Highfield

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: Staff understood the risks to people's health, safety and welfare. Risk assessments provided guidance for staff about individual risks. However, some risk assessments did not have enough guidance for staff to ensure people were as safe as possible. Whilst staff knew people well, positive behavioural support plans were still in the process of being reviewed and updated. Without robust plans and information there was a risk people were not supported in a consistent way.

People were protected from the risks of harm, abuse and discrimination because staff knew what action to take if they identified concerns. Accidents, incidents and near misses were recorded and reviewed. However, the level of detail recorded varied and there was a risk of action not being taken in a timely way.

There were enough staff to provide the support people needed.

Staff provided care to people which was person-centred and promoted people's dignity, privacy and human rights. People's individual choices were recognised and respected. Staff promoted equality and diversity in their support for people and their protected characteristics were considered.

People could communicate with staff as staff understood their individual methods of communication. People were empowered to take part in activities of their choice. People were supported to keep in touch with people who were important to them. Relatives spoke positively about the support their loved ones received.

Right Culture: Checks and audits were being regularly completed. Shortfalls were identified and action taken to address these. However, we found some shortfalls around risk assessments and accidents and incidents which had not been identified. We discussed this with the manager who agreed to take action to remedy these.

The service enabled people and those important to them to work with staff to develop the service.

Feedback was requested from people, relatives and health care professionals.

Safe recruitment practices were followed. Staff knew and understood people well. The provider and staff worked hard to develop strong leadership. The management structure had been changed following the last inspection and staff spoke about the positive impact this had had.

Quality monitoring systems were being developed and embedded. Morale within the staff team was good and staff felt valued.