The inspection was carried out on 17 August 2017 and was announced.

Moordean is a care service providing personal care and accommodation for six adults with complex learning disabilities, mental illness and behaviours that may cause harm to themselves or others. People were at risk of being socially excluded due to their behaviours. This service is one of a group of seven care services owned by Insight Specialist Behavioural Service Ltd. The person centred positive social support people received prevented them from becoming isolated and enabled people to fully participate at service and within their local community.

People had transferred to Moordean within the last year from another service also run by Insight Specialist Behavioural Service Ltd. The move to Moordean had resulted in people living in a more homely setting designed to reduce people stress and anxiety levels. Moordean had been adapted to suit the individual complex needs of the six people who lived there. The building was spacious and airy and has been designed with input from people themselves and the specialised behaviour support team to ensure it met people’s specialist and individual needs. Everyone had access to an on-suite shower room and some people had their own kitchenette facilities. The service also had a communal kitchen, bathroom with a bath, dining/lounge room, and secure garden. One person was learning to be more independent and lived in their own self-contained annex on site.

The providers had fully embraced the principals of Positive Behavioural Support (PBS). PBS is recognised in the UK as the best way of supporting people who display, or are at risk of displaying, behaviour which challenges care services. The providers had resourced and modelled people’s care in accordance with current PBS best practice principles.

Staff clearly understood their roles in minimising risk. Risk assessments were reviewed regularly to ensure that the level of risk to people was still appropriate for them. One member of staff said, “The behavioural management training we get shows us how to minimise risk for each person to keep them safe.”

The appropriate positive responses were delivered through individualised behavioural strategies which consistently reduced the instances, severity and intensity of harm or potential harm to people, staff and others. This created an improving picture of life experiences and choice for people, whom, in the past, may have been excluded, marginalised and isolated from wider society.

Person centred care and people’s safety was at the heart of the care people experienced. The provider’s shared their vision and values with staff and others so that they were understood and acted on. Staff told us that the positive culture and providers values were embedded from the first day of their induction training. Staff saw themselves as enablers, promoting people’s rights and participation.

Positive Behaviour approaches supported social inclusion and was used in maintaining contacts with family members. The providers maintained their own professional knowledge and understanding of best practice in learning disability services.

People were protected from institutionalisation. People’s lives were based on person centred circles of support. (A circle of support is a group of key people that can help someone with a learning disability, mental illness to make decisions about their life.) The providers and staff worked with families to overcome some of the challenges they faced in maintaining contact with their loved ones who may not always respond to them positively. Key family members were involved in planning positive behavioural therapies.

To promote exceptional outcomes for people who may otherwise be excluded the providers led by example and visited the service every week, chairing clinical meetings and overseeing the detailed planning and daily operations of the service.

A health and social care professional commented about the qu