Sandford Road

People who had behaviours that could challenge themselves or others had proactive plans in place to reduce the need for restrictive practices. Systems were in place to report and learn from any incidents where restrictive practices were used. Further improvements were needed around looking at trends of incidents across the service.

Governance systems did not always ensure people were kept safe and received a high quality of care and support in line with their personal needs. People and those important to them, worked with leaders to develop and improve the service.

The service could show how they met the principles of Right support, right care, right culture. People were empowered to have choice in all aspects of their care and were supported to focus on areas of importance to them. People were supported in the way they preferred which was supported by the ethos, values and behaviour of the management and staff team.

The needs and quality of life of people formed the basis of the culture at the home. Staff undertook their role in making sure that people were always put first. They provided care that was person-centred and directed by the person.

The leadership of the service had worked to ensure everyone was included. Staff felt valued and empowered through inclusion in the development of peoples care and to suggest improvements that would benefit the people living at the home. There was a transparent, open and honest culture between people, those important to them, staff and leaders. They all felt confident to raise concerns and were confident these would be responded to appropriately.

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's care and support was provided in a safe, clean, well equipped, well-furnished and well- maintained environment which met people's sensory and physical needs. ● People were protected from abuse and poor care. The service had enough appropriately skilled staff to meet people's needs and keep them safe. ● People were supported to be independent and had control over their own lives. Their human rights were upheld. ● People received kind and compassionate care from staff who protected and respected their privacy and dignity and understood each person's individual needs. People had their communication needs met and information was shared in a way that could be understood. ● People's risks were assessed regularly in a person-centred way, people had opportunities for positive risk taking. People were involved in managing their own risks whenever possible. ● People made choices and took part in meaningful activities which were part of their planned care and support. Staff supported them to achieve their short- term aspirations and goals. Further work was needed to think about longer term aspirations for people. ● People's care, treatment and support plans, reflected their sensory, cognitive and functioning needs. We found that some care plans had not consistently been kept up to date. ● People received support that met their needs and aspirations. Support focused on people's quality of life and followed best practice. Staff regularly evaluated the quality of support given, involving the person, their families and other professionals as appropriate. ● People received care, support and treatment from trained staff and specialists able to meet their needs and wishes. Managers ensured that staff had relevant training, regular supervision and appraisal. ● People and those important to them were actively involved in planning their care. Where needed a multidisciplinary team worked well together to provide the planned care. ● Staff understood their roles and responsibilities under the Human Rights Act 1998, Equality Act 2010, Mental Health Act 1983 and the Mental Capacity Act 2005. ● People were supported by staff who understood best practice in relation to learning disability and/or autism.

At our last inspection the provider had failed to ensure recording and monitoring of the use of restraint had been carried out. This was a breach of regulation 13 (Safeguarding service users from abuse and improper treatment) of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. This inspection found new systems had been put in place to monitor the use of restraint.

At our last inspection the provider had failed to ensure safe recruitment practices had been carried out. This was a breach of Regulation 19 (Fit and Proper persons employed) of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. This inspection found staff were safely recruited and a new system had been put in place to ensure this was carried out consistently.

At our last inspection the provider had failed to ensure people's support plans reflected their needs or had consideration of the impact COVID-19 restrictions had had on peoples' access to activities they enjoyed. This was a breach of Regulation 9 (Person-centred care) of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. This inspection found that new care plans had been developed which focussed on the persons needs and wishes.

At our last inspection the provider had failed to implement robust governance systems or maintain oversight of the service. This was a breach of Regulation 17 (Good Governance) of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. This inspection identified many improvements had been made in the governance systems. However further work was needed to refine these and the provider was

still in breach of Regulation 17

This service has been in Special Measures since 17 September 2020. During this inspection the provider demonstrated that improvements have been made. The service is no longer rated as inadequate overall or in any of the key questions. Therefore, this service is no longer in Special Measures.