This inspection was completed on 23 and 24 April 2018 and was unannounced.

Elizabeth House is a part of the National Star Foundation Charity and is registered to provide accommodation for up to 25 men and women with a physical disability and/ or learning disability or autistic spectrum disorder. Although a part of the National Star Foundation, Elizabeth is a residential home based at a separate site to the main National Star College Campus. The young people living at Elizabeth House attended the main National Star College campus for their education.

Elizabeth House is a ‘care home’. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection. At the time of our inspection there were 25 people living at the service.

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.

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 of the Health and Social Care Act 2008 and associated Regulations about how the service is run.

The previous comprehensive inspection was completed in May 2015 and the service was rated ‘Good’ overall. At this inspection, the service was rated ‘Outstanding’.

Elizabeth House is an outstanding service. It is focussed on the individual needs of the young people. The service ensured that everyone received high quality care regardless of diagnosis, age, ethnic background, sexual orientation, gender identity, disability or social circumstances.

The vision of Elizabeth House and the National Star Foundation was to promote “A world in which people with disabilities are able to realise their potential as equal and active citizens in control of their lives”. All staff and senior management demonstrated this clear vision and a highly positive person centred culture was evident. Staff involved in Elizabeth House had set high standards for themselves and this promoted an exceptionally positive culture for those living there. The provider played a lead role nationally in challenging perceptions of disability which further supported this work. This had improved the confidence of people and the opportunities available to them .

People were supported to focus on making a positive contribution to the service, the college and the wider community in order to achieve their full potential. Young people had been supported to actively campaign to improve rights and entitlements for people with disabilities. We found young people and staff were motivated and passionate about equality and empowering people to live the lives they wanted.

People and relatives we spoke with told us staff were outstandingly caring. They used words such as “Compassionate”, “Caring” and “Excellent” to describe the staff. People and their families spoke of a service that was tailor-made for them and their families said staff went ‘over and above’ what was expected of them. Care staff spoke highly about the service provided. One said, “I’ve been here for 10 years. I love working here”. Another person said, “I really enjoy working here. These people are like family to me”. People told us they would recommend the service to others. There was a genuine sense of fondness and respect between the staff and young people.

People, their families and carers spoke overwhelmingly of the positive support, guidance and healthcare interventions given to them. People were 'very happy' with the service

This inspection took place on 5, 6 and 7 May 2015 and was unannounced. Elizabeth House provides accommodation for up to 24 men and women with a physical disability and/or learning disability or autism who attend the National Star College. The home also offers respite care during the holidays to students from the National Star College as well as other people wishing to have a short break during college holidays. At the time of our inspection there were 22 people living at the home. Accommodation was accessible to people who use wheelchairs. Two rooms provided shared accommodation. Two independent living flats were also available for use.

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 and associated Regulations about how the service is run. The registered manager was registered to oversee four locations owned and managed by the National Star Foundation. A manager supported her at Elizabeth House on a day to day basis. Staff felt supported by management who they said were “positive role models”.

From the moment people were considering moving into Elizabeth House until the time they left their individual needs were paramount in shaping the service they were to receive. People were involved in the planning and delivery of their care. If they needed additional equipment or adaptations to the environment to help them be as independent as possible this was provided. People’s rights to equality, respect and privacy were promoted. They were nurtured to grow from adolescents into confident young adults with aspirations for their future. Outstanding support systems were in place to help people deal with discrimination and to stay safe at home and in their local community.

People were supported by dedicated staff who were invested in by the National Star Foundation to develop in their roles. Through a comprehensive training and support programme staff were encouraged to develop their expertise and knowledge. They delivered person centred care, empowered people and enabled people to live their lives the way they wished, as safely as possible. People had positive relationships with staff. At times they laughed, smiled and talked amiably together. Staff were caring and offered reassurance when needed.

In order to help people achieve their potential, staff guided them through choices and decisions. They recognised where there were risks and talked with people about ways they could stay as safe as possible. When there were accidents or incidents lessons were learnt and action was taken to prevent them happening again. People were supported to stay healthy and well, managing their own medicines if they wished and having access to a range of health care professionals. Menus were chosen by people living in the home. If people needed help or support to eat or drink this was provided sensitively and in a relaxed manner.

People enjoyed a range of social activities as well as learning a range of life skills. They had chosen learning pathways at college and were able to continue with these goals at home. People’s diversity was recognised and celebrated. Some people attended religious services, other people had food prepared to reflect their cultural beliefs and all were encouraged to access local community facilities.

People’s feedback and views influenced the way the service developed and improved. They were involved in committees at home shaping the delivery of activities, meals and planning changes to the garden. By attending the college parliament they could influence the use of resources and the experience of people living at Elizabeth House. The National Star Foundation’s vision to “have a world where people with disabilities are able to realise their potential as equal and active citizens in control of their lives” was embedded in the way in which Elizabeth House was run.