Kingwood – Domiciliary Care provides personal care to people living in their own homes so that they can live as independently as possible. They specialise in providing services to people with autistic spectrum disorder, some of whom may also have learning disabilities. At the time of our inspection there were 34 people using the service. Of those, 28 people lived in shared accommodation in supported living facilities and six people lived on their own in the community. The provider, Autism at Kingwood, provides support to a total of 142 people with autism living in the community. However, this inspection and report only relates to the 34 people receiving the regulated activity of personal care. Their care and housing are provided under separate contractual agreements. CQC does not regulate the premises people live in, this inspection only looked at people’s personal care and support. Those receiving support but not receiving personal care are outside the regulatory remit of the Care Quality Commission (CQC).

At our last inspection in November 2015 we rated the service as good overall, with a rating of outstanding in the responsive domain. At this inspection we found the evidence continued to support the same rating and the service continued to meet all the fundamental standards of quality and safety. There was no evidence or information from our inspection and ongoing monitoring that demonstrated serious risks or concerns. This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection.

This inspection took place on 28 February and 6 March 2018. We gave the registered manager 48 hours' notice because the location provides a domiciliary care service and we needed to make sure someone would be in the office.

Why the service is rated good:

People benefitted from staff who were trained and had an in depth knowledge and understanding of people with autistic spectrum disorder and the individuals they worked with. Staff used those skills when developing care plans that were highly individualised to each person. The service was responsive and proactive in recognising and adapting to people's changing needs. Staff were innovative in exploring ways to help people overcome their anxieties, learn new skills and lead a more fulfilling life. People and their relatives knew how to raise concerns and confirmed they, or their family member, were listened to and taken seriously if they did.

Staff were positive about the work they did with the people who use the service. The majority of staff who responded to our requests for feedback felt supported by the management and felt the support they received helped them to do their job well. Some staff did not feel confident about reporting concerns or poor practice to their managers. Some also felt their managers did not always deal effectively with concerns they raised. These concerns were passed to the registered manager and plans were being developed to explore and resolve those concerns by the end of our inspection. Quality assurance systems were in place to monitor the quality of care being delivered and the running of the service.

People were protected from abuse and supported to make their own choices. Risks were identified and managed effectively to protect people from avoidable harm. Recruitment processes were in place to make sure, as far as possible, that people were protected from staff being employed who were not suitable. There were sufficient numbers of staff and staff were trained to handle medicines correctly.

People benefitted from a staff team that was well trained and supervised. Staff had the skills and support needed to deliver care to a good standard. We have made a recommendation that future ongoing staff training be updated in line with the latest best practice guidelines for social care staff.

People were supported to have maximum choice and control of their lives and staff supported them in the

This inspection took place on 23 and 24 November 2015 and was announced. We gave the registered manager 48 hours' notice because the location provides a domiciliary care service and we needed to make sure someone would be in the office. We last inspected the service on 2 and 3 December 2013. At that inspection we found the service was compliant with the essential standards we inspected.

Kingwood – Domiciliary Care provides personal care to people living in their own homes. They specialise in providing services to people with autistic spectrum disorder, some of whom may also have learning disabilities. At the time of our inspection there were 39 people using the service. Of those, 23 people lived in shared accommodation in supported living facilities and five people had their own flats in an extra care setting. The remaining people either lived on their own or with their family. The provider, The Kingwood Trust, provides support to 102 people with autism living in the community. However, this inspection and report only relates to the 39 people receiving the regulated activity of personal care. Those receiving support but not receiving personal care are outside the regulatory remit of the Care Quality Commission (CQC).

The service had a registered manager. 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. The registered manager was present throughout the inspection.

People were protected from the risks of abuse. Staff knew how to recognise the signs of abuse and knew what actions to take if they felt people were at risk. They were protected from risks associated with their health and care provision. Staff assessed such risks, and care plans incorporated measures to reduce or prevent potential risks to individuals.

