Homewood

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.

Right Support Each person had their own room, which were personalised to meet their needs and preferences. People were being supported to be actively involved in their day to day lives, cooking and doing their own household tasks with staff support. People valued these opportunities and they helped to maximise people's independence.

The service had worked hard since the last inspection, with people, to plan for when they experienced periods of distress so their freedoms were restricted only if there was no alternative. Staff successfully did everything they could to avoid the use of restraint. The past year had seen no recorded incidents where people had needed emergency medication to help them when distressed. Improved staff knowledge and effective strategies had supported this positive improvement. Staff learned from those incidents and how they might be avoided or reduced.

Staff supported people to make decisions following best practice in decision-making.

Right care People experienced an improved quality of care. People and their families told us staff were kind and supportive. We observed staff respecting people's dignity and ensured people had the right to have their say on their care and support. Staff understood how to protect people from poor care and abuse. The service worked with other agencies to do so. People's care, treatment and support plans mostly reflected their range of needs and this promoted their wellbeing. Staff and people worked together to assess risks people might face and were continuing to develop this area to encourage more positive risk taking.

Right culture The formal governance system had been running for a year at the time of this inspection and was delivering assurances. There were areas which were identified at inspection the system had not picked up. Mainly some cleaning and maintenance shortfalls but the registered manager acted promptly to improve the areas the system looks at to avoid future issues. People's opportunity to lead inclusive and empowered lives had improved since the last inspection. This is because staff knowledge and understanding had improved due to the investment in training and the development of a coaching and reflective culture. Managers understood that further work was needed to support more people to develop skills and have the opportunity to all voice their aspirations and plan towards meeting them. Managers and staff clearly tried to deliver person centred support, people and their families were listened too and consideration of their views were reflected in the service delivery. People received good quality health care, support and treatment because trained staff and specialists could meet their needs. Staff knew people well and the staff team was consistent in both numbers of staff and staff approach.