At the time of the inspection, six people were living at the home. All of them had complex needs and sometimes demonstrated behaviour which may challenge others. The home is in a

residential area and has been converted from two semi-detached houses which have been knocked through. The home also has a garden for use by the residents.

At our last inspection we rated the service outstanding. The service had been found to be outstanding in two domains, Responsive and Well-led. All other domains had been rated as Good.

At this inspection we found the evidence continued to support the rating of outstanding in the Responsive domain. The Safe, Caring, Responsive and Well-led domains were all found to be Good.

The home provided accommodation and care to four men and two women, all of whom were living with a learning disability and/or autism. Some people in the home also had a physical disability, although everyone could walk a short distance. People living the home had some challenges around communicating verbally. Staff were knowledgeable about each person’s preferred communication methods and could understand and be understood by them.

The provider had considered how to ensure that people at Ling Crescent were provided care in line with the recommendations made in Registering the Right Support and other best practice guidance. The home was in a residential area of a small town and provided easy access to shops and other commercial premises such as banks. Public transport routes were accessible on foot for people. People were supported to use local facilities and to feel part of the local community. For example, one person visited local shops and the bank on the first day of inspection. People were also encouraged to do activities that supported them to live fulfilled and active lives.

People were supported to have a healthy diet, eating food they enjoyed. However, records for a person who was underweight did not describe accurately what the person’s healthy or average weight was, or what staff should do if the person lost weight. We have made a recommendation about current guidance on Learning Disability and weight management.

Staff had been trained to administer medicines safely. The registered manager and staff had worked with health professionals to review people’s medicines and ensure they were not being over-medicated. They had done this by working with the professionals to find alternative strategies to support people when they displayed behaviours that could challenge others.

People were supported to have maximum choice and control of their lives and staff support them in the least restrictive way possible; the policies and systems in the service support this practice. The registered manager and staff understood and followed the requirements of the Mental Capacity Act 2005. They were committed to supporting people to achieve as much independence as possible, while ensuring each person was safe.

The registered manager and staff were committed to providing care which supported people to live as independently as possible. People were encouraged to do activities they enjoyed both inside and outside the home. Some of the activities supported people to have an active lifestyle which included wall climbing, archery, boating, zip wires and bowling. People were also supported to go on holiday both in the UK and abroad. Staff understood how playing music and attending concerts was important to one person, while other people enjoyed going to the theatre. People were supported to use information technology to help them with aspects of their life, including communicating with families.

Feedback from families was very positive and included comments such as “He’s happy, we are very happy… staff very good” and “I find the home good, very good staff…It’s his home, staff are more like family.”

The home was in a quiet residential area where people could access public transport which helped t

This inspection was carried out over two days on 7 and 12 November 2014 and was unannounced.

Ling Crescent provides accommodation and personal care for up to six people who have learning disabilities. The people living in the home had complex needs and sometimes demonstrated behaviour which may challenge others. At the time of our inspection there were five people using the service. The home is located in a residential area in Headley Down, approximately four miles from the centre of Liphook. Two semi-detached houses have been knocked through to create the accommodation which also has a garden.

Ling Crescent has 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 received safeguarding training. They understood how to recognise the signs of abuse and knew how to report their concerns if they had any. There was a safeguarding policy in place and relevant telephone numbers were available. People behaved in a way which indicated they felt safe.

Risks had been appropriately identified and robustly addressed both in relation to people’s specific needs and in relation to the service as a whole. Staff were keenly aware of people’s individual risk assessments and knew how to mitigate the risks. There was constant monitoring and reassessment of risks which ensured that staff took actions to protect people. People lived in an environment where they were safe and were therefore able to develop their skills and felt comfortable accepting new opportunities.

There were enough staff on duty at all times to meet people’s needs and the registered manager matched staff to people’s preferences, skills and experiences.

Medicines was administered safely by staff who had been trained and were competent to do so. There were procedures in place to ensure the safe handling and administration of medication. Staff knew how to administer emergency medicines for people.

People were asked for their consent before care or support was provided and where people did not have the capacity to consent, the provider acted in accordance with the Mental Capacity Act 2005. People’s mental capacity was assessed and decisions were made in their best interest involving the relevant people.

The service worked well with health professionals to ensure the best and most effective care was provided for people. A nutritionist, speech and language therapists, psychiatrists and psychologists had worked with the service developing specific care for people which had been effective.

Relatives were very happy with the care. There was calm caring environment within the home. Staff knew how to meet people’s needs and this showed through their caring actions and their interaction with people using the service. People behaved in a way which showed they felt comfortable with staff. Independence was encouraged whenever possible and people responded positively to this.

Support plans were reviewed on a monthly basis and people were involved in these reviews through keyworker meetings and through staff observation of their behaviour when carrying out activities. Relatives and professionals were involved in regular reviews. Support plans were regularly updated with key information about people’s support and their individual preferences.

People were encouraged to take positive risks and live their lives to the fullest. They were able to overcome challenges and benefit from new and exciting opportunities. Everyone had benefitted from new and exciting trips and the registered manager and staff were constantly looking into new ideas and opportunities for people.

Support plans showed that the staff had responded to behavioural and health needs and that innovative ideas had used to manage behavioural issues. This had led to positive outcomes for people.

Management of the home was outstanding. There was exceptional morale amongst staff who worked as a team, in an open and transparent culture, for the benefit of people. Regular staff meetings and team building exercises meant that staff were involved in the development of future plans and contributed to the values and vision for the home. Staff were empowered to develop their own ideas. These led to a positive and caring atmosphere in the home and effective and responsive planning and delivery of care and support.