This inspection took place on 30 December 2016 and 6 January 2017.

Melvyn and Jan John provide care and accommodation for people who have Autism and learning disabilities. The home is set in a rural area.

The service had a registered manager. 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.

The culture of the home was totally person centred and people were supported to have the lifestyle they chose. The registered manager and staff found out how people wanted to be supported and how they wanted to spend their time. Meetings were held regularly with people and their circle of support, to plan and discuss their goals and aspiriations, so that the service was run in the way people wanted.

The home was run as part of a family. It was warm, friendly and people’s individuality was respected and nurtured. The registered manager and staff were skilled and competent to support people in their care. A person’s friend commented, “The life offered to [person] is one of culture, travel, nature, art, music, food and meaningful relationships with people.”

The providers were qualified nurses for people with learning disabilities and had the right skills and competencies to give people outstanding care. They had extensive knowledge and experience in supporting people with Autism and learning disabilities and made sure they kept up to date with current good practice and knowledge based on research in the areas that related to the people in their care.

People were cared for and supported to develop their independence and confidence. People chose what they wanted to do each day. There was a mixture of a familiar routine and different activities offered so that people’s daily life was secure and varied. The providers were committed and worked hard to provide a service that increased people’s quality of lifestyle.

All eventualities were taken into consideration rationally and systematically, and responded to in a way that if the experience was going to enhance a person’s life then it was worth trying.

By learning what was important to people to help them feel secure and finding out innovative ways to assist with this, the registered manager and staff had helped people develop their self confidence. The result of this was that they had overcome situations that had previously limited their experience. There was a familiar routine full of techniques and predictable activities that helped people know where they were in time and place and gave them the self confidence to be able to try new experiences.

As a result people’s world had opened up and they had countless new experiences and opportunities to visit places and engage in activities that they had previously not had the opportunity nor confidence to try. For example when one person first moved to the service they had no idea how to walk in the countryside, negotiate stiles and rough ground, run, eat in a socially acceptable manner at home or in a restaurant, ride a horse, bounce on a trampoline, go on an aeroplane or ferry, go upstairs, grate cheese, stir gravy, indicate agreement, attract someone’s attention, request something and look at anything more than about 15 feet away. Now the person had flown on holiday three times to the Canary Islands, had been to music concerts and ballets, had climbed to the top of Ben Nevis, had eaten in countless restaurants and been camping, boating and even went canoeing. These were amazing achievements where the person had needed to overcome fears from past experiences, sensory confusion and communication difficulties.

The providers supported people effectively to help them overcome any barriers to relationships with other people and to enrich their lives by develop

This service is provided to one person who lives as part of the family. The person using the service was not able to talk to us directly about their lifestyle and experience but they participated in the inspection and we observed their interactions and behaviour during our discussions with the providers.

The person was assisted to express their views and make day to day decisions because the providers helped them with their communication and spent time with them. When the person needed to make important decisions they also had the support of an independent advocate.

The person received support to maintain a healthy, active lifestyle. They were able to pursue a variety of hobbies and interests at home and out in the community. The person was assisted to manage health conditions and was given the support they needed with their physical and mental health.

The home was well maintained and checks were in place to make sure it provided a safe environment for the people who lived there.

This service is provided to one person who lives as part of the family. The person using the service was not able to talk to us directly about their lifestyle and experience but they participated in the inspection and we observed their interactions and behaviour during our discussions with the providers.

The person was assisted to express their views and make important decisions because the providers helped them with their communication and spent time with them.

The person received support to maintain a healthy, active lifestyle. They were able to pursue a variety of hobbies and interests at home and out in the community. The person was assisted to attend health care checks and was given the support they needed with their physical and mental health. A healthy balanced diet was offered and the person was supported to develop their independence skills, including making snacks and drinks.

The owners are the only staff and keep themselves up to date with current good practice through training courses and journals. The service was reviewed by the funding authority and there was a good relationship with neighbours and people in the local community.