivation of Liberty Safeguards (DoLS). The staff we spoke with had some knowledge of these and said they would speak to the registered manager and other managers in the team for further advice.

People were supported to eat and drink sufficient to maintain a balanced diet. Snacks were available in-between mealtimes. Meals were flexible to meet the needs of the people who used the service.

People were supported to maintain good health, have access to healthcare services and received ongoing healthcare support. We looked at people’s records and found they had received support from healthcare professionals when required.

People who used the service were supported to maintain friendships. Support plans contained information about their circle of friends and who was important to them. We saw that people had their own interests and hobbies and took part in several activities and events on a weekly basis.

We saw staff were aware of people’s needs and the best ways to support them, whilst maintaining their independence.

People’s needs were assessed and care and support was planned and delivered in line with their individual support plan.

The service had a complaints procedure and people knew how to raise concerns. The procedure was also available in an ‘easy read’ version.

The registered manager told us the company sent out satisfaction surveys to people for them to comment on their experience of the service provided. However, people in the North Yorkshire area had not received this as yet. The registered manager told us this would be sent out shortly. The people in the South Yorkshire area had a survey sent in February 2015, but we did not see any completed returns.