Mill Green

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 care home was registered to provide support for a maximum of six people, which is in line with best practice guidance. The service was an adapted two storey house in a residential street where people had easy access to local amenities. At the time of this inspection there were five people living at the home.

The registered manager and senior managers fostered a culture of openness and professional challenge. This ensured all staff understood and were motivated to meet the high standards of quality expected of them. Staff and the registered manager had been recognised both within the provider organisation and the county council as providing exceptional care. They had been nominated for and been successful in achieving awards as the best performing team and as a finalist for the best registered manager in the county.

There was a consistent staff team, many of whom were very long-serving and knew people very well. Staff showed exceptionally caring, thoughtful and compassionate care to each person. Staff used different communication methods with each person and were able to interpret fluently what people wanted. This meant that the people living at Mill Green, some of who had little or no verbal communication, were very well understood and supported. Each person had a highly individualised communication and support plan

taking into consideration all their communication methods. Support plans described the risks, needs and preferences and how staff should work with each person to ensure the person was able to lead as fulfilled and independent life as possible. New ideas for activities were explored and trialled to keep people occupied in a meaningful and enjoyable way. A professional commented that the care "…provided at Mill Green is personalised to meet physical, mental, emotional and social needs. They promote independence and autonomy."

There were sufficient staff, who knew people very well, to support people safely both in the home and in the local community. Staff supported people to get involved in their preferred activities, individually and as a group. Staff knew how to keep people safe both from the risk of abuse and from assessed risks. Medicines were administered by staff who were well trained and competent. There were robust systems to ensure medicines were received, stored, administered, recorded and returned safely.

The outcomes for people using the service reflected the principles and values of Registering the Right Support. People's support focused on them having as many opportunities as possible for them to gain new skills and become more independent. Staff understood and had taken appropriate actions to ensure people were supported in line with the Mental Capacity Act (2005).

People, and their families, were involved as much as possible in their care and support which helped to give them choice and control in their lives. People were encouraged to join in activities and be part of the local community, regardless of any physical or learning disability they had. Activities reflected people's preferences. People's families spoke very highly of the quality of care and of the approach of the registered manager and staff in supporting their relative. All the relatives and professionals we received feedback from, held the service in very high regard. Health professionals praised the service describing the positive outcomes and benefits to people living at Mill Green due to the way staff advocated for each person using evidence to support their proposals.

Quality assurance measures were extremely robust and well embedded into everyday practice. Staff reviewed the quality and safety of care delivered in an in-depth way on a regular basis. Staff performance was closely monitored in a supportive way. Staff undertook training to ensure their knowledge and skills remained current.