The Meadows

The service has been developed and designed in line with the principles and values that underpin Registering the Right Support and other best practice guidance. This ensures that people who use the service can live as full a life as possible and achieve the best possible outcomes. The principles reflect the need for people with learning disabilities and/or autism to live meaningful lives that include control, choice, and independence. People using the service receive planned and co-ordinated person-centred support that is appropriate and inclusive for them.

The service was a large home, bigger than a domestic style property and was adjacent to other services that used space in the building as offices, these with separate dedicated entrances. These services were also managed by the provider, for example shared care services. The Meadows is registered to accommodate 12 people. This is larger than current best practice guidance. However. the size of the service having a negative impact on people was mitigated by the building design offering a range of high-quality facilities, as well as extensive internal and external space which enhanced people's experiences. In addition, the service did not offer a permanent residence for people, only short breaks which some people likened to stopping in a hotel for a holiday. Support staff did not wear anything that suggested they were care staff when coming and going with people and transport used by the service was not identifiable as anything other than family transport.

As part of the thematic review, we carried out a survey with the registered manager at this inspection. This considered whether the service used any restrictive intervention practices (restraint, seclusion and segregation) when supporting people.

The service used positive behaviour support principles to support people in the least restrictive way. No restrictive intervention practices were used.

People and relatives told us the service was safe and staff were very aware of how to minimise risks to people and promote their safety, without compromising their freedom. Staff knew how to work with people to identify risks and change their approach to minimise these.

People were supported by care staff that were caring, showed compassion and expressed genuine interest about the people they cared for. People received person centred care and support based on their individual needs and preferences. Staff were knowledgeable about people, their needs and preferences and used this to develop a good relationship with the people who stayed at the Meadows.

People were supported by care staff who had the skills and knowledge to meet their needs. Staff understood, felt confident and well supported in their role. People's health was supported as staff worked with other health care providers when needed to support people's healthcare needs.

People were supported to have maximum choice and control of their lives and staff understood they should support them in the least restrictive way possible; the policies and systems in the service supported this practice.

People told us they enjoyed meals they chose and there was access to a range of foods that met people's needs due to their health, culture or specific preferences. People's care plans reflected people's needs and preferences and the staff were able to explain how people were involved to ensure care plans were current, person centred and fully involved people and their wider family. We saw the service was responsive to information from people and relatives. People knew how to complain and felt concerns would be listened and responded to by the staff. Complaints and comments were used as a tool to drive improvement of the service.

People, relatives and staff gave us a positive picture as to the quality of care people received, and said they were able to share their views with staff. People enjoyed their stays at the Meadows and said they were able to follow their chosen routines and enjoyed access to activities at the service.

Quality monitoring systems included audits, regular checks on people's satisfaction with the service they received, by surveys, phone calls, social events or meetings. The provider has systems in place to ensure they kept up to date with developments in the sector and changes in the law.

People and relatives told us the registered manager and staff were approachable, organised, listened and responded to them and acted on feedback when they shared this with them. The registered manager had high expectations in respect of the quality of the service. This reflected the views of staff. People and relatives told us the service they received was to a high standard. The registered manager demonstrated they were not complacent and wished to improve the service further, for example developing support networks for people so the service was more inclusive.

The outcomes for people using the service reflected the principles and values of Registering the Right Support by promoting choice and control, independence and inclusion. People's support focused on them having as many opportunities as possible for them to gain new skills and become more independent.