Cotswold Lodge

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.

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 carried out a survey with the registered manager at this inspection. This 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. No restrictive intervention practices were used.

Staff received appropriate induction and training to give them the right skills to fulfil their role and support people safely. Staff received training to raise their awareness and understanding of safeguarding issues and protecting people from abuse, they were proactive in challenging discrimination and raising alerts to the safeguarding team. Risks were appropriately assessed.

There were enough staff to provide people with good levels of care and support. People were protected because there was a safe system of recruitment in place. Medicines were stored and managed safely. The registered manager and provider analysed accidents and incidents for trends and patterns and

implemented measures to mitigate further risks. People lived in a clean well-maintained environment.

Systems were in place to ensure people referred to the service had their needs assessed prior to admission to ensure these could be met. Staff monitored people's health and wellbeing and supported them to access routine and specialist healthcare. Staff understood people's food likes and dislikes and consulted with them to provide a varied menu.

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. Staff understood How the Mental Capacity Act 2005 (MCA) impacted on their support of people and how people could be helped to make decisions.

People had detailed plans of care and support that guided staff in how people preferred their support to be delivered. Peoples concerns were listened to and acted upon. Relatives said they felt able to express any concerns they might have to staff and were confident these would be addressed.

A quality assurance system provided the registered manager and the registered provider with a detailed overview of service quality and where improvements needed to be made. Feedback from people, relatives, and professionals helped inform this.

The service applied the principles and values of Registering the Right Support and other best practice guidance. These ensure that people who use the service can live as full a life as possible and achieve the best possible outcomes that include control, choice and independence.

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 for them to gain new skills and become more independent.