Parkbourn

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 most domestic style properties. It was registered for the support of up to eight 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 fitting into the residential area and the other large domestic homes of a similar size. There were deliberately no identifying signs, intercom, cameras, industrial bins or anything else outside to indicate it was a care home. Staff were also discouraged from wearing anything that suggested they were care staff when coming and going with people.

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 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. We saw many examples where staff had supported people to become more independent, make choices and increase their physical and emotional wellbeing. With staff support and by increasing their understanding, personalised daily routines were established, reflecting people's preferences and healthy eating was promoted.

The Secretary of State has asked the Care Quality Commission (CQC) to conduct a thematic review and to make recommendations about the use of restrictive interventions in settings that provide care for people with or who might have mental health problems, learning disabilities and/or autism. Thematic reviews look

in-depth at specific issues concerning quality of care across the health and social care sectors. They expand our understanding of both good and poor practice and of the potential drivers of improvement. As part of 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.

Parkbourn is located in an area that enabled people using the service to participate in their own local community. People were active each day to and enjoyed activities at a day service; some attended local community facilities. Social activities also took place at home, with regular trips to local places of interest, restaurants and pubs.

The service was highly effective at promoting people's independence. This included personal care and daily activities such as laundry, cleaning their home, shopping, preparing meals and drinks.

Staff had developed effective communication with people. This meant that they were able to make their own decisions about their support; staff ensured they were supported to make choices on a day to day basis.

Risks that people faced had been assessed and those identified were safely managed. Medicines were managed safely. Staff showed a good understanding of their roles and responsibilities of keeping people safe from harm.

People were supported to access healthcare when needed. Staff worked with healthcare staff to enable coordinated appointments which gave the people the best outcomes and maintained their dignity. For example, planning ahead, no waiting time and home visits where possible.

People were offered choice and control and where able consented to their care and support. Staff supported people to be as independent as possible with activities of daily living, such as personal care, shopping, cooking and laundry.

People were encouraged and supported to eat and drink well. People were given a choice of suitable meals and snacks. Staff supported people to make meals of their choice throughout the week.

People received care from a consistent staff team, who had worked at the service for a number of years. Enough staff were employed each day to meet people's needs, keep them safe and give them the opportunity to take part in their chosen activity.

Staff received a range of training appropriate to their role and people's needs, and were supported by the registered manager and senior support workers through regular supervision.

Effective systems were in place to check the quality and safety of the service. The environment was clean and safe and in a good state of repair and decoration.

The leadership of the service promoted a positive culture that was person-centred and inclusive. The registered manager and the staff team showed a desire to improve on the service provided and in turn the quality of life experiences for the people at Parkbourn.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk