Start Service - Broxtowe, Gedling and Rushcliffe Locality

People were protected from harm, neglect and avoidable harm. Risks to people's safety were discussed with them and acted on by staff. There were sufficient numbers of qualified and experienced staff to support people. Where people needed support with their medicines, staff did so safely. Staff understood how to reduce the risk of the spread of infection. The provider ensured processes were in place to act on and learn from any accidents or incidents.

People were supported in accordance with current best practice guidelines and legislation. Staff were well trained and had the skills needed to support people. Where people needed support with their meals, staff did so effectively to help maintain or improve people's nutritional health. The service worked in partnership with other health professionals to ensure people received the support they needed. 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 support this practice.

People found the staff to be kind, caring and they were treated with dignity and respect. People were involved with decisions about their support needs. Staff spoke respectfully about the people they supported and helped to maintain people's privacy. People had access to advocates if they needed them.

People were provided with support in accordance with their personal preferences. Staff took swift action to ensure people's changing needs could be met. No formal complaints had been received since our last inspection, but processes were in place that enabled these to be responded to appropriately. End of life care was not provided.

The service was managed well by the registered manager with support from provider. There was a clear focus on continued improvement and development and people and staff were involved with this process. Staff felt valued and enjoyed their role. Robust quality assurance processes were in place to help identify good practice and areas for improvement.