Caerus Care Limited

Right support Some risk assessments were not recorded and care plans lacked detail how staff should manage risk. Medicines administration records did not always reflect safe medicines administration. People were supported to have maximum choice and control of their lives and staff supported them with decisions that were in people's best interest. However, a lack of recorded best interest decisions, meant there was a risk that the restrictions in place might not be the least restrictive.

Some audits were not as effective as they could have been, such as for the detail in care plans and risk assessments, medicines administration, mental capacity assessments and best interest decisions.

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.

We have made a recommendation in the well-led section of this report for the provider to seek support and ensure that audits and records are accurate and up to date and reflect care in people's best interests.

Staff supported people to be cared for as safely as practical. 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 and how happy and settled they now were.

Staff supported people to achieve their goals and go on to further achievements. A staff member said, "Seeing [person] now safely at home with the right equipment means they are making good progress in their own time but with some support, regaining their independence."

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 physical 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 said, "My life has been changed so much. I can travel independently." Staff's perseverance in listening to what the person wanted. One relative told us how much more their family member could now do and how well staff understood their communications in ensuring the person was given equal opportunities.

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 a few words and visual prompts.

People received care that supported their needs and aspirations, was focused on their quality of life, and followed best practice. One relative told us the service always went the extra mile and said, "They go above and beyond. Staff have transformed my [family member's] life. They used to be calling me on the phone all the time, but now they are settled and so happy there. If there were any concerns they would ring me but they have told me they love it."

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. One relative told us the service had made a huge difference to their family member saying, "I am not generous in giving accolades but I can only speak good of them. They go over and beyond. I can't praise them enough." 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