Hammonds

The layout of the service did not promote person centred support, for example main meals were cooked in an area that people did not have access to. People went in and out of other's homes uninvited, limiting people's ability to enjoy their home without interruption.

The service worked with people to plan for when they experienced periods of distress so that their freedoms were restricted only if there was no alternative. Staff did everything they could to avoid restraining people. Staff learned from those incidents and how they might be avoided or reduced.

Staff enabled people to access specialist health and social care support in the community. Staff supported people to make decisions following best practice in decision-making.

Right care People experienced mixed quality of care, some staff spoke over people and talked to each other about people in the presence of others. Not all staff respected people's dignity, this was something raised in the last inspection and was still happening at this inspection. In contrast most staff were delivering kind and compassionate care. Staff understood how to protect people from poor care and abuse. The service worked with other agencies to do so. People's care, treatment and support plans reflected their range of needs and this promoted their wellbeing. Staff and people cooperated to assess risks people might face. Staff had begun to encourage people to take positive risks.

Right culture People did not always lead inclusive and empowered lives because of the ethos, values, attitudes and behaviours of the provider, management and staff. There was mixed understanding or opportunities to apply active support approaches. The provider had not fully considered people's needs and wishes in the planning and deployment of staff. Some improvements had been made towards person centred support, with more choices being offered and developed understanding of people's communication needs. Managers and staff were trying to further develop these areas locally within the limitations of the layout and staffing structure of the service.

People received good quality health care, support and treatment because trained staff and specialists could meet their needs. Most staff knew and understood people well but there was a reliance on agency staff who did not always know people.