Redbourne

The service was exceptionally well led and organised. Staff were extremely well motivated and positive about the service. Staff told us "We are a really good team" and "We are open and honest with each other and the atmosphere is good." The registered manager was without exception caring and open about the service and his relationship with staff was built on trust and mutual respect. Positive working relationships had been formed with external professionals.

People told us they were tremendously happy at Redbourne and comments from professionals and relatives were very positive. Innovative steps have been taken by the service to support and promote people's communication skills. Relationships between people and their relatives have been extremely well supported.

Feedback about the registered manager was extremely positive and staff felt very well supported. People, relatives, staff and professionals told us, "[Registered Manager]is brilliant and so supportive", "he responds well to anything we tell him", [name] is the boss, he is nice we like him" and "I have been nothing but impressed with the responsiveness of the manager."

The registered manager had excellent systems and processes within the service to improve patient care, these involved people and staff at all levels to achieve extremely high standards of care.

Staff were amazingly kind and caring and respected and valued the people they cared for. One staff member told us "We just want to do our best for the people that live here and make sure they enjoy life." Advocates were exceptionally visible within the service and people knew them very well and had a very good understanding of their role.

People received exceptionally personalised care and support specific to their needs and preferences. This had been particularly effective in supporting people to achieve their goals and aspirations, this supported people to become more confident in developing skills that would enrich their lives.

Medicines were managed safely, and people were protected from avoidable harm by staff that knew them remarkably well. There was enough staff to meet people's needs and provide one to one support when necessary. Staff were recruited in a safe way.

Staff received training, supervision and appraisals to support them in providing personalised care and were encouraged and supported to learn and develop within their role. Staff champions were identified to promote health, wellbeing and safety within the service. Accidents and incidents were reviewed by the registered manager and lessons were learnt when things went wrong.

Other professionals were involved in planning care and staff were extremely supportive in ensuring people's healthcare needs were met. Capacity assessments were embedded with individual care plans and staff had a very good understanding of the mental capacity act 2005 (MCA). Managers and staff always acted in people's best interests.

People were very well 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 the underpinning principles of Right support, right care, right culture. The service maximised people's choice and promoted their independence through the model of care they promoted. The care was extremely person centred and promoted people's dignity, privacy and human rights. The leadership of the service had achieved a service that was outstandingly effective and responsive. The service was dedicated to ensuring continuous quality improvement to make a real difference to people's lives. People's life's were empowered and they were supported to achieve their aspirations which led to extremely positive outcomes.