People received effective care and support from staff who were well trained and knew how people liked things done. Staff received effective supervision and their work was reviewed in yearly appraisals.

People's rights to make their own decisions were protected. Managers and staff had a good understanding of the Mental Capacity Act 2005. They were aware of their responsibilities related to the Act and ensured that any decisions made on behalf of people were made within the law and in their best interests.

People were treated with care and kindness and they were supported to be as independent as possible. Their wellbeing was protected and all interactions observed between staff and people using the service were caring, friendly and respectful. They benefitted from having staff who had an in-depth understanding of their individual problems and challenges and who were skilled at minimising the effects of those issues on their daily lives. Staff showed great skill in helping people remain calm and not get anxious in situations that were difficult for them. Staff were also very good at helping people understand what was happening so that they were not anxious or uncomfortable.

People received support that was individualised to their personal preferences and needs. They benefitted from a service that was responsive and innovative in finding new ways to help people reach their full potential and live the life they wanted. The provider had initiated and taken part in a number of research projects to help find ways to improve and explore ways of working with people. A social care professional told us the service was led well from the top and were fantastic at doing things differently. A relative commented that their family member did a lot more for himself and that staff were very good at giving him the opportunity to do as much for himself as he possibly can

People benefitted from receiving a service from staff who worked in an open and friendly culture and

People expressed their views and were involved in making choices about their care. People we spoke with told us staff treated them with respect and supported them to make their own choices. This was confirmed by relatives of people using the service we spoke with.

We looked at people's support plans and found their needs were assessed, and care and support was planned and delivered in line with their individual needs.

People using the service were protected from the risk of abuse because the provider had taken reasonable steps to identify the possibility of abuse and prevent abuse from happening. People told us they trusted staff and felt safe in their care. One person using the service told us “I feel safe when staff are with me, I trust them.”

The provider had a robust recruitment process in place to ensure people who use the service were not placed at risk of being cared for by inappropriate staff.

An appropriate complaints system was in place. One relative told us when they had raised any issues in the past with the management they had been resolved to their satisfaction.

As part of this inspection we contacted people, who use Kingwood Domiciliary Care, by telephone.

People told us they had received information prior to deciding to use Kingwood Domiciliary Care. Their needs were assessed by the manager and they were fully involved in how their care was delivered.

They told us staff respected their dignity and rights. They were fully involved in developing and agreeing how their care and support was delivered.

Everyone we spoke to was very complimentary about the staff.

People told us that they had plenty of opportunities to get involved in having their say about how the service is run. They also told us that they were confident that if they reported any problems, they would be dealt with.

Relatives of people who use the service we spoke with were complimentary about the quality and consistency of care received for their family members. One relative of a person who uses the service told us, “X is always happy when they (staff) come to provide X’s care.”

We used a number of different methods to help us understand the experiences of people who use the service. This is because the people who use the service had complex needs which meant not all of them were able to tell us their experiences. We spoke with five people. The expert by experience talked with people, their relatives and staff. The expert by experience observed staff interactions with people. The specialist advisor looked at a sample of peoples’ assessments and support plans. The specialist advisor spoke with staff and observed their interactions with people.

Care was planned with the involvement of the people and their relatives. Support plans reflected their individual needs. The provider had put measures in place to ensure that users of the service were safeguarded against the risk of abuse by identifying and responding appropriately to incidents involving allegations of abuse.

A system of staff supervision and appraisal was in place to support workers. Staff did received appropriate training and professional development to enable them to deliver care and treatment to people safely and to an appropriate standard.

There were systems for monitoring the quality and safety of services provided to people. These included recording and investigating complaints and collecting feedback from people using the service and their relatives. Spot checks by management were in place to monitor the quality and safety of services provided to people in their own homes.

People’s records and other records relevant to the management of the service were accurate and fit for purpose. People's records were stored securely in each person’s home and accessible only by the person who uses the service, care workers and management.