The inspection took place on 10 and 13 December 2018 and 8 January 2019 and was unannounced. The inspection was bought forward due to concerns we had received.

The last comprehensive inspection took place in November 2017, when the provider was rated as good. At this inspection we found the service had declined and was rated inadequate. You can read the report from our last inspections, by selecting the 'all reports' link for ‘Rother Heights’ on our website at www.cqc.org.uk.

Rother Heights is a care home. People living in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

The care service had not been developed and designed in line with the values that underpin the Registering the Right Support and other best practice guidance. The values of choice, promotion, independence and inclusion, which the guidance promotes were not being provided for people who used the service at Rother Heights. This meant the people they supported with learning disabilities and autism were not able to live as ordinary a life as any citizen.

Rother Heights can accommodate up to 28 people. At the time of our inspection 26 people were using the service. The service comprises of a complex of four bungalows and an office block. Each bungalow has six bedrooms with en-suite facilities. There are also two other houses nearby which can each accommodate up to two people.

At the time of our inspection the service had 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. However, the registered manager was not at the service at the time of our inspection and there were two regional managers overseeing the service.

Risks associated with people’s care and treatment were not always identified or managed safely. This put people at risk of not receiving the right support to meet their needs and showed the registered provider was not doing all that was reasonably practicable to mitigate risks associated with people's care and treatment.

We completed a tour of the home and found a number of environmental risks which had not been identified prior to our inspection.

We found risk in relation to fire safety that had not been managed.

Accident and incident analysis was not taking place effectively and there was no evidence that trends or patterns were being identified, or that actions had been taken to reduce hazards in relation to people's care.

Medication systems were not followed; therefore, it was not evident people received their medication as prescribed.

People were not effectively protected from the risk of abuse. The registered provider had a system in place to safeguard people from the risk of abuse. However, we found staff did not always communicate effectively to ensure safeguarding concerns were reported to the safeguarding authority. During this inspection we identified two safeguarding concerns which were reported to the safeguarding authority.

The provider did not ensure that there were enough numbers of suitable staff to support people to meet their needs. We saw staff took breaks without replacing their role and people were not supported by the assessed number of staff required to meet their needs.

The provider ensured that staff received training to carry out their role. However, training was not effective. Staff told us they received one to one sessions with their line manager but there was no evidence to support this.

People’s needs and choices were assessed but care and treatment was not always delivered in line with current legislation and standards.

People were not alway

We inspected Rother Heights on 12 October 2017, the inspection was unannounced. The service was last inspected in September 2015 when it was rated as 'good'. Although the effective domain was rated as ‘requires improvement’ as we found some issues with staff supervision and training. At this inspection we found the service remained 'Good' and improvements had been made to the effective domain

Rother Heights provides accommodation for up to 28 people and specialises in care for people with autism. The service is a purpose built complex comprising of four bungalows and an administration block. Each bungalow has six single bedrooms with en-suite facilities. There are also two other houses nearby which can each accommodate up to two people.

There was a registered manager employed at the service. 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 responsible for the day to day control of the service.

People continued to receive care and support from staff who understood how to keep them safe. Staff understood how to protect people from abuse and were clear about the steps they would need to take if they suspected someone was unsafe. Staff were available to meet people's needs and understood how to best support people and the risks to their well-being. People were supported by staff to have their medicines as prescribed and checks were made to ensure staff supported people with their medicines appropriately.

People received effective care and support from staff that had the skills to meet their individual needs. Staff were supported by the management team through regular supervisions and staff meetings. Staff understood they could only care for and support people who consented to being cared for and throughout the inspection we saw people supported to communicate their choices. Staff supported people in the least restrictive way possible; the policies and systems in the service supported this practice.

People were supported to have a balanced diet. People were involved in decisions about what they ate. Staff monitored people's nutritional needs to help them stay healthy. Risks to people with complex eating and drinking needs were identified and monitored. We saw people were encouraged to be involved in the preparation of food and drinks. Staff responded when people were unwell and arranged appropriate healthcare appointments in support of people's well-being.

People continued to receive support from caring staff who treated them with dignity and respect. We saw people were happy in the company of staff, who they looked to for support and reassurance when needed. People were involved in how their care and support was received and their choices were respected by staff.

The service remained responsive. Staff provided care that took account of people's individual needs and preferences. People and their relatives were listened to and felt confident they could raise any issues should the need arise and action would be taken.

There was a culture of openness, inclusivity and empowerment which was promoted by staff. Clear visions and values were understood and promoted by staff to make sure people received care and support in a dignified, respectful and compassionate way. Robust auditing processes were in place to check the quality and safety of the service provided. The registered manager had submitted notifications about important events that happened to CQC in an appropriate and timely manner and in line with guidance.

The inspection took place on 17 September, 2015 and was unannounced. The service was registered with the CQC in December 2014 so this was the first inspection of the service under the new registration.

Autism Care UK’s location at Treeton in Rotherham is known as Rother Heights. It provides accommodation for up to 28 people and specialises in care for people with autism. The service includes a purpose built complex comprising of four bungalows and an administration block. Each bungalow has six single bedrooms with en-suite facilities. There are also two other houses nearby which can each accommodate up to two people.

The service had a registered manager in post at the time of our 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 legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

We looks at policies and procedures in place to safeguard people from abuse. These were clear and concise and explained different types and how to recognise abuse, as well as how to report abuse.

The provider had safe arrangements in place for handling medicines. We spoke with a team leader who explained the procedure in place. They were knowledgeable about the policy and felt trained to administer medicines.

The service had a staff recruitment system which was robust. Pre-employment checks were obtained prior to people commencing employment.

We saw there were enough staff available to meet the needs of people living at the service. Staff told us they worked as a team.

We looked at records in relation to training and found the service had a training matrix in place to record when staff had completed training. We saw this was out of date and did not reflect some of the comments made by staff.

We found the service to be meeting the requirements of the Mental Capacity Act (MCA) and Deprivation of Liberty Safeguards (DoLS). The staff we spoke with had a good knowledge of this and were involved in best interest meetings with other professionals.

Staff told us that where possible people were involved in planning menus. People’s likes and dislikes were taken into consideration when menu planning.

People who used the service had access to health professionals as required. Staff ensured appointments were kept and that people were supported to attend them.

We observed staff interacting with people and found them to be understanding of people and their different needs. There was a clear ethos of person centred care and staff were caring and professional in their manner.

Support plans were in place to ensure people’s needs were met. Support plans were reviewed on a monthly basis to ensure they reflected the current needs of people.

The service had a complaints procedure and people knew how to raise concerns.

We saw systems in place to assess and monitor the quality of the service. Each house manager had the responsibility of ensuring the service worked well.

People were able to contribute their opinions and ideas and they felt listened to.