This was our first comprehensive inspection of the service and it took place on 19 June 2018 and was unannounced.

Hillcrest House is a 'care home' for up to five people with autism and mental health needs. At the time of inspection, four people were living at the service. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection. Hillcrest House accommodates people in one adapted residential house that is located on a residential street. The care service has been developed and designed in line with the values that underpin the Registering the Right Support and other best practice guidance. These values include choice, promotion of independence and inclusion. People with learning disabilities and autism using the service can live as ordinary a life as any citizen.

People were supported to work towards and complete major achievements in their lives. The service had strong and positive links with local leisure facilities, charities, health and wellbeing providers, and the community. The service was flexible and adapted to people's changing needs and desires, enabling positive outcomes for all concerned. People felt a part of their community, and were able to take pride in their achievements.

Professionals involved in people's care confirmed that the service was focused on individuals needs and the service had been able to meet people's high level of needs where previously this had not been achieved. Staff had gone the extra mile to ensure that people received the medical treatment that they needed and they had taken innovative steps in complying with the accessible information standard.

The provider was involved with the development of a national initiative to try and prevent the over

medication of people with learning disabilities, autism or both and this ethos was firmly embedded within the service. The provider was awarded by external bodies for educating the wider community about positive approaches to autism, and for the on-going investment into the strong development within their staff team.

The service had a consistently high level of engagement with relatives of people that used the service. Feedback from relatives was extremely positive who had commented on the unique nature of the service, and how their own lives had been improved as well as their relative using the service.

Staff were well supported by the registered manager and senior management team. The registered manager had a clear vision for the service and its development. Staff were passionate and dedicated to their roles and had belief in the ethos of the support they received, and that of the provider in general. Staff at all levels had a strong belief that they were providing the best possible care for people, and were confident and empowered in their roles because of the strong leadership and management across the company. Staff were innovative in their approach to support, and were enthusiastic about supporting people to overcome life's hurdles.

There was a registered manager in post. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

Staff had an understanding of abuse and the safeguarding procedures that should be followed to report abuse. Safeguarding procedures were followed accurately and alerts made when required.

Detailed risk assessments and behaviour management plans were in place to manage all risks within a person's life. Staff were all confident in supporting people with complex needs and behaviours which may challenge the service.

The staff recruitment procedures ensured that appropriate p