Options Watermill Lodge

The care service has been developed and designed in line with the values that underpin the Registering the Right Support and other best practice guidance. These values include choice, promotion of independence and inclusion. People with a learning disability and/or autism using the service can live as ordinary life as any other citizen.

At the last inspection, the service was rated Outstanding. At this inspection, we found the service remained Outstanding.

The service has built on their previous success and sustained the outstanding model of care and was committed to personalising the services they provided and to following the recommendations outlined in 'Putting People First'. (A shared vision in transforming adult social care to put people first through a radical reform of public services, enabling people to live their own lives as they wish, confident that services are of a high quality, are safe and promote their own individual needs for independence, well-being and dignity) and the Autism Act (2009)). The service was accredited with the National Autistic Society (NAS), which drove best practice to deliver outstanding care to people who used the service.

The strong person-centred culture apparent at our previous inspection continued to be a driving force in delivering a consistent approach to support and enabled people to try new things and to make positive changes in their lives. The provider, the registered manager and staff team all had an excellent understanding of positive risk taking and positive behaviour support strategies (PBS) were in place to support people that have previously challenged services, to reach their full potential. Personalised programmes and flexible staffing arrangements continued to enable people to live meaningful and fulfilled lives. Positive risk taking was driven throughout the organisation, balancing the potential benefits and risks

of choosing particular actions over others, in order to support people to lead as ordinary a way of life as possible.

Staff had a clear understanding of systems in place to manage medicines, safeguarding matters and behaviours that are challenging to others. People's medicines were managed so that they received them safely. A robust recruitment and selection process was in place which ensured prospective new staff had the right skills and are suitable to work with people using the service.

Staff were compassionate, kind and caring and had developed good relationships with people using the service. People were seen to be comfortable in the presence of staff and relatives and professionals confirmed staff looked after people very well. People benefited from staff having exceptional skills around understanding each person's needs and aspirations. This included an excellent understanding of sensory impairment and how to support people to be as independent as possible in all areas of their life, through positive communication. Information was available in each person's preferred format including policies and procedures such as activity programmes and complaints.

People continued to be supported to access health care professionals when required and supported to have maximum control over their lives and staff supported them in the least restrictive way possible; policies and procedures supported this practice. Menus were planned with input from people, based on their personal preferences and choice.

Staff told us they enjoyed working at the service and felt supported by the registered manager. Quality assurance systems were in place and regularly carried out by both the provider and registered manager. Feedback was sought from people who used the service, staff and relatives, this information was analysed, and action plans produced when needed. The provider continues to work in partnership with other organisations and has taken part in good practice initiatives, designed to further develop the service and support other providers to develop their services.

Further information is in the detailed findings below

The five questions we ask about services and what we found