Hollyhurst

Based on our review of key questions of safe, responsive and well led, the service was not able to demonstrate how they were meeting some of the underpinning principles of Right support, right care, right culture. The environment of a large (more than 6 people) living in one communal home does not meet the principles of Right support, right care, right culture. Despite the large environment consideration had been given to the principles and meeting these, as follows:

Right Support: People lived safely and free from unwarranted restrictions because the service assessed, monitored and managed safety well. This had improved since the last inspection. Where restrictions were imposed these were robustly reviewed, by the staff who knew people best and relevant professionals, to see if these were appropriate or could be reduced. Infection control measures were in place, people were supported by staff to keep their home safe and clean. Staff supported people with their medicines in a way that promoted their independence and achieved the best possible health outcome. There were effective staff recruitment and selection processes in place. There were enough skilled and experienced staff who knew people well to safely meet people's needs, for example their communication needs. Staff recruitment and retention was a priority in the service, as there were vacant posts. Management had developed induction processes to help them find and keep staff that were right for the needs of the service.

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.

Right Care: People received care that supported their needs and aspirations, was focused on their quality of life, and followed best practice. Despite the large environment, people did not have their support dictated by the routines of the service. Staff and people cooperated to assess risks people might face. Where appropriate,

staff encouraged and enabled people to take positive risks. People were kept safe from avoidable harm because staff knew them well and understood how to protect them from abuse. The service worked well with other agencies to do so.

Right Culture: Since the last inspection there was a new registered manager. They and staff were working to a development plan with a strong focus on improving the culture and positive outcomes for people. Many of the people and staff we spoke with told us they saw an improvement in the service and the culture. People commented on the positive atmosphere and caring attitudes of staff. People led inclusive and empowered lives because of the ethos, values, attitudes and behaviours of the management and staff.

The service enabled people and those important to them to work with staff to develop the service. Staff valued and acted upon people's views. The registered manager recognised the importance of sharing information in an accessible way so people understood it and could respond. Staff had worked closely with the professionals in the service to develop meaningful engagement and increase opportunities for people to have their say.

People were supported by staff who understood best practice in relation to the wide range of strengths, impairments or sensitivities people with a learning disability and/or autistic people may have. This meant people received compassionate and empowering care that was tailored to their needs. The service had strong links with other organisations, and the wider community, for the benefit of people who used the service. This included sharing best practice and organising events to increase the wider communities understanding about learning disabilities and autism.