AM-R-AZ LLP

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.

People's communication needs were not always fully recorded to ensure new staff would understand and know their individual communication needs.

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 did not always support this practice.

People were supported by staff who understood and were trained in recognising the signs of abuse. The provider had a policy and procedure in place should any concerns be raised.

Right Care: Medicine records were not always kept up to date and staff did not always have the required information to ensure medicines were given as prescribed. Staff had not always recorded the reasons for giving 'as required' medicines.

Risks to people were not always recorded. Care plans and risk assessments were not always in place and kept up to date to ensure staff had the information required to support people safely. Staff did not always have the training, skills or knowledge to meet people's specific needs.

People were supported to maintain a healthy diet and adequate fluid intake. When required, staff supported people to eat and drink safely.

Right Culture: Systems and processes were not always effective in ensuring the provider had oversight of the service and that all records were kept up to date and factual.

People, relatives and staff told us the provider had not asked them to feedback on the service. There were no formal systems in place to capture people's feedback to learn from and improve care.

Staff told us they did not have any 1:1 time to discuss concerns or issues. The provider completed spot checks on staff to check person centred care was delivered. However, this meant that senior staff observed people having personal care completed.