Hillbrow

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 received planned and co-ordinated person-centred support that is appropriate and inclusive for them. People were encouraged and supported to be active within their community and be independent.

People continued to be safe living at the service. Risks to people from health conditions and the environment were well managed. Medicines were administered well, and people received their medicines on time and as prescribed. The service was clean, and people were protected from the risk of infection.

When things went wrong staff responded appropriately and took action to reduce the risk of incidents occurring again.

There were enough staff to support people and staff were recruited safely. Staff were appropriately managed and supported and had the skills and training they needed. Staff applied their learning from training to improve people's lives.

People's needs were assessed, and support plans were updated when appropriate. The support people received was personalised and met their needs. They were supported to take part in activities of daily living such as going shopping, making meals and managing laundry. Where appropriate people were involved in the running of the service through assisting with audits and undertaking gardening.

People were encouraged to maintain their health and had access to healthcare services when needed. They were provided with support to eat and drink well and safely where there were risks such as diabetes and difficulties swallowing.

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.

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.

The building was designed and adapted to meet people's needs and promote independence. Adaptations to the environment had been made to ensure that the building remained suitable for people as they grew older as some people had lived there for a long time.

There was an open and transparent culture at the service. Staff were motivated and appropriately managed and supported. Regular checks on the quality of the service were undertaken and action was taken to make improvements where these were identified.

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 the thematic review, we carried out a survey with the registered manager at this inspection. This 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.