No 36

The last rating was outstanding (published 17 September 2019). The service remains outstanding.

People received exceptionally personalised care and support. Staff understood their individual needs and tailored care to ensure expectations and outcomes were exceeded. Some people previously required high levels of support and expressed anxiety and distress when outside of their home. Since moving to the service, they had been supported to take holidays abroad, attend places of worship and be valued members of the community. Comments from staff included, “I never want anyone I support to feel that they are different or less important because of their disability. They deserve the same respect, opportunities and happiness as everyone else” and “[When we are on day trips] it does not feel like staff taking ‘residents’ on an organised activity. It feels like a group of people enjoying a day out together.”

Before people moved to the service, staff spent time with them getting to know them and planning their care. Staff challenged barriers and perceptions imposed by previous care settings. They found ways to understand what people wanted and what mattered to them, even when there were barriers to communication. The ethos of the service was to provide a rich holistic experience of the world, to allow people to live their lives to the full and to be as independent as possible. Staff supported people to learn new skills. This included supporting people to provide care and support for others. A staff member told us, “I feel proud of the progress I have seen with the people we support.”

Staff encouraged people to take risks and try new things. There were comprehensive and well thought out assessments of risks. Staff worked with professionals to find ways to support people. The provider understood best practice and ensured staff were trained to follow this. They provided advanced training to staff within the team to understand about positive support techniques and to ensure people were not restricted. This approach had led to a reduction in incidents where people were distressed. Staff also worked to reduce people’s reliance on medicines. A staff member commented, “The important outcome is not simply ’less medicines’. It is seeing people more alert, engaged and able to participate in their lives while they continue to be safely supported.”

Staff always put people at the centre of decision making, supporting them to understand about decisions and allowing them to express their wishes. Instead of imposing restrictions, staff supported people to understand how to keep themselves healthy. For example, supporting people to enjoy food, exercise and healthy lifestyles. The result of this was that people had achieved healthy weights, were physically well and were happier.

Staff were exceptionally caring and constantly referred to people in a loving and positive way. Staff were also well supported and cared for. They explained they felt part of a ‘family’ and a community within the service. People using the service and staff respected each other and enjoyed spending time together. Comments from staff included, “I genuinely treasure working here”, “I am thankful for the trust people, and their families give to us”, “I genuinely love working here because it feels like a family to me” and “I feel blessed to work alongside staff who are so passionate and caring.”

Staff were encouraged to share their skills and interests with people. They were supported to take on extra responsibilities and new roles, working towards management roles if this is what they wanted. A staff member told us, “Managers encourage us to use our own skills. I enjoy painting and drawing, so I have been able to do this together with people. It is lovely because sometimes you can connect with someone through an activity even without many words.”

The provider had robust systems for monitoring and improving the quality of the service. They had achieved accreditation with the National Autistic Society. They continuously sought out innovative ways to develop the service and ensure people’s needs were met. All the staff understood and believed the values of the organisation. They wanted to achieve the best for people. They constantly monitored and reflected on their work, discussing this with managers and looking at ways to improve people’s care and support. A staff member told us, “We celebrate people’s achievements because sometimes a small step represents a very big achievement for that person.”

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 provider was meeting these principles and continued to provide an outstanding level of care for people, ensuring their rights were upheld and central to decision making within the organisation.