The National Autistic Society operates Field View care home and it is registered to provide accommodation and personal care for up to a maximum of 8 people with autism and learning disabilities. There were 7 people living at the service at the time of this inspection. The service is situated in Goole and provides communal living and dining space, a sensory room and a large amount of safe outside space for people to access.

At the last inspection in March 2015, the service was rated good, although the well-led domain was rated as requiring improvement. We identified a breach in regulation for failing to establish and operate systems or processes to effectively assess, monitor and improve the quality and safety of the service. This included a lack of staff supervisions, staff and relatives meetings and reviewing of quality auditing. The registered provider sent us an action plan in response to the breach we identified stating what measures they were going to take in order to address the issues. At this inspection we found the registered provider had taken the action required of them to meet the regulation.

This comprehensive inspection took place on 1 June 2017 and was announced. At this inspection we rated all the domains as good and therefore the service remained ‘Good’.

The service had a manager who was registered with the Care Quality Commission (CQC) in March 2016. A registered manager is a person who has registered with the CQC 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.

We found improvements to the quality assurance systems at the service. The registered manager had implemented an effective quality assurance system which ensured the service was continually improving and a range of audits and checks were completed regularly to ensure that good standards were maintained. Staff were receiving regular supervision and team meetings were held frequently. People’s relatives were receiving regular updates in the form of a ‘letter home’ from the service.

People were relaxed with staff. Staff had a good understanding of how to safeguard adults from abuse and who to contact if they suspected any abuse. Risks assessments were individual to people's needs and minimised risk whilst promoting people's independence.

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's permission was sought before any care or support was given.

Staff demonstrated good communication with people and supported them to express their views. They had clear strategies and aids in place where people had difficulties with communication. The staff were familiar with the needs of people living with autism and learning disabilities.

Staff supported people in a positive way and were able to recognise when people may require additional support. They had received bespoke training to intervene when people were at risk from behaviour that may challenge others.

Staff were well supported and had access to additional training specific to people's individual needs. The training was monitored and refresher courses made available. We found some gaps in the training records at the service. We discussed this with the registered manager who addressed this immediately after the inspection and provided us with updated records and an action plan to ensure this remained relevant.

There were enough staff to provide a good level of interaction. Staff felt that they were able to contact the registered manager at any time if they needed support or guidance. People were supported by staff that had the knowledge and skills to understand and meet their health needs.

Effective recruitment and selection processes were in

Field View is a residential care home that provides accommodation for up to eight people who require support with their personal care and all aspects of daily living. The service supports people with Autism and Learning Disabilities. At the time of the inspection there were eight people permanently living at the service. The service has a communal lounge and dining area, sensory room and ample outdoor space featuring allotments and seating areas.

The inspection took place on 11 March 2015 and it was an announced inspection, which meant we provided the service with 24 hours notice before the inspection took place. We did this because the service is small and we wanted to ensure that the manager and some of the people who use the service would be available on the day.

During the inspection we spoke with one person living at the service. The reason we only spoke with one person was because the verbal communication of the people who used the service was severely limited. We also spoke with five support staff, one relative and the current manager. The service has a registered manager in place but they are on extended leave. The National Autistic Society has been using interim arrangements to cover the registered manager’s position by utilising managers from other services.

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. Since our inspection the Care Quality Commission has received a notification asking for the registered manager to be deregistered which means the service is currently without a registered manager.

The last inspection took place on 26 September 2013. At that inspection we found the provider was compliant with all of the standards we assessed.

We found that the service was safe in its delivery of care. Staff had a good knowledge of individual’s needs and knew how to keep people safe from harm. There were sufficient staff numbers to support and respond to people’s needs. Staff had been employed through robust recruitment procedures and we saw clear documentation for reporting and responding to accidents.

People had clear, personalised care plans in place which enabled staff to work towards goals and outcomes. Individual’s choices and preferences were clearly documented and risk assessments were in place to enable people to complete the activities they enjoyed whilst keeping risks minimised.

Staff told us they completed a variety of training from classroom based learning to computer e-learning programmes. The evidence we saw within the training records and from speaking with staff showed us that staff were equipped with the knowledge required to enable them to carry out their role effectively.

We saw that people living at the service took part in a range of activities. Information we received prior to our inspection from the local authority contracts team confirmed that lots of meaningful activities took place at the service.

Family and friends were able to visit the service whenever they wanted to and people living at the service were encouraged to participate in activities and daily living chores as much as possible.

People’s communication needs were taken into account and all staff used the Picture Exchange Communication System (PECS) to enable people with limited verbal communication to make choices and be involved in decision making.

We observed positive interactions between staff and those who used the service during our inspection. We saw people reading, singing and laughing together. Relatives told us they were happy with the care their loved one received living at the service.

Staff told us things had been unsettled at the service since the registered manager had gone on leave. We saw from records that staff supervision, team meetings and residents meetings had not regularly taken place. We found that quality audit records have not been reviewed or updated for over a year and although surveys requesting feedback had been sent out, a relative we spoke with said they never received any feedback from this process. Staff told us that now they had a new manager in the service things were improving and they were hopeful things would get better.

This was a breach of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2010, now replaced by the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see what action we told the provider to take at the back of the full version of this report.

Field View is a service for people with Autism and related conditions. We found that people who used the service were well cared for and the support provided was personalised to the individual. Care plans were detailed and gave staff clear guidance on the ways people wanted to be supported. There was a varied activity timetable available for people. One person told us “I do lots of things I like”.

We looked at the ways nutrition was managed and found people were able to choose what they ate and where necessary weight and dietary intake was monitored effectively. The service was clean and hygienic and infection control procedures were followed well by staff.

We found that staff were well supported to carry out their roles and were able to access a wide variety of training. Staff supervision and appraisals were regular and thorough. One staff member told us “My progress and performance is discussed at each supervision meeting, which is really useful”. There was a robust system in place for monitoring the effectiveness of the service and people who used the service and families were involved in the development and improvement of the service.

We observed that staff were supportive in their roles and reflected a good knowledge of how people who used services communicated with others. Staff had knowledge of people's individual needs.

People were supported through a care planning process to have their needs met and care plans included a large amount of information about the individual and how they were to be supported.

We saw that there was a staff recruitment process in place and that all staff had completed this to help ensure that people were only supported by staff suitable for the role.

We saw that staffing levels ensured support to maintain peoples one to one hours and that any shortfalls were covered by regular staff in the home.

There was a quality assurance system in the home that included the views of relatives and was being developed to include the views of people who lived in the home.

Some people who lived in the home had complex needs and we were unable to verbally communicate with them about their views and experiences