Membership review for Options Bredon House

By – Date of visit:

The membership review is intended to reflect the experiences of the visitor who might be looking for a placement. The review is subjective, consistent and impartial, representing the impressions of our team member on the day of the visit.  It is a snapshot view only.

The contents of this review are intended to cover some of the subjects and issues which an individual, their relatives or their placement officer might ask.

This review has been published with the written agreement of the home owner, or an authorised representative of the company.

Summary of findings

Bredon House is a new service, just six months old when I visited in April 2013. It is set in Powick near the city of Worcester. Bredon House essentially comprises of eight self-contained flats of varying sizes. Although Bredon House is registered as a residential establishment the feel is more akin to a supported living arrangement which is very much the idea.  It was impressive that the young people living at Bredon had as much autonomy as possible and  that clearly staff were prepared to take managed risks with individuals. Bredon House also has access to the Options Group Professional and Clinical Multidisciplinary Team who are based down the road at AALPS Midlands. The team includes a Psychologist, an Assistant Psychologist, a Speech and Language Therapist and an Occupational Therapist.

This would, in my opinion, be an ideal service for individuals who would be classed as having higher functioning autism to prepare them for a move into a supported living arrangement.  Often, individuals are moved into supported living too quickly, and a service like this provides a vital link in the chain that, for me, gives a clear pathway to independence.

Introduction

Based in the small town of Powick, Bredon House is situated in a very peaceful rural location. The accommodation consists of eight independent flats each with bedroom, en-suite bathroom, kitchen/diner and lounge. On the day of the visit every individual residing at Bredon had their own key fob to access the main door and keyed entrance to their flat. There is also a central lounge area where the individuals residing at Bredon and the staff can spend time. Bredon House sits just a few miles outside Worcester and there is a bus stop within easy walking distance of the house providing easy access to both Worcester and Malvern.

First Impressions

Bredon House is set adjacent to a large modern estate of detached houses. On approach you would not actually think that Bredon is a residential care home; on the day of the visit, to me; it looked like a small refurbished block of flats. I rang the doorbell at the front of the building and a member of staff greeted me and took me inside whereupon I was asked to make an entry into the visitor register. I was then taken through to meet the Registered Manager, Paul Whitefield. The main building requires a fobbed entry and each individual residing at Bredon has keyed entry to their flat.

The Environment (External)

As previously mentioned, I felt on the day of the visit that the building had the atmosphere of a refurbished block of flats rather than a care establishment. There was plenty of space for parking and the area itself around Bredon House was really quiet with very few cars passing.

The property has quite a large grassed area to the rear with some seating and a picnic bench and a vegetable growing plot had recently been prepared. The grounds were well maintained and tidy.

The Environment (Internal)

The house still had a newly decorated feel having been only fairly recently renovated. That is not to say that it did not feel homely, far from it. Paul Whitefield (Registered Manager) showed me round the building. At the time of my visit, all the individuals living at Bredon were either out or had yet to emerge so it was not appropriate to enter any of the occupied flats. I did, however, view an empty flat which was tastefully furnished but essentially left as a blank canvas. I particularly liked the communal lounge idea where both staff members and those residing at Bredon could mingle informally; only at certain agreed points of the day would staff members be able to have time alone. There was also a well stocked games room in the basement with a pool table and Nintendo Wii set up.

I saw no damage to anything internally or externally and everywhere I saw was ordered, tidy and uncluttered.

The Wider Environment

The close proximity of Worcester to Bredon House means that a whole host of amenities are easily accessible including supermarket and shops. Most individuals had bus passes. The individuals residing at Bredon are expected to shop and cook for themselves, although support is given when and where it is required. Bredon House has its own designated vehicle, but this is used on rare occasions, usually to transport individuals home to family when the distance might be prohibitive for some individuals.

Understanding Autism

The Registered Manager, Paul, has many years of experience of working with individuals with autism and he demonstrated to me a very clear vision of the ethos of Bredon House. As well as an understanding of autism amongst the staff there was an even greater focus on the understanding of the individual, the needs being many and varied. Individuals who required a greater structure to their day were given that, however, developing a person’s autonomy is a key focus.

Whilst the majority of individuals residing at Bredon would usually communicate verbally, one individual at the time of the visit was an elective mute who was able to communicate with a medium of his choice. Several individuals had only recently arrived at Bredon and it felt to me, from the issues discussed, that the most important thing initially was to make sure each individual felt safe.

