Grenville House

We found the service was not always operating in accordance with the regulations and best practice guidance.

People were not always supported to have maximum choice and control of their lives and staff were not supporting people in the least restrictive way possible and in their best interests.

Some systems and processes to monitor the service were not undertaken robustly. This meant they were not always effective and did not identify the issues we found at this inspection.

People were protected from the risk of abuse because staff had been trained on how to recognise and report abuse and they knew how to apply it.

People were supported by staff who had been recruited safely and there were enough staff to make sure people had the care and support they needed.

There was a clear management structure and staff felt supported and listened to.

We expect health and social care providers to guarantee autistic people and people with a learning disability the choices, dignity, independence and good access to local communities that most people take for granted. Right support, right care, right culture is the statutory guidance which supports CQC to make assessments and judgements about services providing support to people with a learning disability and/or autistic people.

The service was mostly able to demonstrate how they were meeting the underpinning principles of Right support, right care, right culture.

Right support: Model of care and setting maximises people's choice, control and Independence. People were able to choose how they spent their time and were supported by staff to take part in activities and pursue their interests in their local area/community. People were supported and encouraged to be independent and staff had a good awareness of people's needs and preferences. However, we found more work was needed to embed the principles of the Mental Capacity Act 2005 (MCA).

Right care: Care is person-centred and promotes people's dignity, privacy and human rights. Staff knew people well and understood how to communicate effectively with people. Staff spoke to people in a dignified and respectful way and it was clear from our observations that people and staff had developed good relationships.

Right culture: The ethos, values and attitudes of managers and staff helped to ensure people using services were enabled to lead confident, inclusive and empowered lives. Staff understood their role in making sure that people were always put first, and their care and support was tailored to their individual needs and preferences.