Esmer House

There was a genuinely open culture in which all safety concerns raised are highly valued as integral to learning and improvement.

Staff training was developed and delivered around individual needs. This promoted and achieved positive outcomes for people and allowed them to gain more independence, they were motivated and supported to live full lives. Creative ways of balancing nutritional need against the characteristics of Prader-Willi syndrome had seen a reduction in weight for all people living in the home. This led to increased mobility and reduction in prescribed medicines and had improved people's quality of life.

The provider focus' on building and maintaining open and honest relationships with people and their families and friends. People were consistently treated as individuals and changing needs were responded to quickly. People were fully involved in creating and reviewing their care plan. Privacy, dignity and respect were at the heart of the provider's values and culture. People's equality, diversity and human rights were exceptionally well supported and promoted, which resulted in positive outcomes for people and their relatives.

People told us that staff had outstanding skills and had an excellent understanding of people's needs including care, social and cultural needs. The open culture promoted a 'nothing is off limits' ethos, and this covered conversations and activities people wanted to have or do. Positive risk-taking supported by robust risk assessments meant people were living active lives and fulfilling wishes and ambitions.

People, relatives and staff told us this service was distinctive, challenged and supported people to be the best version of themselves. They described an exceptional leadership team with a 'can do attitude' that put people first. There was exceptional organisational commitment ensuring there was equality and inclusion across the workforce, which was demonstrated through staff retention and internal progression. Performance management processes were effective, reviewed regularly, and reflected best practice. The dedication from people and staff meant this home was at the heart of the local community and lives were

enriched by this connection.

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.

We expect health and social care providers to guarantee autistic people and people with a learning disability the choices, dignity, independence and good access to local communities that most people take for granted. Right Support, right care, right culture is the statutory guidance which supports CQC to make assessments and judgements about services providing support to people with a learning disability and/or autistic people.

The service was able to demonstrate how they were meeting how they were meeting the underpinning principles of Right support, right care, right culture. The size, setting and design of service exceeded people's expectations and aligned with current best practice. A comprehensive holistic approach was taken to admittance to the service and people were offered choice about where and who they lived with. People were given choice and control in a supported way. For example, people had a keyworker and information was provided in a person-centred accessible format. People were fully supported and motivated to be active members within the community which reduced social isolation and promoted development of social skills.