The Sycamores

We assessed the service against ‘Right support, right care, right culture’ guidance to make judgements about whether the provider guaranteed people with a learning disability and autistic people respect, equality, dignity, choices, independence and good access to local communities that most people take for granted.

Care was delivered in a way that encouraged people’s independence, choice and access to opportunities while continuing to reduce potential risks. For example, empowering people to access their local community safely without constant staff supervision or travelling independently. Staff recruitment practices ensured people were supported by staff who were suitable for their roles and understood people’s needs, including how to recognise and report abuse. Staff received induction and ongoing development opportunities to support them in their roles. Additional face to face training about Learning Disability and Autism awareness had been arranged for staff. This supported staff to develop their understanding as well as listen to and reflect on the experiences of autistic people and people with a learning disability.

Medicines were managed safely with regular reviews and effective oversight, including consideration of STOMP guidance. STOMP (Stopping Over Medication of People with a Learning Disability, Autism or both) is a national initiative which promotes the appropriate use of medicines and regular reviews to reduce unnecessary medicines.

The environment was clean and personalised, although action was ongoing to address damp on an outside wall, resolve a wasp infestation and complete planned redecoration work.

People can only be deprived of their liberty where this is necessary and authorised through the appropriate legal framework. We checked whether the service was working within the principles of the Mental Capacity Act 2005 (MCA) and how Deprivation of Liberty Safeguards (DoLS) were managed. We found that staff and management worked within the MCA. DoLS authorisations were appropriately applied for and overseen. People were not subject to unlawful or excessive restrictions and had choice and control over their lives. However, records relating to mental capacity assessments and best interest decisions required greater detail to better demonstrate involvement in decision making. Staff understood people’s rights and the importance of using the least restrictive approach.

People received effective care based on detailed assessments of their needs and preferences. Staff understood the importance of seeking consent and supporting people to make their own choices. People were involved in decisions about their care and the running of the home such as menu planning and how to spend their time. Regular key worker meetings helped review people’s experiences and progress towards goals.

People told us they were supported to access healthcare services when required. Staff worked alongside health and social care professionals to monitor people’s wellbeing and ensure support remained appropriate.

We identified the use of positive and respectful language could be improved within the electronic system and some aspects of care plans. Leaders were open to reviewing this with a view to implementing change. Staff told us they would benefit from further support to use the electronic care planning system more effectively, including addressing connectivity issues and the time required for recording care outcomes.

People spoke highly about living at the service and the support they received. People and relatives told us staff were kind, caring and respectful and had developed positive relationships. People appeared comfortable, relaxed and confident within their home environment.

People were supported in a person-centred way to maintain and develop their independence. Staff promoted equality, dignity, choice and inclusion, supporting people to be active members of their local community. This included opportunities for employment, shopping, visiting family and taking part in activities that were important to them, such as attending live music events, circus shows, theme parks and visiting the local pub.

People were encouraged to pursue personal goals, make their own choices and lead fulfilling lives. The principles of Right Support, Right Care, Right Culture were embedded throughout the service and reflected in staff practice and interactions.

Communication was adapted to meet people’s needs through the use of photographs, easy read information and Makaton. Makaton is a communication method which uses signs, symbols and speech together to support understanding and expression. People knew how to raise concerns and told us they felt confident to do so.

The service was well-led, with a warm and welcoming culture where positive and respectful relationships between people and staff were evident. Leaders maintained a visible presence within the home. Staff understood the provider’s values and applied them consistently in practice.

Effective governance and oversight systems supported continuous improvement through regular audits, action planning and ongoing review.

A positive learning culture was promoted, with staff encouraged to develop their skills, reflect on practice and identify opportunities for improvement. The management team responded positively to feedback from people, relatives and professionals. Where improvements had been identified, action had been taken or plans were in place to address them, including environmental improvements and maintenance works within the home.