The Knowls

The service was a large home, bigger than most domestic style properties. It was registered for the support of up to 13 people. 13 people were using the service. This is larger than current best practice guidance. However, the size of the service having a negative impact on people was mitigated by the building design fitting into the residential area and the other large domestic homes of a similar size. There were no identifying signs outside to indicate it was a care home. Staff were also discouraged from wearing anything that suggested they were care staff when coming and going with people.

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 to gain new skills and become more independent.

People lived in a home where there were adequate numbers of staff to meet their needs and to assist them with activities and accessing the community. Risk assessments were carried out to make sure people received their care safely and had opportunities to take part in activities which interested them and promoted their independence.

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. People were treated as individuals and were able to make choices about their day to day lives.

People were able to follow their own routines according to their preferences and abilities. Staff respected people's routines and choices.

People were cared for by staff who were kind and caring. People looked very comfortable with the staff who supported them. When people became anxious or distressed staff remained calm and professional. Staff used verbal reassurance to help people to relax and told us physical restraint was not used at the home.

People had access to a range of professionals to meet their physical and emotional health needs. The staff

had good relationships with other professionals which enabled them to seek advice and support for people.

People had support plans which gave staff clear information about how people wanted to be cared for. Staff knew people well and understood people's different communication. This helped to make sure people received care and support in accordance with their wishes and preferences.

People lived in a home which was well led. The provider and registered manager monitored standards and were committed to making on-going improvements to people's support and quality of life.