Peppard House

Peppard House is a care home (without nursing) which is registered to provide a service for up to seven people with learning disabilities. People had other associated difficulties such as behavioural issues and being on the autistic spectrum.

People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. The Care Quality Commission (CQC) regulates both the premises and the care provided, and both were looked at during this inspection.

Peppard House accommodates people in a large domestic sized building. The service was run in line with the values that underpin the "registering the right support'' and other best practice guidance. These values include choice, promotion of independence and inclusion. People with learning disabilities and autism can lead as ordinary a life as any citizen.

At the last inspection, on 23 February 2016, the service was rated as good in all domains. This meant that the service was rated as overall good. At this inspection we found the service had improved to outstanding in two domains and therefore had improved to an overall rating of outstanding.

Why the service is rated outstanding.

The service was exceptionally responsive and strove to meet people's aspirations and lifestyle choices. It was flexible and readily adapted to meet people's changing, diverse and complex needs. It was extraordinarily person centred and people were seen and responded to as individuals. Activity programmes were creative and designed to meet people's individual preferences and choices. Care planning was highly individualised and regularly reviewed which ensured people's current needs were met and their equality and diversity was respected.

The registered manager was extremely experienced, respected and highly thought of by staff, families and other professionals. She and the management team ensured the service was exceptionally well-led. The registered manager and the staff team were committed to ensuring they offered people the very best care possible and that people were as involved as possible in running the service. The quality of care the service provided was constantly assessed, reviewed and improved by the provider, people and the staff team.

People continued to be protected from all forms of abuse. Staff were trained in safeguarding people and knew what action to take if they identified any concerns. The service identified general health and safety and individual risks. Action was taken to reduce identified risks. All aspects of safety were considered and actions were taken to assist people to remain as safe as possible.

People continued to be supported by appropriate staffing ratios, which were reviewed on a daily basis. Staff were able to meet people's specific needs, including any diversity, safely. Recruitment systems made sure, that as far as possible, staff recruited were safe and suitable to work with people. People were supported to take their medicines, at the right times and in the right amounts by trained and competent staff.

A well-trained and knowledgeable staff team remained able to offer people effective care. They met people's diverse needs including their current and changing health and emotional well-being needs. The service worked very closely with health and other professionals to ensure they offered individuals the best care in the most effective and comfortable way.

People continued to be 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 caring, committed and enthusiastic staff team continued to meet people's needs with kindness and respect. They ensured they promoted people's privacy and dignity and communicated with them effectively.

The five questions we ask about services and what we found