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The residential care home provides the regulated activity of personal care and accommodation for up to five adults with a learning disability. At the time of the inspection there were five people using the service. People had complex care needs, including learning disabilities, autism and physical health needs. Most people had limited verbal communication so were unable to provide feedback by speaking to us directly.

The community based domiciliary care agency delivered personal care to 82 people in their own homes. This included older people, people with dementia, physical disabilities and learning disabilities. Not everyone who used the service received personal care. CQC only inspects where people receive personal care. This is help with tasks related to personal hygiene and eating. Where they do we also consider any wider social care provided.

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.

Right Support: Staff were working towards consistency in supporting people to make decisions following best practice in decision-making. Staff worked with people to plan for when they experienced periods of distress so that their freedoms were restricted only if there was no alternative.

People were supported by a regular team of staff who knew them well, which promoted continuity of care. People were involved in personalising their rooms so these were decorated to their taste and contained things that were important to them. Staff enabled people to access specialist health and social care support in the community. Staff supported people with their medicines in a way that achieved the best possible health outcome.

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's needs and preferences had been assessed prior to receiving a service. People received kind and compassionate care from staff who understood and responded to people's individual needs. People who had individual ways of communicating, using body language and sounds, could interact comfortably with staff and others involved in their care and support because staff had the necessary skills to understand them.

There were enough appropriately skilled staff to meet people's needs and keep them safe. Environmental risk assessments identified and reduced any risks to people and staff. Where appropriate, staff encouraged and enabled people to take positive risks. Staff understood how to protect people from poor care and abuse.

Right Culture: People benefitted from the open and positive culture of the service where the management team was approachable and listened and responded to people's views. Quality assurance and monitoring systems were used to identify shortfalls and improve the service for the people who used it.

People received good quality care, support and treatment because trained staff and specialists could meet their needs and wishes. People were supported to maintain good health, were supported with their medicines and had accessed healthcare services when needed. Staff prepared food and drink to meet people's dietary needs and requirements.

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. People received consistent care from staff who knew them well. People and those important to them were involved in planning their care.