Cascade (Hurst House)

We assessed the service against ‘Right support, right care, right culture’ guidance to make judgements about whether the provider guaranteed autistic people and people with a learning disability respect, equality, dignity, choices, independence and good access to local communities that most people take for granted.

The service had been intentionally designed around the needs of autistic people and people with a learning disability, rather than adapting a traditional care model. From admission, people experienced support from a small, consistent staff group who took time to understand how each person communicated distress, choice, and preference. This approach resulted in people becoming more settled and confident over time, which was reflected in a sustained reduction in incidents and the need for restrictive interventions. Staff consistently interpreted behaviour as communication and responded proactively, enabling people to experience greater stability, choice, and independence.

Opportunities for staff to develop personally and professionally helped them to deliver high standards of person-centred care and staff were motivated to complete their role to the best of their ability.

Staff had a good understanding of safeguarding and how to promote people’s safety and to recognise how people communicated their needs. The reduction of incidents within the service illustrated how staff had become skilled in identifying and responding to people’s needs in a timely way.

People’s needs were clearly documented and regularly reviewed to ensure their accuracy. Case studies demonstrated the achievements people had made since living at the service. There was a sharp focus on promoting individual goals and independence with communication tools being adapted to help people express themselves and make their own choices. As part of the homes approach to lifetime learning people have clear learning and well-being objectives which they were supported to achieve with the support of care staff and staff working in an educational role.

There was an integrated approach to providing holistic care and support to ensure every young person was thriving and achieving their potential.

Strong links with the community and partnership working helped to ensure young people felt safe and a sense of belonging, identity and security and they were regularly supported to build friendships and retain links with family and friends.

There was a strong ethos and drive to continuously improve the service and learn from incidents, safeguarding concerns and complaints which were all seen as an integral part of the quality assurance process. Inclusive managers actively sought to support their staff through robust training programmes and a detailed programme of support. Staff felt able to raise any issue and described the service as inclusive. Staff knowledge helped them to support people to maximise their quality of life.

A staff member told us, “Personally I don't feel like I'm at work because it's one of the most amazing work settings one can wish for. Hurst has an amazing staff team and residents alike; both are welcoming and approachable”. They said, “it’s indeed a home away from home and I don't just feel safe at Hurst. I know I belong here.”

The environment was inclusive and helped to ensure people had a high standard of living and a building which was intuitive to their needs. For example, by creating different accommodation types both bedrooms and flats, subtle lighting, underfloor heating, and versatile space to promote people’s individual needs.