60 Cobham Road

We expect health and social care providers to guarantee people with a learning disability and autistic people respect, equality, dignity, choices and independence and good access to local communities that most people take for granted. 'Right Support, Right Care, Right Culture' is the guidance CQC follows to make assessments and judgements about services supporting people with a learning disability and autistic people and providers must have regard to it.

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.

Right Care: People told us they felt supported by staff in a kind, caring and dignified way and we observed this. People's differences were respected by staff and they had undertaken relevant training to support people. This included training for learning disabilities and autism awareness. Feedback from relatives was mixed as some felt that there had been delays in seeking medical attention and that the activities provisions offered were not enough. People's right to privacy was respected and staff encouraged people to provide feedback about the quality of care in a format they could understand. Care plans were personalised and included information on people's healthcare needs, communication needs, preferences and social history. Care plans included steps to take to ensure people had regular access to a dentist and were following good oral care guidelines, however this had not always been followed. People were supported to enjoy the diet of their choice and staff encouraged them to have a nutritionally balanced diet. The service was located in a residential street with minimal information to indicate that it was a care home. The service was of a similar size as neighbouring properties.

Right Culture: The provider's monitoring systems were not always effective in identifying and acting on shortfalls we found during the inspection. For example, we identified areas for improvement in relation to medicines documentation, some of which had not been identified by the provider's governance systems. Other areas of improvement had been identified by the provider's systems and there was an action plan to address these. Where we highlighted shortfalls, the registered manager took immediate action and implemented processes to ensure this would not happen again. People and their relatives told us they felt able to share concerns with the provider and that these would be addressed by the operations manager who was overseeing the service. Staff were complimentary about the registered manager and told us they were able to raise concerns.