Lombard House

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.

The service was able to show how they fully met the principles of right support, right care, right culture.

The service supported people to have the maximum possible choice, control, and independence, be independent and they had control over their own lives. Staff supported all the people to take part in activities and pursue their interests in their local area and to interact online with people who had shared interests. Staff supported all people to make decisions following best practice in decision-making. Staff communicated with people in ways that met their needs. People received kind and compassionate care. Staff protected and respected people’s privacy and dignity. They understood and responded to their individual needs. People could communicate with staff and understand information given to them because staff supported them consistently and understood their individual communication needs. People could take part in activities and pursue interests that were tailored to them. The service gave people opportunities to try new activities that enhanced and enriched their lives. People led inclusive and empowered lives because of the ethos, values, attitudes and behaviours of the management and staff. People received good quality care, support and treatment because trained staff and specialists could meet their needs and wishes. People were 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. This meant people received compassionate and empowering care that was tailored to their needs. The leaders and staff shared a passion for supporting people which shaped the culture across the service.

This was a comprehensive inspection where we looked at all the key questions in full. We looked at safe, effective, caring, responsive and well led. As a result of this inspection, the overall rating of this location stayed the same. We rated it as good because:

• Feedback from the people who used the service were unanimously positive, the people were extremely happy living in the hospital and spoke very highly of all the staff and managers, describing them as kind, respectful and the hospital as home.
• People’s care and support was provided in a safe, clean, well equipped, well-furnished, and well-maintained environment which met people's sensory and physical needs. People were protected from abuse and poor care and the service had sufficient, appropriately skilled staff to meet people’s needs and keep them safe.
• People’s risks were assessed regularly and managed safely and involved in managing their own risks whenever possible. If restrictive practices were used, which was rare, there was a reporting system in place and there were comprehensive reviews to try and reduce the use of these practices.

• People’s care, treatment and support plans, reflected their sensory, cognitive and functioning needs. The service provided a range of treatments suitable to the needs of the people cared for in a rehabilitation setting and in line with national guidance about best practice. Managers ensured staff had relevant training, regular supervision and appraisal. People received care, support and treatment from trained staff and met their needs and aspirations. Care focused on people’s quality of life and followed best practice and staff used clinical and quality audits to evaluate the quality of care.
• People and those important to them, including advocates, were actively involved in planning their care. The multidisciplinary team worked well together. Staff and managers understood their roles and responsibilities, had excellent relationships and spoke freely of each other’s roles and responsibilities in a positive and supportive way.
• People’s emotional and social needs were highly valued by staff and all the people spoke of how staff listened to them and supported them to achieve their goals. Relationships between people were strong, caring, and supportive, these relationships were highly valued by staff and managers. People received kind and compassionate care from highly motivated staff, who protected and respected their privacy and dignity and understood each person’s individual needs. People had their communication needs met and information was shared in a way which could be understood.
• All people were supported and empowered to be independent and spoke of being in control of their care and support. The staff were exceptional in enabling people to remain independent and uphold their human rights. People made choices and took part in activities which were part of their planned care and support. Staff supported people to achieve their goals and the service worked to a recognised model of mental health rehabilitation.
• People were in hospital to receive active, goal-oriented treatment and people had clear plans in place to support them to return home or move to a community setting. Staff worked well with external services which provide aftercare to ensure people received the right care and support when they went home. Staff supported people through recognised models of care and treatment for people with a learning disability or autistic people.
• The leadership, governance and culture drove and improved the delivery of high-quality, person-centred care. All staff were very proud to work at the hospital and spoke in an extremely and complimentary way about colleagues and how dedicated they were to support the people to succeed. There was a fully embedded and systematic approach to improvement and a strong record of sharing work locally, nationally, and internationally. Leaders continuously thrived to improve, by undertaking external accreditations, benchmarking their services and including people from their service with as many opportunities as possible to be involved.
• There was a strong collaboration and support across the staff teams to continuously improve the quality of care and people experience. There was a positive culture at the hospital and a shared drive and determination to deliver excellent standards of care and support. Staff we spoke to were highly motivated and inspired to offer care which was kind and promoted people’s dignity. There was a very strong visible culture of person-centred care and all staff went the extra mile to support all the people. The leadership processes ensured the service kept people safe, protected their human rights and provided good care, support and treatment.