The staff team were very flexible; individuals who needed less support could opt not to work with staff whilst other individuals required, in terms of their needs and their risk assessments, one-to-one staffing.  From the information received on the day, I got a strong feeling that the management and the staff are very proactive and very upfront and honest with individuals. It was also great to hear how each person had been supported to attend a variety of clubs and meetings that addressed interests and issues that affected them beyond their autism.

Health and Wellbeing

All staff working at Bredon House receive medication training, some of it delivered by Boots the Chemist in an online package.

Several individuals residing at Bredon House were looking after their own medication and their rooms were provided with appropriate storage facilities including one individual who was taking a controlled drug. This had been thoroughly risk assessed and agreed by the placing authority and monitored closely at regular intervals. Paul Whitefield reported that there had been no issues or concerns around this arrangement and the individual had responded well to the responsibility placed upon them.

Essentially, the individuals living at Bredon are allowed to make mistakes and learn from them and because of the supportive and nurturing environment it means that issues do not escalate.

As mentioned in a previous section, individuals residing at Bredon House are expected to shop and cook for themselves and again they are supported where necessary around budgeting, but have autonomy around what they purchase food-wise. Staff encourage healthy eating and healthy options.

Individuals in the home

All the individuals residing at Bredon House at the time of the visit could be categorised as having higher functioning autistic spectrum conditions, although at least one individual I believe had no formal diagnosis. As stated previously the needs of individuals were many and varied and were managed with support from the clinical team based at AALPS Midlands. Some individuals were helped to access support and guidance from other groups and services within the community. Individuals undertake a variety of activities and some undertake voluntary work. One person is supported to undertake talks and lectures across the country whilst a couple of others were attending college and one young lady was due to begin a hair and beauty course. Paul had also introduced a couple of individuals to bee-keeping.

Individuals residing at Bredon House meet together on a regular basis; input for the meetings is also sought from those individuals not wanting to attend the formalised meeting.

There have been occasions where staff have had to manage one individual’s unrealistic expectations and this appeared to have been handled in a sensible and sensitive manner.

I was really pleased to hear that a person I had met previously several years ago was now settled and attending college. In fact, she also had her own car and was driving herself there. She was also managing all her own finances and only required minimal support. This is testament to the support she had received from the Options Group over the years and was continuing to receive in a more independent environment.

Some individuals had a money management plan in place to support them to develop skills in budgeting and payment of utility bills.

Staffing

I was able to speak to a couple of members of the staff team. The atmosphere was relaxed but focused. When staff had been recruited, references and Disclosure and Barring Service checks were made and no new staff members were allowed to start work before clearance had been achieved. New staff undergo a three week induction period before actually beginning to shadow present staff on site. The induction period runs over 6 months.

There is a staff handbook available and Options Group policies and procedures are available via the Options Group own intranet, as well as in paper form on site.

All staff working at Bredon House are trained in the use of PRICE (Protecting Rights In a Caring Environment) which can ultimately involve physical intervention to prevent individuals harming themselves or others. Thus far its usage has been rare and the focus is very much on pre-emptive de-escalation.

Communication between staff is enhanced by handover meetings and the use of a communication book.

Staff supervisions take place on a bi-monthly basis or monthly for newly recruited staff and these are conducted in the main by Paul the Registered Manager. I understood that there was also going to be a Deputy Manager in post shortly. 

Management of the Home

Paul Whitefield manages Bredon House. He has a lot of experience working and managing in residential care services and supporting individuals on the autistic spectrum. I understood that there was also going to be a Deputy Manager in post shortly. Paul spoke of how well he felt supported by the Options Group as a whole. Bredon House uses the ‘outcome star system’ http://www.outcomesstarsystem.org.uk/ to monitor change particularly on an individual level with clients. Care plans and Independent Living Plans are reviewed at least every 6 months.

Paul Whitefield conducts assessments on potential new clients with support from the clinical team.

Paul had already developed a relationship with a local housing provider and this is something that could be really positive in the future in terms of next steps for individuals.

Summary of findings

Considering Bredon House was such a new service it already felt well established. Although Bredon House is registered as a residential establishment, the service is clearly focused on developing an individual’s autonomy allowing them as much independence from staff support as possible. Staff were prepared to take managed risks with individuals following thorough assessment and this is vital in the development of the individual.

This service would, in my opinion, be an ideal service for individuals who would be classed as having higher functioning autism to prepare them for a move into a more independent living arrangement either through supported living or their own independent tenancy. Bredon House provides a vital link in the chain and, for me, forms a wonderful stepping stone on the pathway to independence.


 

Visiting Officer - Craig Godding
Director of Compliance and Client Liason, Living Autism