Millbrook House

The service is an adapted manor house. There is one main communal lounge. Every bedroom is en-suite and some people had their own lounges and kitchens. The building sits in the same grounds as a children's service. Some people transition from the children's to the young adults service.

The service had not been designed in line with the principles and values that underpin Registering the Right Support and other best practice guidance. This ensures that people who use the service can live as full a life as possible and achieve the best possible outcomes. The principles reflect the need for people with learning disabilities and/ or autism to live meaningful lives that include control, choice, and independence.

The service was within a campus style setting and was linked to a children's service in the same grounds. However, the size of the service having a negative impact on people was mitigated by the building design fitting into the residential area and the other large domestic homes of a similar size. There were deliberately no identifying signs, intercom, cameras, industrial bins or anything else outside to indicate it was a care home. Staff were also discouraged from wearing anything that suggested they were care staff when coming and going with people.

Some staff did not understand the safeguarding procedure and told us they would fear recriminations if they raised concerns. Since the manager was appointed four months before the inspection, they had implemented a proactive approach to risk assessment. This included encouraging people to take positive risks to develop their independence.

Care planning was focused on a person's whole life, including their goals, skills and abilities. Before the manager took their role there was a reliance on restrictive practice which the manager had identified as requiring immediate improvement. The manager has since implemented positive behaviour support with the assistance of appropriate healthcare professionals.

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.

The service applied the principles and values of Registering the Right Support and other best practice guidance. These ensure that people who use the service can live as full a life as possible and achieve the best possible outcomes that include control, choice and independence.

We saw people were treated with dignity and respect in all their interactions with staff. Staff knew people well and knew how to communicate in a way that people understood. Staff demonstrated an understanding of the importance of people's relatives or advocates being actively involved in their lives.