This inspection took place on 2 October 2017 and was announced. Carricks Brook provides accommodation and care for up to 12 people, specialising in care for adults with autism, learning disabilities and challenging behaviour. On the day of the inspection, 11 people were living at the service.

The service had a registered manager in post, who was present during the 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 a legal responsibility for meeting the requirements in the Health and Social care Act 2008 and associated Regulations about how the service is run.’

At the last inspection on 24 May 2015, we had no concerns and the service had an overall rating of ‘Good.’ At this inspection, we found that the service remained Good.

People and relatives told us that the service was safe. People were protected from risk of harm and abuse because they were encouraged to think about and express what made them feel safe and staff understood and were confident on how to report and respond to any concerns. Incidents and risks to peoples’ wellbeing and their independence were assessed, recorded, reviewed and lessons acted on. People were encouraged to be involved in how staff supported them when they experienced behaviours that could put them or others at risk of harm. Staff used communication tools to help people understand and communicate how they felt before, during and after the behaviour and any restraint that was used to reduce the risk to their or another’s wellbeing.

Relatives and staff told us there were suitable levels of skilled staff available to meet people’s needs safely. The provider had safe recruitment procedures in place to ensure people were supported by caring and responsible staff. People received their medicines safely and staff were trained and competent in the administration, ordering, storage and auditing of medicines.

People told us that staff were trained and helped them with what they needed. One person told us, “We go out together, they helped me get a gaming chair and they help with things at home”. Another person told us that staff were, “There when they needed them”. Relatives told us that staff were skilled and well trained in the needs of people with autism. Staff were supported to develop their skills and knowledge effectively through training and told us they were well supported by regular supervision and appraisals with their manager. One staff member told us, “I have monthly supervisions which are beneficial; you need to discuss things and be open”.

Staff understood that the needs and capacity of people with autism and additional needs such as dementia changed and always sought consent when supporting people with their care needs. Staff had received training on the Mental Capacity Act (MCA) 2005 and understood the principles and importance of gaining consent.

People’s nutritional needs were met and they had sufficient control over their food and drink choices. People were supported to maintain good health and had access to healthcare professionals. A relative told us their relation was, “Always fit and healthy”. All health appointments with, or visits by health care professionals were recorded and acted on.

People and their relatives told us and we saw that the staff were caring and respectful. One person told us, “They’re nice staff here”, and a relative told us, “They are caring and look after my loved one.” Care and support provided was personalised and met peoples’ diverse needs. People and their relatives were included in the assessment of their needs and development of care plans. One relative told us, “The staff surprise me with new ideas. My relative now has varied interests and they are well engaged with them. They are now trying drama and singing. It all adds to enrichment”.

People were encouraged to be as independent as poss

This inspection took place on 24 August 2015 and was unannounced. The inspection was carried out by two inspectors and an expert by experience.

Carricks Brook is a home specialising in providing support for up to twelve adults with autism, autistic spectrum disorders and challenging needs. It is located in an extended former farmhouse which has twelve en-suite bedrooms and a large garden.

At the time of our inspection there were eleven people being supported to live at the home with autism, learning disabilities and behaviours that challenged. Not all the people were able to communicate verbally with us. Some people used signing or body language to express themselves. Staff at the home knew people well and were able to support them to tell us about their experience of living at Carricks Brook.

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.

Relatives were full of praise for the staff and the care their loved ones received at the home. One told us, “I could not have found a more amazing provision for X. Their own personal care has improved. Their self-confidence, ability to make choices and understanding of consequences has just been brilliant.” Another said, “They give X a huge amount of time and a lot of patience.”

Staff were knowledgeable about safeguarding adults. They were able to describe what constituted abuse and knew who to contact if they had any concerns to keep people safe.

Staff were trained in the management of people’s behaviours which challenged. They had also received training in how to restrain people safely as a last resort. Any use of restraint was documented, reported to relatives and discussed at staff meetings as a learning process.

Staff received regular training including specific areas to help them support people living at the home. This included training about supporting people living with epilepsy, autism awareness and diverse communication methods.

Staff had a good understanding of managing risks and supported people to lead fulfilling lives and take part in activities both in the home and in the community.

People were supported by staff to maintain relationships that were important to them. There was a strong emphasis on person centred care. People were involved in planning their support and this was based on their personal needs and wishes. People had key workers who reviewed their support plans with them and adjusted them as people’s needs changed.

People were encouraged to participate at residents’ meetings and express their views. These were held regularly and used to plan menus, activities and special events.

The provider’s complaints procedure was available in a pictorial format to ensure all people were aware of the process.

Staff felt part of a team and valued by the registered manager. They told us their ideas were listened to. The running of the home was subject to regular reviews by the registered manager and the provider to make sure standards were maintained and the provider’s values for the home were followed. These included enabling people to live as full and independent lives as possible and to help people achieve their personal goals whilst keeping them safe.

During our inspection we spoke with two people who used the service, four members of staff including the deputy manager, two team leaders and a support worker. We also looked at relative and resident surveys to help us understand the views of the people who used the service.

One person we spoke with told us “I like it here and I like to go shopping and the gym three times a week”. Another person we spoke with communicated with us through a tablet computer and told us they enjoyed the food there and could communicate with their family on the device and liked their self contained room.

Staff we spoke with really enjoyed working at the home and felt they were a great team. If they needed additional training and support they felt their manager was always there to help them. One person told us “I love it, taking the residents out and helping them to reach their goals “.

We also looked at staff records, care plans and policies and procedures.

During our inspection we spoke to three people who used the service, three members of staff and the manager. We looked at nine sets of records and observed how care, treatment and support were provided and delivered.

We found that people's needs were comprehensively assessed before and during the service. The planning and delivery of care met the people's individual needs. People who used the service told us "I like it here, I do what I want". Another person told us "It is the best place, people are kind, we laugh a lot, I love working on the computer and I love my big bedroom".

The service had a strong safeguarding policy and clear procedures in place. The staff had received all updated training relevant to their roles and could access additional training. One member of staff told us "I work for the guys, they are what matters". The service provided appropriate training, supervision and appraisals, and encouraged the staff to improve their knowledge, skills and qualifications. One care worker said "I am studying for a diploma and I have been given time to study ". Another member of staff stated "We get loads of support but sometimes we are too busy to consult more experienced staff".

We found that the service took people who used the service's comments and complaints into account when delivering care, treatment and support.