The care home at 7 The Cedars is a residential service for up to seven people with autism spectrum condition. The accommodation for six people is within a large detached Victorian house and the seventh place is within a separate coach house in the grounds. The home is opposite parkland and is close to the city centre. At the time of this visit there were seven people using the service.

At the last inspection, the service was rated Good.

At this inspection we found the service remained Good.

People actively sought out staff to spend time with and appeared comfortable in their presence. Relatives said the service was very safe for people. There had been few occasions where the service had made safeguarding referrals to protect the people who lived there. Staff were regularly trained in safeguarding processes. The local authority told us that the service took appropriate action to deal with these.

There were enough staff to support the seven people both in the house and out in the community at leisure events. The organisation vetted potential new staff to make sure they were suitable to work with people. Staff were trained in medicines management and supported people with their medicines in a safe way.

Staff felt well-trained and supported to carry out their roles competently. The cook was knowledgeable about people’s individual nutritional needs and also supported people towards greater independent cooking skills where possible.

People were supported to have maximum choice and control of their lives and staff assisted them in the least restrictive way possible; the policies and systems in the service supported this practice. All staff were trained in how to support people when they are agitated or upset. This involved the least physical or restrictive intervention.

Relatives said staff were “genuinely very caring” and went beyond the call of duty. Staff supported people in a friendly and encouraging way that promoted their decision-making skills. Staff were skilled at understanding and respected people’s individual communication methods.

Staff understood each person and supported them in a way that met their specific needs. Each person had a range of social and vocational activities they could take part in if they chose.

The registered manager had worked at the service for several years. They were passionate about the continuous development of the service for the people who lived there. Staff said the management team were open and approachable. They felt very well supported by the management team and by the organisation.

The provider had effective quality assurance processes that included checks of the quality and safety of the service.

Further information is in the detailed findings below.

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008 and to pilot a new inspection process being introduced by CQC which looks at the overall quality of the service.

Education and Services for People with Autism - 7 The Cedars provides care and support for up to seven people who have autism spectrum condition. The accommodation for six people is within a large detached Victorian house and the seventh place is within a separate coach house in the grounds. The home is opposite parkland and is close to the city centre. At the time of this visit there were six people using the service.

This was an unannounced 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 and has the legal responsibility for meeting the requirements of the law; as does the provider.

People were unable to tell us about the service because of their complex needs. Their relatives made many positive comments about the service people received. Relatives said people felt safe and settled at the home. Relatives felt included in decisions about their family member’s care.

Staff understood the Mental Capacity Act 2005 for people who lacked capacity to make a decision and Deprivation of Liberty Safeguards to make sure they were not restricted unnecessarily. Relatives confirmed they had been involved in the agreements about keeping people safe and that people enjoyed fulfilling lifestyles that did not compromise their rights.

Staff were clear about how to recognise and report any suspicions of abuse. Staff told us they were confident that any concerns would be listened to and investigated to make sure people were protected.

There were sufficient staff to meet people’s needs. Staff provided one-to-one support for some people and additional support when people were out in the community. Staff received relevant training to assist each person in the right way.

People were supported to enjoy a healthy lifestyle that included healthy diets which met their individual dietary needs. People had choices about what, where and when they ate their meals. There was a calm, supportive atmosphere in the home and there were positive interactions between staff and the people who lived there.

People were treated with dignity and respect. People were encouraged to make their own choices and decisions about their day to day lives, wherever their capabilities allowed. Staff were respectful of people’s individual and diverse needs.

Relatives told us they felt people were well cared for in the home. They said any changes in people’s health were referred to the relevant health care agencies. The health care professionals we spoke with felt the home responded quickly and appropriately to any changes in people’s needs.

People and their relatives were asked for their views about the home and their suggestions were used to improve the service. People and relatives had clear information about how to make a complaint or comment.

The provider involved people and their relatives in reviews about the care service. Relatives and staff felt there was an “open” and “approachable” culture within the home and in the organisation.  Staff said they felt valued and fulfilled in their roles. They felt they could make any comments and were confident these would be acted upon.

There were six people living at the service when we visited. We were not able to talk to people about their experiences of care, but we observed interactions between staff and people at the service. We observed that people were treated with respect and encouraged to express themselves.

We found that people's needs were assessed and reviewed and their health and wellbeing was monitored and supported. People were supported to take part in activities that they liked. The service also had arrangements for dealing with emergencies.

We found that the people who were using the service were protected from abuse as the provider had procedures in place for the staff to follow if they suspected anyone was at risk of abuse.

We found that the provider has taken steps to provide care in an environment that was suitably designed and adequately maintained.

There had been no complaints about the service in the past year and procedures were in place to obtain people's views.

We found that some records, which the provider is required to keep, to protect the peoples' safety and wellbeing, were being stored securely and could be located promptly when needed. For example, the care records were kept in secure cabinets.

During the inspection, the staff members on duty were observed speaking to people in a kind and respectful way. We also observed that the people were clean and well groomed.

We haven’t been able to speak to the people using the service because all who were using it had complex needs, which meant they were not able to tell us their experiences. Although one person did provide us with some comments. However, we gathered some evidence of people’s experiences of the service by reviewing the care records, surveys and observing care practice.

Staff members on duty were observed speaking to people in a kind and respectful way. We also observed that the people looked clean and well groomed. One person commented, “I am going out today”.