The Tager Centre

The Tager Centre is a care home without nursing which is registered to provide care and accommodation for up to 16 people with learning disabilities. It specialises in supporting people who are on the autistic spectrum. At the time of our inspection there were 16 people living at the home. The home is split into four wings with four people living on each wing. All bedrooms are en-suite, with each wing having communal lounge, dining and kitchen areas.

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 uniqueness and individuality was respected.

There is a registered manager running the service. A registered manager is a person who has registered with the Care Quality Commission 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 2008 and associated Regulations about how the service is run.

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 management approach was inclusive of all parties and there was a strong emphasis on developing all staff members, regardless of role, for the benefit of people living in the service. There was an open and transparent culture where all visitors to the service were welcomed and listened to. There was a strong drive to enable people to benefit from regular community presence and to have fulfilling and satisfying life experiences. The approach of the home was embedded so that new staff were incorporated into the ethos and values of the service in a seamless manner.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. There were examples of excellent and consistent practice which had enhanced and improved the lives of people living in the service. These are detailed in the main body of the report.

The quality of care the service provided was constantly assessed, reviewed and improved by the provider,

people and the staff team. The service was run in line with the values that underpin "Registering the right support'' and other best practice guidance. These values include choice, promotion of independence and inclusion. The service followed the principles that people with learning disabilities and autism can lead as ordinary a life as any citizen.

People's safety was contributed to by staff who had been trained in safeguarding vulnerable adults and health and safety policies and procedures. Staff understood how to protect people and who to alert if they had any concerns. General operational risks and risks to individuals were identified and appropriate action was taken to eradicate or reduce them. 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 safely and took account of their diversity. The provider had robust recruitment procedures which ensure that all staff recruited were, as far as possible safe and suitable to work with people. People were supported to take their medicines at appropriate times and as instructed by trained and competent staff.

The service continued to be caring and responsive. The committed, attentive and knowledgeable staff team provided care with kindness and respect. Individualised care planning ensured people's equality and diversity was respected. People were provided with a range of activities, according to their needs, abilities, health and preferences. Care plans were reviewed by management regularly. Care plans contained up to date information and records demonstrated that risk assessments were reviewed within stated timescales. The service sought advice from and worked with health and other professionals to ensure they met people's needs in the most effective and comfortable way.

People were encouraged and supported to have maximum choice and control of their lives and staff helped 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. 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