Stokelodge

At the time of the inspection nine people were living at the home. The service is a residential home that has been developed and adapted in line with the values that underpin the Care Quality Commission's 'Registering the Right Support' and other best guidance. These values include choice, promotion of independence and inclusion. People with learning disabilities and autism using the service can lead as ordinary life as any citizen.

The home had a registered manager. A registered manager is a person who has registered with the CQC to manage the service. Like registered providers, they are 'registered persons'. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act and associated Regulations about how the service is run.

This comprehensive inspection took place on 18 December 2018. The inspection was unannounced, which meant the staff and provider did not know we would be visiting.

At our last inspection we rated the service good. At this inspection we found the evidence continued to support the rating of good. There was no evidence or information from our inspection and on-going monitoring that demonstrated serious risks or concerns. This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection.

At our last inspection in March 2016 we found the provider required to improve their provision of staff training in relation to supporting people living with autism. At this inspection we found the provider had made the required improvements and now ensured staff had completed the necessary training.

During this inspection we identified the service had improved and now delivered outstanding personalised care that was responsive to people's needs. People experienced exceptional care that was extremely flexible, to their individual changing needs and preferences. People and relatives regularly reported that the dedicated staff team consistently went the extra mile to make people's dreams come true. The care provided to people, achieved exceptional outcomes, enriching the quality of their lives and improving their physical and mental wellbeing.

Staff were particularly skilled at helping people and their families to explore and record their wishes about care at the end of their life, which made them feel empowered, valued and listened to.

The registered manager sought the views of people and their relatives and reviewed complaints to drive improvements in the home.

People were protected from avoidable harm by staff who received the required training and understood their responsibilities to safeguard people. Risks to people had been identified and were managed safely. The provider had enabled staff to develop and maintain the necessary skills and knowledge to deliver effective care to meet people's needs. The registered manager ensured there were always sufficient suitable staff deployed to support people safely.

Staff knew people well and delivered their care in accordance with detailed assessments, which were reviewed regularly. People were protected from the risks associated with malnutrition and supported to eat a healthy balanced diet. People were 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. Staff quickly referred people to external services, when required to maintain their health.

Staff supported people to maintain required standards of cleanliness and hygiene in the home, which reduced the risk of infection. Staff followed required standards of food safety and hygiene, when preparing or handling food.

Staff promoted people's independence, self-esteem and confidence, whilst treating them with dignity and respect. Staff consistently considered people's needs regarding equality and diversity.

People were supported to take part in stimulating activities of their choice and to maintain relationships with their families and those that mattered to them.

The service was well led by the registered manager, who inspired staff to deliver care and support in line with the provider's core values, which promoted people's dignity, independence and choice.

The provider operated effective performance management processes to monitor the quality of service being delivered, which were reviewed regularly, and reflected best practice.

The registered manager had developed good links to local community, that reflected the needs and preferences of the people who used the service.

Further information is in the detailed findings below.

The five questions we ask about services and what we found