Preston

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 service was a medium sized house with small areas of communal space. The registered manager told us they would assess people before admission to ensure the environment would be suitable for them in relation to space, stimulation and independence. There were deliberately no identifying signs, intercom, cameras, industrial bins or anything else 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.

Staff were suitably trained and supported. The registered manager listened to staff's opinions and invested in their professional development. Staff morale had significantly improved.

Staff supported people to access a wide range of health and social care professionals. Staff acted when people's physical or mental health declined and supported them to follow guidance and advice from professionals.

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.

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.

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.

Since the last inspection the registered manager had developed staff knowledge of supporting people in a person-centred way and had worked closely with them to improve the way staff engaged with people. The organisation deployed a specialist trainer who worked with staff to develop positive intervention strategies, to help de-escalate and reassure people with distressed behaviours. We found examples of how this had created positive outcomes for people.

People told us staff were kind and respectful. The culture within the service was positive and inclusive. Staff supported people to live meaningful lives.

The registered manager demonstrated commitment to providing good care and had made significant improvements since the last inspection. Governance systems were in place and used to highlight and action areas for continued development.