HF Trust Chestnuts

We expect health and social care providers to guarantee people with a learning disability and autistic people respect, equality, dignity, choices and independence and good access to local communities that most people take for granted. 'Right support, right care, right culture' is the guidance CQC follows to make assessments and judgements about services supporting people with a learning disability and autistic people and providers must have regard to it.

The home used an active support approach aimed at increasing people's participation in daily life, increasing people's skills and being a valued member of their household. People were generally supported to have 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.

Staff supported people with their medicines in a way that promoted their independence and achieved the best possible health outcomes. Staff supported people to play an active role in maintaining their own health and wellbeing.

Right Care: We observed kind and compassionate care being delivered by both permanent staff and agency staff. People told us they liked the staff. One person said, "Staff are alright, I am just getting to know the new ones, we have had a lot of agency in the past." Care was mostly person-centred and staff spoke of people with friendliness and respect.

Right Culture: There were inadequate processes in place for assessing and monitoring the quality of the service. Systems had failed to identify shortfalls in staff training, meaning staff were not suitably skilled in

positive behaviour support. The leadership team had not effectively analysed incidents in order to learn lessons that could have reduced harm to people.

Where issues had been identified by the providers audit system, actions were not always followed up in a timely way.

People and relatives told us they could talk to managers and staff freely. One person said, "I like all the staff."

Staff told us they felt supported by managers and the provider. New staff were inducted into the values of right support, right care, right culture. One staff told us "I feel very supported to ask questions of the registered manager."