Breagha House

People were protected from the risk of abuse. People's needs were assessed, and any risks associated with their health conditions documented. Relatives felt their family members received safe care and support generally. People received their prescribed medicines safely. Risks associated with the service environment were now assessed and mitigated. The service was clean, and risks to people associated with acquired infections were minimised. Accidents and incidents were monitored to identify trends and prevent the risk of them happening again.

People's needs and choices were assessed in line with current legislation and guidance in a way that helped to prevent discrimination. The provider and manager had worked with the staff team to ensure they were up to date with the training and skills needed to support people. 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 were supported and encouraged to have a varied diet that gave them enough to eat and drink. People were supported by staff to access healthcare services when required. The provider ensured the environment was suitable for people's needs.

The leadership of the service had improved since our last inspection. Relatives felt confident in the manager's skills and ability to create a safe environment with good quality care for people. Staff we spoke with clearly understood their roles and responsibilities and felt able to make suggestions to improve people's daily lives.

The provider and manager had implemented systems that helped them to analyse the causes of incidents or poor care and identify risks to people. This information was then used to improve the quality of care. The provider was working with the local authority and CQC in an open and transparent way to ensure the quality of the service steadily improved. Local authority staff involved in safeguarding processes for people felt the service was much improved since our last inspection.

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.

Based on our review of Safe, Effective and Well-led the service was able to demonstrate how they were meeting the underpinning principles of Right support, right care, right culture.

People were able to have choice and control in their day to day decisions. Staff were supported to demonstrate the values the provider felt essential to delivering good quality care that was person-centred. The provider and manager were dedicated to ensuring staff demonstrated values in line with Right support, right care and right culture. The provider was looking at ways to develop staff knowledge and skills which meant people were being supported in the best way possible. This was through reviewing peoples' care, enhancing staff knowledge and training and listening to people and their relatives.