About the service:

¿ NAS Community Services (Harrow) provides care and support to people with learning disabilities and/or autism living in a ‘supported living’ setting, so that they can live as independently as possible. People’s care and housing 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.

¿ The service supported people to live in a two-bedroom semi-detached house that was situated in an ordinary residential area and blended in with its surroundings. People had their own bedrooms and one of these had an en-suite bathroom. People shared the rest of the house and garden. There was an additional sleeping-in room for staff staying overnight. A team of care staff supported people during the day and there were two staff on shift during the night. The service was supporting one person when we inspected. For more details, please see the full report which is on the CQC website at www.cqc.org.uk.

People’s experience of using this service:

¿ Some aspects of the service were not consistently safe as the provider did not always ensure the safe and proper management of medicines. The provider could not always ensure that people received their ‘when required’ prescribed medicines as intended. The provider had not sufficiently assessed staff to ensure that they were competent to give the medicines support being asked of them. The provider did not always accurately record the amount of medicines stored at the service.

¿ Some aspects of the service were not consistently responsive as people’s care plans did not fully reflect their physical, mental, emotional and social needs. We have made a recommendation about developing person-centred care.

¿ Some aspects of the service were not consistently well-led as the quality checking systems had not identified and addressed the issues we found regarding the safe management of medicines and the person’s support plan.

¿ One relative told us, “I'm a fan of the National Autistic Service. They know what autism is, it’s not just any staff coming in. I can’t think of [the person] being with anyone else.”

¿ Staff were aware of the person’s individual needs, preferences and routines. They used their knowledge to deliver person centred care. Relatives felt that staff cared and treated them with respect and dignity. Staff were responsive to the person’s needs.

¿ The service provided people with activities that were meaningful to them and they could choose how they spent their time.

¿ Staff received induction, training, supervision and support to perform their roles effectively.

¿ Staff supported people to manage behaviours that may challenge others in line with best practice.

¿ The outcomes for people using the service mostly reflected the principles and values of Registering the Right Support in the following ways. People's care and support was planned and coordinated but the care plans were not as person centred as they could have been. People had a choice about who they lived with. People were supported to maintain their home the way they wanted it. People’s family and support staff were involved in supporting the person to live in the community. Support focused on promoting people’s choice and control in how their needs were met. Support and interventions were provided in the least restrictive ways and staff promoted a relaxed home environment. This approach promoted people with learning disabilities and/or autism to live an ‘ordinary’ life as any other citizen.

¿ We identified breaches of regulations in relation to safe care and treatment and good governance. You can see what action we have asked the provider to take within our table of actions.

Rating at last inspection:

¿ We rated the service “good” at our last inspection. We published our last report on 8 July 2016.

Why we inspected:

¿ This inspection was part of our scheduled plan of visiting services to che

This inspection took place on 8 and 11 July 2016 and was the first inspection of the service. On 8 July we visited the service’s office and met with the registered manager. On 11 July we visited the home of the person using the service to meet them and speak with support staff. Both visits were announced as this is a small service and we needed to be sure people would be available to assist with the inspection. We gave the provider 48 hours’ notice of our visit on 8 July and arranged to complete the inspection on 11 July.

NAS Community Services (Harrow) is a supported living service that provides care and support to people on the autistic spectrum living in their own homes. When we inspected, the service was supporting one person.

The service has a registered manager. 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.

People using the service were protected because staff understood the types of abuse that might occur and knew what to do if they had concerns about a person’s welfare. All support staff had completed safeguarding adults training.

People using the service received the medicines they needed safely. Staff stored medicines securely and kept accurate records each time they supported people with their medicines.

The provider carried out checks to make sure new staff were suitable to work with people using the service and there were enough staff to meet people’s care and support needs.

The provider supported staff and provided the training they needed to work with people using the service.

The provider and registered manager understood the principles of the Mental Capacity Act 2005 and had followed its requirements. Staff supported people using the service to make decisions about their care and support.

The service was responsive to people’s health care needs and people were able to access the healthcare services they needed.

People using the service were able to choose where they spent their time. They spent time in their room when they wanted privacy and in communal areas when they wanted to be with support staff.

We saw very positive interactions between support staff and the person using the service and staff respected the person’s privacy.

The provider made information available to people using the service and their relatives on how to make a complaint.

Support staff had a good understanding of the person’s support needs, routines and preferences.

The service had a manager who was registered with the Care Quality Commission (CQC).

People’s relatives and staff told us managers were approachable and supportive.

The provider had systems in place to monitor quality in the service and make improvements.