Destiny Intergrated Care Cambridge Branch

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.

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.

Right support Medicines administration records did not always reflect safe medicines administration. Some risk assessment and care plans lacked detail how staff should manage risk. No person had been harmed but this put people at risk of harm. The nominated individual who was also the registered manager addressed these matters promptly, but until we highlighted these, actions had not been taken. Staff however were clear on exactly how to administer these medicines in a specific way and supported people with their medicines in a way that respected their independence.

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.

Staff supported people to be cared for as safely as practical and risks to people were being managed. Staff complied with measures designed to reduce the risk of infections spreading.

Staff focused on people's strengths and promoted what they could do, enabling the opportunity for people

to lead fulfilling and meaningful lives. One relative told us how proud they were at what their family member had achieved.

Staff supported people to achieve their goals and go on to further achievements. A staff member said, "Seeing [person] making good progress at their own pace, growing in skills and independence, is so rewarding for them and me too."

Staff received effective training in the use of restraint and were confident in their ability to deploy this training should it ever be needed. At the time of our inspection no person required restraint. Any restraint would be in an emergency situation as a last resort and for the shortest time possible. Staff supported people to make decisions following best practice in decision-making.

Right Care Staff focused on and promoted people's equality and diversity, supporting, and responding well to their individual needs. This changed people's lives for the better. One person told us how well staff had adapted their care to ensure they were treated equally well.

People or their legal representative helped create and review their care plans when they chose to, and as such were a reflection of the support they needed and what people could do independently. Staff had training on how to recognise and report abuse, and had the skills to help protect people from poor care and abuse, or the risk of this happening. The service worked with other agencies to do so.

The service had enough appropriately skilled staff to meet people's needs and keep them safe. All those we spoke with felt people were safe and had enough support to do this.

Staff's diligence and persistence enabled people to achieve their aspirations. People lived a meaningful life and staff supported people to gain independent skills. People were supported to communicate in their preferred way including the use of computer tablets and visual prompts. People received care that supported their needs and aspirations, was focused on their quality of life, and followed best practice.

Right Culture People were supported by staff who understood best practice in relation to people's strengths, impairments, or sensitivities for people with a learning disability and/or autistic people may have. Staff knew people well and responded to their needs and wishes.

Staff put people's wishes, needs and rights at the heart of everything they did. Staff ensured risks of a closed culture were minimised so that people received support based on transparency, respect and inclusivity. People, relatives, staff and health professionals had a say in how the service was run.

The ethos, values, attitudes and behaviours of leaders and care staff ensured people using the service led confident, inclusive and empowered lives.

For more information, please read the detailed findings section of this report. If you are reading this as a separate summary, the full report can be found on the Care Quality Commission (CQC) website at www.cqc.org.uk