The Orchards

The service was developed and designed before Registering Right Support came into existence. Despite this, the service was run in line with the principles and values that underpin Registering 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 large, both homes were located on a single site on the outskirts of Lydbrook in an area of outstanding natural beauty. The site had a fully accessible woodland walk, small-holding, sensory garden, activity park, learning centre and therapy centre with swimming pool and floor trampoline (rebound therapy). The on-site facilities were used by many local providers, for example for dementia walks, which brought the local community in, creating a dynamic and stimulating environment. There were deliberately no identifying signs, intercom, cameras, industrial bins or anything else outside to indicate there were care homes on-site. Staff wore everyday clothes when supporting people at home and when accessing the wider community with them.

Offa's Dyke was bigger than most domestic style properties, providing accommodation for up to 14 people. This is larger than current best practice guidance. However, the size of the home having a negative impact on people was mitigated by the design of the home, which was made up of two distinct houses (Silver Birch and Oak House), joined by a common entrance hall. Offa's Dyke was purpose-built and provides accommodation for up to seven people in each house. Offa's Dyke and its garden are fully wheelchair accessible. The houses are equipped with hoists and other specialist equipment suitable for people with profound and multiple disabilities. Accommodation is provided on the ground and first floors with a passenger lift to the first-floor bedrooms.

The Orchards are located five to 10 minutes' walk from Offa's Dyke. This consisted of two adapted semi- detached cottages, (The Orchards 1 and The Orchards 2), joined by an internal connecting door. Each cottage housed three people, with accommodation provided over two levels. Ground floor bedrooms were suitable for wheelchair users. Two bedrooms, with en-suite bathrooms, were located on the first floor in each house. The first floor was accessed via stairs.

The service applied the principles and values of Registering the Right Support and other best practice guidance. These ensure that people who use the service can live as full a life as possible and achieve the best possible outcomes that include control, choice and independence. The service was fully inclusive, people were involved in deciding who worked with them. Staff recognised people's strengths and people were enabled to use these. For example, to improve services for themselves and others.

People felt safe and knew their needs would be met with respect and dignity. They were confident in the staff who supported them, describing them as "friends". Staff were trained to meet their needs and had been recruited safely. Risks to people were managed through detailed person-centred support plans, timely involvement of health professionals and regular reviews of their needs.

People benefitted from a service which was effective in meeting their complex needs and in promoting their health and well-being. The staff team had formed working partnerships with specialist teams and other health professionals to achieve positive health outcomes for people with significant health challenges. The quality of the service and staff contributions to successful outcomes, were commended by commissioners and health professionals alike.

People were cared for by a staff team who worked flexibly to meet their needs, both in times of ill-health and to improve their everyday lives. One person said, ''Sometimes I need to have a chat with the staff about personal things and they are really, really understanding. It's quite special to feel that I can do that." Staff were sensitive and responsive to people's relatives, other people living at the service and to each other, when people reached the end of their life. One relative said, "They [people using the service] are looked after so well you can't believe it."

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice. Staff used a variety of techniques to communicate with people, enabling them to make their wishes and goals known. People were supported to have a good quality of life, to experience activities they enjoyed and to maintain relationships with people who were important to them. Staff were proactive in overcoming barriers related to people's disabilities. People's feedback about the service was sought regularly and they were confident their views would be respected and responded to positively, including complaints.

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 opportunities to gain new skills, become more independent and enjoy life. Support was tailored to the person's needs and abilities. For example, increasing their independence through assisted technologies and supporting them to learn, work and follow interests that were meaningful to them. One person said, "I really do enjoy the fun I have here."