Bigwig House

The service has been developed and designed in line with the principles and values that underpin Registering the Right Support and other best practice guidance. This ensures that people who use the service can live as full a life as possible and achieve the best possible outcomes. The principles reflect the need for people with learning disabilities and/or autism to live meaningful lives that include control, choice, and independence. People using the service receive planned and co-ordinated person-centred support that is appropriate and inclusive for them.

Staff enabled people to live as fulfilling live as possible and achieve the best possible outcomes. Staff knew people exceedingly well and worked together as a team. They set high standards for people to achieve and strived to support people to reach their full potential. The care and support people received was exceptionally compassionate and kind.

People were supported to try new experiences while any related risks were identified and action taken to help reduce the risks. Staff were exceptionally skilled at understanding and managing people's complex needs and behaviour. This knowledge, and the strategies put in place, had enabled people to exceed expectations in the skills they had learnt and how their independence and well-being had been enhanced.

People received care and support that was individual to their needs and wishes. Care plans were regularly reviewed and updated and were an accurate reflection of people's needs. Staff actively supported people to maintain links with the local community, their friends and family.

People were supported to pursue their interests, hobbies and gain new skills. Staff were flexible and responded to people's needs and wishes, adjusting activities accordingly, as well as exploring and trying new ideas with people.

People were supported to access healthcare services, staff recognised changes in people's health, and

sought professional advice appropriately. Staff helped people to plan meals and shop as well as preparing and cooking meals. Staff encouraged people to eat a well-balanced diet and make healthy eating choices.

Staff were recruited safely and there were sufficient numbers to ensure people's care and social needs were met. Staff received induction, training and supervision to assist them to carry out their work.

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/ did not support this practice. Any restrictive practices were regularly reviewed to ensure they remained the least restrictive option and were proportionate and necessary.

There was a clearly defined management structure and regular oversight and input from senior management. Staff were positive about the management of the service and told us the registered manager was supportive and approachable.

The Secretary of State has asked the Care Quality Commission (CQC) to conduct a thematic review and to make recommendations about the use of restrictive interventions in settings that provide care for people with or who might have mental health problems, learning disabilities and/or autism. Thematic reviews look in-depth at specific issues concerning quality of care across the health and social care sectors. They expand our understanding of both good and poor practice and of the potential drivers of improvement.

As part of thematic review, we considered whether the service used any restrictive intervention practices (restraint, seclusion and segregation) when supporting people. The service used positive behaviour support principles to support people in the least restrictive way. The service used some restrictive intervention practices as a last resort, in a person-centred way, in line with positive behaviour support principles.