Forge House

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 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 manager at Forge House and the behaviour support therapist at this inspection. The service had a registered manager who was also the registered provider and a manager for Forge House. The registered manager was not available for most part of this inspection. The thematic review 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.

The registered manager and staff had not spoken with people and their relatives about end of life plans. We found no end of life care plans in place. This is an area for improvement.

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.

People were safe at Forge House. Staff knew what their responsibilities were in relation to keeping people safe from the risk of abuse. The provider followed safe recruitment practices.

Medicines practice was safe. Medicines records were accurately signed with no gaps in recording. Staff had detailed knowledge of the system in place. The environment was well maintained, and infection control procedures were adhered to.

People were consulted on key issues that may affect them. People's rights, their dignity and privacy were respected.

People received the support they needed to stay healthy and to access healthcare services. Each person had care plan, which set out how their care and support needs should be met by staff. These were reviewed regularly.

Staff supported people to maintain a balanced diet and monitor their nutritional health.

Staff received regular training and were provided with appropriate support and supervision as is necessary to enable them to carry out their duties.

People knew how to complain and that any concerns would be listened and responded to by the provider. Relatives said they felt able to express concerns and were confident of these being addressed.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.