Precious Homes Bedfordshire

Treow House comprises of 22 one-bedroom flats, with a shared communal living room and garden. Staff also support individuals in their own homes through an 'outreach support in the community' service.

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. At the time of this inspection the service was supporting 21 people. Of these, 9 people were receiving personal care.

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: Daily records demonstrated improvements in the way some staff recorded the care and support provided. However, there were still entries that lacked personalised information and read as a list of tasks carried out by staff. Senior staff were checking these regularly to address this. Staff enabled people to access routine and specialist health and social care support in the community. However, more work was needed to ensure people received good oral healthcare. People's care and support plans reflected their range of needs, and this promoted their wellbeing. 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. Improvements had been made to learn lessons from incidents; to see how they might be avoided or reduced in future. Staff helped people to live in a clean and well-maintained environment that met their sensory needs. Staff supported people to make decisions following best practice in decision-making. Senior staff carried out regular spot checks and audits to support with making sure people received their medicines in a safe way and as prescribed.

Right care: Further work was needed to ensure all staff had the skills to communicate with and understand people who had individual ways of communicating such as using body language, sounds, Makaton (a form of sign language), pictures and symbols. People did not consistently receive care which focused on their aspirations, quality of life, and followed best practice. Some people did not yet routinely take part in activities. New activity planners had been introduced to support people to try new activities which enhanced and enriched their lives. Staff had identified potential goals for people, however, there was little evidence of people's involvement, progress, or measurable steps to achieve their goals. More work was needed to ensure people were supported to increase their independent living skills too. People received kind and compassionate care. Staff protected and respected people's privacy and dignity. Staff understood and responded to people's individual needs. Staff understood how to protect people from poor care and abuse. The service worked with other agencies to do so. Staff had training on how to recognise and report abuse, and they knew how to apply it. There were enough staff to meet people's needs, and to keep them safe.

Right culture: Work was in progress to ensure people were consistently 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. The service was not always proactive in enabling people and those important to them to provide feedback and develop the service. Throughout the inspection the registered manager and senior team spoke openly and honestly about what had been achieved since the last inspection and what still needed to be done. They were open to feedback and acted on this in a timely way. An improved recruitment process had been introduced to ensure staff were suitable to work with people. The provider had recently introduced a new auditing system to check the quality of the service provided to people. The new system included all the areas CQC assess when inspecting services.