Reach Upton Court Road

The service had a registered manager as required. 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 present and assisted us during the inspection.

At our last inspection we rated the service Good. At this inspection we found the evidence continued to support the rating of Good and there was no evidence or information from our inspection and ongoing monitoring that demonstrated serious risks or concerns. This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection. However, we found improvements had been made in the Responsive domain which is now rated Outstanding.

People told us they felt safe and they had built trusting relationships with the staff. Medicines were managed safely and people were supported to receive them at the required times. Staff were knowledgeable in how to safeguard people, they had received training and understood their responsibilities to report concerns. Risks related to people and their well-being had been assessed. Measures were in place to minimise identified risks without restricting people's freedom. The provider had a robust recruitment procedure which was followed to ensure as far as possible only suitable staff were employed. The service was clean, fresh and well maintained. Appropriate personal, protective equipment was supplied and used to help control the spread of infection.

People continued to receive effective support from staff who had the necessary skills to fulfil their role. Staff received an induction and training which was refreshed on a regular basis. Staff felt well supported and received regular one to one supervision and had annual appraisals of their work. Staff supported people to eat a healthy and nutritious diet. When necessary, advice was sought from healthcare professionals in relation to people's diet and other healthcare needs. People had routine health checks with their GP and were supported to attend appointments with other healthcare professionals. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible, the policies and systems in the service supported this practice.

The service continued to be caring. People told us they liked the staff and said they had were kind towards them. It was clear trusting relationships between people and staff had been built. People laughed and

talked with staff in a relaxed manner. Staff understood how to protect people's privacy and showed respect for people's wishes to spend time alone and have personal relationships. People were fully involved in making decisions about their care. Staff worked hard to encourage people to develop and maintain as much independence as possible.

The service had improved and showed outstanding practice in responding to people's individual needs. Staff kept focus on the wishes of each individual and worked in a person-centred way, considering people's personal preferences, culture, beliefs and protected characteristics. People's support plans were very comprehensive and reflected the extremely person-centred approach taken by the service. Staff had found innovative ways to respond to individuals and enhance their lives for the better. People had opportunities to take part in activities of their choice and were encouraged to try new and different things which would help them live a fulfilled life, as independently as possible. The service was meeting the requirements of the accessible information standard.

The service continued to be well-led. There was an open, empowering, person-centred culture in the service. People benefitted from a stable and longstanding staff team led by a registered manager who provided strong leadership. Staff felt supported in their roles and said they worked as a team to support each other. The service had a clear vision and a set of values which staff demonstrated they were familiar with and committed to achieving. Records were easily accessible, current, complete and reviewed regularly. Feedback was sought and used to monitor the quality of the service. Audits were conducted and used to make improvements.

Further information is in the detailed findings below.

The five questions we ask about services and what we found