Larkfield

The care service has been developed and designed in line with the values that underpin the Registering the Right Support and other best practice guidance. These values include choice, promotion of independence and inclusion. People with learning disabilities and autism using the service can live as ordinary a life as any citizen.

The service had a registered manager in post. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are 'registered persons'. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

At our last inspection of this service in January 2016 the service was rated Good. At this inspection we found the service remained Good overall, although improvement was required to ensure records relating to the administration of people's medicines was accurately recorded, and that people consistently received their medicines as prescribed.

Risks to people had been assessed and staff were aware of the action to take to manage identified risks safely. There were sufficient staff deployed at the service to safely meet people's needs. The provider followed safe recruitment practices when employing new staff. Staff were aware of the need to report any accidents and incidents which occurred, and the registered manager reviewed accident and incident records to identify any trends and reduce the likelihood of recurrence.

People were protected from the risk of abuse because staff were aware of the different types of abuse and the action to take if they suspected abuse had occurred. Staff worked in ways which reduced the risk of the spread of infection. People's needs were assessed, and their care and support was planned in line with nationally recognised guidance. Staff received an induction when they started work for the provider, and received support in their roles through regular training, supervision and an annual appraisal of their performance.

Staff were aware to seek people's consent when offering them support. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice. Staff supported people to maintain a balanced diet, and to access a range of healthcare services when required to ensure they maintained good health. The provider sought to ensure that people received effective joined up care when moving between different

services.

Staff treated people with care and consideration. They involved people in decisions about their day to day care and treatment. People were treated with dignity and staff respected their privacy. People received care and support which reflected their individual needs and preferences. They were able to take part in a range of meaningful activities which met their need for social stimulation, and staff supported them to maintain the relationships that were important to them. The registered manager told us the service was committed to ensuring people received good quality care at the end of their lives and people had end-of-life care plans in place which had been developed in their best interests where appropriate.

The provider had a complaints policy and procedure in place which was available in formats appropriate for people's needs. Relatives confirmed they knew how to complain but told us they had not needed to do so. The provider had systems in place for monitoring the quality and safety of the service, and staff acted to address any issues identified during monitoring.

The views of people, relatives and other stakeholders were sought through meetings and surveys, and the outcome of the most recent survey was positive, indicating a high level of satisfaction with the service provision. Relatives and staff spoke positively about the management of the service and the registered manager. The provider ensured the rating of the service was displayed and the registered manager ensured the notifications regarding important events had been submitted to CQC where required. Staff told us they worked well as a team. The registered manager shared information about the running of the service with staff through regular staff meetings. The provider worked openly with other agencies, including local authorities and the local clinical commissioning group, to ensure people received good quality care and support.

The five questions we ask about services and what we found