Baytree House

Right Care We observed people receiving kind and compassionate care. A relative said, "I have no worries (name of loved one) is the happiest I have seen them in years, a lot calmer now, all smiles." Staff protected and respected people's privacy and dignity. Staff had been recently received training which provided them with guidance about how to support people with learning disabilities and autism and knew they knew people well. The home manager told us that they had moved away from a model of support where staff did most things for people, to one where people were actively involved in their lives. They said, "This has had the greatest positive impact for people." People who had individual ways of communicating, using body

language, sounds, Makaton (a form of sign language), pictures and symbols we observed to be responding positively to staff's improved understanding and practice in their use. Managers confirmed although there were improvements with staff communication there were further areas where they needed to improve. For example, staff required more learning about communication and the approaches and tools to use with autistic people in order to create and implement effective communication plans. There were now more visual supports for people to help them find things like what's for dinner and which staff are working today, this had reduced people's reliance on staff for information and improved independence. Staff understood how to protect people from poor care and abuse and the service worked well with other agencies to do so. Staff had training on how to recognise and report abuse and they knew how to apply it. People and relatives told us they felt safe. Training had supported staff to understand what people needed when they became distressed, one staff said, "I understand that transitions from one activity to another can be hard for some people, so I make sure I prepare them."

Right culture The new emphasis on improving people's quality of life experiences had begun to make a positive impact for people. We observed people were talking with staff on a more equal footing and were gaining in confidence to make choices, do things for themselves but ask for help when they needed too, which we saw staff respecting. For example, one person called to a staff member by name and asked for help cutting their pie, the staff member helped quietly and only did what the person needed, asking them if they would like them to cut anything else, the person said, "no I am alright now." The provider had invested in training and development for managers and staff, such as positive behavioural support (PBS) which had helped managers and staff understand the reasons people might behave in a certain way when distressed. Managers now understood how to analyse incidents and share the learning from them to reduce situations which cause people distress. People who had sensory perception and processing needs had been referred to health professionals for assessment. Staff had begun to recognise some sensory needs, for example a person who has difficulty with noise was being supported to avoid prolonged situations they found difficult so they could control their surroundings by taking action themselves. Investment in learning for managers and staff was reflected in staff practice. People and relatives told us they could talk to managers and staff freely. One person said, "I like all the staff."

Staff told us they felt supported by managers and the provider. New staff were inducted into the values of right support, right care, right culture. One staff told us "it's their (the people who live at Baytree house) home, we are there to support people to live their own lives."